A giving purpose


If you’ve ever tried using maturity or illness as an excuse not to participate in organ or tissue donation, then you may need to rethink your strategy.

Because despite what you think you may know about the barriers of age as it relates to organ or tissue donation, if you think being aged 65 or over precludes your kidneys, liver, heart, lungs or pancreas, eye tissue or intestines from being of use to anyone else, then you’ve got it all wrong.

Dr Helen Opdam is one of Australia’s foremost experts when it comes to organ and tissue donation. A senior intensive care specialist at Melbourne’s Austin Hospital, Dr Opdam is also a member of the Australian and New Zealand Intensive Care Society Death and Organ Donation Working Party and The Organ and Tissue Authority’s (OTA) national medical director.

Dr Opdam concedes it is frustrating when people of any age believe themselves ineligible from organ or tissue donation – particularly when not armed with all the facts to help them make a considered decision.

She says while age and medical history is taken into consideration when accessing the suitability of a potential donor, Australian active seniors should never assume they are “too old or not healthy enough”.

“We’ve had people donating organs that have been life-saving for others when they’ve been in their 70s or 80s, therefore age alone is not a barrier.

“There’s also very few medical exclusions. Some people say ‘I’ve been a drinker’, I’ve been a smoker’ or ‘I’ve got diabetes’ and they think they’ve got [ailments or habits] that exclude them from donating. But none of those things are exclusions because if your organs are still functioning and you die under circumstances where donation is feasible then there is a possibility you may have an organ, or more than one, that could help someone if it was transplanted into them.”

Others believe their religious or cultural beliefs may also prevent them from being donors despite the fact all major religions – including Christianity, Islam, Buddhism, Hinduism and Judaism – support organ and tissue donation, she says.

“People shouldn’t rule themselves out.”

According to the OTA, there are currently around 1,400 Australians waitlisted for a transplant and around 12,000 receiving kidney dialysis.

Last year 1,618 organ transplant procedures took place in Australia, equating to a national donation rate of 22.2 donors per million people. The largest number of donors came from Victoria (193), New South Wales (151) and Queensland (94) with 41 donors hailing from Western Australia, 36 from South Australia, 21 from the ACT, 14 from Tasmania and four from the Northern Territory.

Of these, the kidney was the most popular organ harvested with 897 donations, followed by liver at 318, lung (221), Heart (129) and pancreas 52. Just one small intestine was transplanted last year.

In addition, 10,500 people benefited from eye and tissue donation in 2018, an increase of nine percent over the previous year. The medical threshold for those who wish to be considered for a living donation – i.e someone who donates a kidney or partial liver to another person who has end-stage kidney disease or liver failure – is much higher with strict medical and legal criteria applicable before a living donation can proceed.

To be eligible to provide a living donation, you must have good kidney and liver function and be in good physical and psychological health. Your blood and tissue type must also match with the recipient.
Meanwhile, people can donate eye tissue or other tissues in a much broader range of circumstances, Dr Opdam says.

While philosophical about the eligible criteria – “If someone is not medically suitable or the circumstances in which they’re dying makes them unsuitable ...well, that’s just how it is” – Dr Opdam believes there is much work to be done to encourage more Australians to consider organ or tissue donation whether it be upon their death or while still living.

Complicating the matter is the fact that the number of people able to donate organs or tissue after death is limited by the circumstances in which they die.

Each year around 160,000 Australians lose their life but owing to the fact that organ donation is only suitable for those who die while attached to a ventilator only around 1,200 of these die in circumstances where they are able to donate their organs to help others.

“What this means is that all those people that say they are a donor are probably not. Everyone’s more likely to need a transplant than they are to die in circumstances whereby they could ever be a donor.”

Dr Opdam says the best thing for people to do to find out about donation if they’re uncertain is to arm themselves with the facts. Having decided to be a donor, it’s important they then make their family aware of their intention to donate. Lastly, she recommends helping to formalise the process by registering on the Australian Organ Donor Register.

“That adds more of an official statement to their express willingness to be a donor,” she says.

“It’s very helpful for families if they’ve had a first-hand conversation with the person that they love who is dying about donation. Sometimes we have families who say I want to bring up donation because they’ve had this conversation.”

Dr Opdam says while it does happen on occasion, only rarely does it eventuate that there are discrepancies between the wishes of the potential donor and that of their family.

While strictly speaking, if a potential donor has signed the register, the doctors and medical professionals are able to proceed without family approval, in reality that never happens, she says.

“The family is always part of the experience when the people they love is dying. Families usually want to honour the wishes and the choices of the people they love. What usually happens when there’s a problem is that someone has registered and haven’t told their family and it comes as a bit of a shock to the family. There’s donation specialist staff who support the family through that process.

“Generally families get a lot of comfort knowing their loved one has been able to help other people. How often do you get to potentially save someone else’s life?”


The numbers

 - Around 1,400 Australians are currently waitlisted for a transplant. A further 12,000 are on dialysis, many of whom would benefit from a kidney transplant
 - In 2018, 1,782 lives were transformed by 554 deceased and 238 living organ donors and their families
 - In 2018, more than 10,500 Australians benefited from eye and tissue donation
 - The majority of Australians (69%) are willing to donate their organs and/or tissue when they die
 - In Australia, 90% of families say yes to donation when their loved one is a registered donor. This compares to the national consent rate of 64%
 - If our national consent rate reaches 70%, Australia would be in the top 10 performing countries
 - One in three Australians are registered donors despite the majority (69%) believing that registering is important
 - While the majority of Australians (71%) think it’s important to talk a with their family/partner, only half (51%) of Australians have discussed whether they want to be a donor
 - Of the 36% of Australians who feel confident they know if their loved ones are willing to be a donor, 93% say they would uphold their wishes.

Source: Donate Life


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