As the number of transplants falls for the first time in 11 years, do we need an opt-out policy to increase organ donor numbers?
Donated organs, tissue, blood and stem cells have saved or transformed millions of lives since the first-ever kidney transplant in 1950.
Demand is increasing, thanks to medical advances and population changes, and around 7,000 people are on the UK transplant waiting list. Yet fewer than 60% of us have signed up to be an organ donor, while 96% of us rely on the other 4% to donate blood.
The health authority NHS Blood and Transplant has just launched the new easier-to-use NHS Organ Donor Register across the UK, which is voluntary. But from 1 December, everyone in Wales will be automatically registered unless they opt out.
What can I donate?
Currently you can choose to donate your kidneys, heart, liver, lungs, pancreas and/or small bowel after death, giving one or more people the chance of a longer, healthier life.
You can also donate tissues, including corneas to restore sight; bone and tendons for grafts; heart valves (congenital heart disease) and/or skin (for severe burns).
You may not be accepted if, for example, you have widespread cancer, but you can still donate tissue for research, such as your brain (through Parkinson’s UK and the Alzheimer’s Society).
Living donation of organs is carefully regulated and increasing. Around half of donated kidneys now come from living donors (with slightly better results) but liver/other donations are still uncommon.
Donors are often relatives, but may be unconnected to the recipient in altruistic (charitable) donation and paired/sequential donation (unrelated people donate to each other’s relatives). Donors are carefully counselled about the risks, such as relying on one kidney.
Blood donations can improve oxygen levels and blood clotting, fight infection, boost immunity and provide stem cells to replace bone marrow destroyed by chemotherapy in leukaemia and other diseases.
Stem cells can also be obtained from bone marrow donations and blood taken from the umbilical cord and placenta of newborn babies (placental amniotic membrane can also help eye grafts and wound healing) and ‘surplus’ bone can be donated during a hip replacement.
What happens in organ donation?
If we suffer brain stem death (irreversible damage with loss of consciousness and vital functions – for example, after a head injury) or circulatory death (irreversible heart/lung damage), our family may be asked if we wished to be an organ donor, or to give their consent. This is usually easier for loved ones if we have already registered and they know our wishes.
The hospital’s specialist nurse in organ donation will provide information and support; a team of specialist surgeons will come to the hospital to perform the organ donor operation.
The organs are then offered up to surgeons at transplant centres across the country via an electronic offering system (computer system) and are matched to a patient (by size, blood and tissue type) in need of a life-saving transplant. But some tissues, such as corneas and heart valves, can be removed and stored for months or years.
5 things you need to know
1. Tell family and friends that in the event of your death, you want to be an organ donor.
2. Find out more and/or register by visiting organdonation.nhs.uk, by calling the free NHS Donor Line on 0300 123 2323, texting SAVE to 62323, or filling in a form at your GP’s/hospital.
3. Sign up when you register with a GP, or renew your driving licence/EHIC (European Health Insurance Card).
4. To donate blood – as well as find out about all its useful constituents – or book an appointment, visit blood.co.uk or call 0300 123 2323.
5. Stem cell and cord blood donations are organised by the British Bone Marrow Registry (nhsbt.nhs.uk/bonemarrow; 0300 123 2323) and Anthony Nolan Foundation (anthonynolan.org).