Elaine Loughlin: People dying on transplant waiting lists need a new organ donation law
Today, 600 people have their lives on hold as they wait for that one call.
For this group and their families, social distancing, mask wearing, and handwashing was all part of the routine long before Covid was ever mentioned.Â
Some of this group really only get a four-day week as three days are set aside for long car journeys and dialysis. Add medication, check-ups, oxygen and hospital stays, constant clinic appointments, blood tests, and ever-present worry to the mix, and you get a fair idea of the limits put on their existence.
When you are on the organ transplant list, that call becomes your life.
This column could have been copied and pasted from last year, because as we approach Organ Donation Awareness Week, yet another year has gone by with no action taken on a bill that would introduce a soft opt-out system of organ donation in this country.
Ireland was to the fore when it first committed to soft opt-out, an approach that automatically assumes a person is in favour of donating their organs unless they state otherwise, but which also gives families the right to have the final say in the matter.
It's a system that would make another difficult decision easier for families at a time of extreme pain, but as other countries have shown, it would also increase the number of people who receive lifesaving heart, lung, liver, kidney, and pancreas transplants each year.
Back in May 2019, when then Heath Minister Simon Harris published general scheme of a Human Tissue (Transplantation, Post-Mortem, Anatomical Examination, and Public Display) Bill, he referenced the late senator Fergal Quinn who had introduced a similar Private Members Bill more than a decade before.
"Senator Quinn was a committed advocate for organ donation. While it has taken some time, I think that the publication of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination, and Public Display) Bill and the commencement of drafting work, is a fitting tribute to him at this time," Mr Harris noted in citing the 2008 bill.
This time last year, this column highlighted the estimated 240 people, or an average of 30 each year, who have died waiting for an organ transplant since the then government launched a consultation process with the view to introducing soft opt-out organ donation.
Taking averages, that figure now stands at 270 people — mothers, fathers, sons, daughters, aunties, uncles, friends, and colleagues — who never made it to the top of the list.
Like other areas, Covid has had a severe impact on the number of transplants carried out. There were 63 deceased donors in 2020 and 64 in 2021, this was down from a yearly average of 85 in the five years up to 2019.
There were also 35 living donors, down from a pre-pandemic five-year average of 43. These generous donations translated into 203 transplants last year, but again this is a reduction from the five-year average of 284 between 2015 and 2019.
The pandemic has simply exposed the vulnerability of the national organ donation and transplant programmes, according to the Irish Kidney Association.
The fragility of the transplant service hit home in November of last year when a patient was called for a transplant, but this operation did not proceed at the Mater Hospital, due to the unavailability of an intensive care unit (ICU) bed.
The pressure on ICU capacity has been described as "substantial" by Professor Jim Egan, director of Organ Donation Transplant Ireland (ODTI), who wrote in his 2020 annual report that "the demands around organ donation underscored the ICU bed capacity infrastructure deficit".
"Furthermore, the provision of specialised transplant surgical services was under threat from unscheduled acute care in the three major acute hospitals providing transplant services," he stated.Â
Campaigners, including Irish Donor Network chairperson and Cystic Fibrosis Ireland CEO Philip Watt have also been calling for ringfenced ICU beds and a dedicated theatre for lung and heart transplants, which, unlike the passing of legislation, could be rolled out relatively quickly with the proper resources and staffing.
"When an organ becomes available, they can call seven or eight people for the one organ to see who the best match is, people can often be called several times," said Mr Watt.Â
"There is no doubt that there are people now dying on the waiting list waiting for an organ transplant. I think one of things that certainly could help with that is a dedicated operating theatre in the Mater, for example, for heart and lung transplants."
Of course, it's difficult to improve any service when you don't know where your starting point is.
The introduction of an annual audit that would provide detailed data and analysis of donations across individual hospitals nationwide would provide invaluable information on where improvements could be made.
“We need more clarity about the reasons why more transplant operations are not taking place in Ireland," said Irish Kidney Association Carol Moore.Â
It can be tough conversation to have, but the reality is you are three times more likely to need a transplant than to be an organ donor.
In the absence of legislation for a soft opt-out system, campaigners will yet again be encouraging the public to have 'the chat' with their families as national organ donation week kicks off on April 23.
Someday the long-awaited Human Tissue Bill will hopefully be signed into law. Until then, the 600 people on the list are reliant on #ShareYourWishes hashtags and the generosity of grieving families.
April 14: The Belfast-built Titanic sank. As word of the disaster began to reach land, the Cork Examiner reported that "news received shortly before going to press makes it only too probable that one of the most appalling disasters in the history of the sea has to be recorded". The article detailed conflicting reports that the ship had sank and other indications that her watertight compartments held so well that she was able to make for Halifax, accompanied by several liners.
The country ground to a halt on the first day of an ESB strike. In Leinster House, politicians were forced to work by candlelight. "Some people, [not me] of course, subscribe to the popular belief that Dáil deputies are mostly 'in the dark' anyway," wrote Anthony Ring in the as he reported on how candles were drafted in to Leinster House.
April 17: In a short single-column piece on the front page, it was reported that Ireland's search for alternative energy was taking a "significant step forward" with "the simple planting of a tress at Bord na Mona's Clonsast peat works". "It will mark the beginning of a major Irish-EEC experiment in producing electricity from biomass," it stated. The report also plugged a four-part Cork Examiner series that aimed to examine "how Ireland plans to generate energy from nature's alternative power supplies — the wind, waves, the sun, and plants".
April 17: The author of the Hanly Report on reform of the health system said "all sorts of politics" were being played ahead of the local elections. David Hanly had recommended that emergency department and acute services at both Ennis and Nenagh hospitals should be transferred to Limerick Regional Hospital. However, with Fianna Fáil under pressure ahead of local and EU elections, it was announced that eight doctors would be appointed to the emergency departments in both hospitals.
The Dáil and Seanad are on Easter recess this week and next, with TDs resuming business on April 26. However, there will still be some business happening in Leinster House this week as a number of committees are scheduled to meet.
After attending a meeting of EU foreign ministers where sanctions were discussed yesterday on Monday, Minister Simon Coveney will be at Foreign Affairs and Defence Committee to discuss the Defence Forces (Evidence) Bill 2019 which is at committee stage.
With the Dáil on recess, the weekly Cabinet meeting has been pushed out by a day. It is expected that ministers will sign off on a cost-of-living package brought by Green Party leader Eamon Ryan, which will include the scrapping of the current PSO levy on energy bills.
The agriculture committee has a full day scheduled where members will discuss afforestation and the forestry sector with minister of State Pippa Hackett and a number of interested groups in the morning. After lunch, the committee will turn its attention to the challenges facing the pig industry before members discuss fixed-price milk contracts with representatives from the Irish Co-operative Organisation Society (ICOS) in the evening.
Comhchoiste na Gaeilge will also meet on Wednesday to explore how to further promote publishing and reading in the Irish language.
The three Government leaders and Foreign Affairs Minister Simon Coveney will be in Dublin Castle for the 2022 Global Ireland Summit.
Back in Leinster House, the Joint Committee on International Surrogacy will hear from Dr Andrea Mulligan, assistant professor of Law at Trinity College Dublin, and Professor Mary Wingfield, clinical director at the Merrion Fertility Clinic.
On The Plinth' appears each week in Tuesday's (in print and online). Make sure you are up to speed on the major political stories by signing up for the On The Plinth politics newsletter HERE.
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