Friday is world organ donation day. Sylvia Thompson reports on transplants in Ireland
You are three times more likely to need organ transplantation than to be a donor. This stark statistic is one of the slogans of the Irish Donor Network whose underlying aim is to encourage more people to carry donor cards. "We are not asking you to commit your body to science or research, purely transplantation after your death," it continues.
On Friday, healthcare professionals and members of donor networks from around the world will meet at a conference in Geneva, Switzerland to mark the First World Day for Organ Donation and Transplantation.
October 14th is also designated the seventh European Day for organ donation and transplantation, which is an awareness day across Europe to highlight the importance of organ donation for transplantation.
Ireland has quite a high level of organ donation compared with its nearest neighbour, Britain, with approximately 22 donations per million of population here compared with 13 donations per million in Britain.
"We believe about 25 per cent of the population carry organ donor cards - compared with 15-18 per cent in the UK," says Mark Murphy, chairman of the Irish Donor Network and chief executive of the Irish Kidney Association.
However, the Irish Donor Network believes there is no room for complacency as more people need transplants and patients are dying while waiting for compatible organs. "Donor levels are similar to previous years but we know that there have been missed opportunities," says Murphy.
More than 500 people are awaiting life-saving transplant organs in Ireland.
"What we want is for people to think about donating their organs - to sit down and talk to their families about it," Murphy says.
"So many people have never been in hospital. They have never felt threatened by their bodies and these are ideal candidates for donating organs - when it comes to hearts and lungs for transplantation, young is beautiful," he adds.
Murphy believes that apart from an unwillingness to deal with life after death among those under 40, there are misconceptions around the situations in which organs are donated with many believing that most organ donations result from traffic accidents.
"Organ donations come from people who have had brain tumours, brain haemorrhages and accidents. Only about one-sixth of donated organs come from traffic accidents," he says.
The kidney is the most common organ transplant performed worldwide. In Ireland, patients with renal failure are first put on kidney dialysis before a kidney transplant is considered.
Kidneys are then transplanted from donors whose bodies are artificially kept alive once "brain stem" death has been confirmed.
In some countries, kidneys are more routinely transplanted from living donors.
"Ireland is one of the few European countries which relies on 'cadaver' donations. Most European countries have living kidney transplant programmes and we are hopeful such a programme can be started here soon as there is no way cadaver donations will be sufficient for the number of kidneys we will need in the future," says Murphy.
Heart, lung, liver, pancreas and small bowel (small intestine) are the other organs transplanted. "We currently export hearts for transplantation. We also send livers and lungs abroad - the latter will probably change now with the lung transplantation unit operating in the Mater Hospital," Murphy says.
Tissues, including the corneas of the eye, bone and tendons and heart valves are also transplantable.
Carrying a signed donor card signals the willingness of the card owner to allow their organs and tissues to be transplanted. However, the next-of-kin has the final decision once the patient has been confirmed dead.
"Some countries have a system of presumed consent by law but what happens in practice is that doctors still ask the next-of-kin for consent and that person can still refuse.
"In Ireland, we have better organ donation levels than countries that have presumed consent. The key issue is to discuss your wishes to donate your organs with family members," says Murphy.
Due to the short timeframe (10-48 hours, depending on the organ) in which organs remain viable for transplantation, no organ is removed unless a specific recipient is identified and ready. Each recipient is chosen by computer matching of the patients waiting on the various transplant lists.
At the conference in Geneva on Friday, an international organ donor card will be launched.
"I regard all donor cards as being international anyway," says Murphy.
"We have had successful donations from tourists in this country and Irish people who have donated organs abroad.
"With the huge numbers of Irish people travelling nowadays, the international card will encourage the mindset of donating organs no matter where you are," he adds.