Donations up as Organ guidelines revised

12 January 2008Organ donation numbers have risen after plunging to a record low in 2006.

More patients are expected to be able to give organs this year as hospitals allow donations after cardiac deaths. Until now, patients have had to be brain-dead before their organs could be donated.

Thirty-eight people donated organs after death in 2007, and 122 people benefited from those organs. That was a substantial increase on 2006, when 25 people donated organs.

"Fundamentally, 38 families agreed to donate, and that's the single major determinant," said Organ Donation New Zeland clinical director Stephen Streat, an intensive care specialist at Auckland City Hospital. "Obviously, the next determinant is just how many families were offered that option."

Organ Donation NZ had been strengthening its relationships with hospital staff across New Zealand to ensure donation opportunities were identified and followed up, he said.

At present, it did not know how many potential donors New Zealand had. Last year it introduced a national online database to audit intensive care deaths - believed to be the first of its kind in the world. With the help of hospital staff, it would show how many patients became brain-dead and how many families were asked to donate their organs.

Organs from two brain-dead Wellington Hospital patients were donated last year. Intensive care medical director Peter Hicks said the families of three other patients had turned down donation requests.

He said clinicians had worried that increasing use of surgical treatment called decompressive craniectomy, which involves removing a piece of the skull to take pressure off the brain, was a factor in the decline in donors.

"Our concern last year was that this particular treatment would stop people's brains from dying but not necessarily improve their recovery."

In some cases, patients could become severly brain damaged and not recover, but could not be used as organ donors either.

Organ Donation New Zealand has finalised protocols for taking organs from people whose hearts have stopped, but who are not technically brain dead. From this year, their families will be able to donate their kidneys and livers. "It applies to people who have severe brain damage, who are dependent on intensive care treatment , but whose brain has not died," Dr Hicks said.

Dr Streat said the change would provide only a handful of extra donors. "But even four more donors could mean 10 more transplant recipients."

It was first being introduced at Auckland, Wellington and Christchurch hospitals. Dr Hicks said the families of two Wellington Hospital intensive care patients, whose hearts had stopped beating last year, said they had wanted to donate their organs. "But their brain hadn't died so we weren't able to proceed with organ donation."

The Dominion Post Weekend