Why is there STILL an organ shortage?
When the first successful organ donation transplant was carried out in 1954, it seemed like a miracle. Cut to 2015 and surgical procedures like this are routine – last year alone more than 4,400 people in the UK had their lives saved or vastly improved by transplant surgery, according to NHS statistics.
While this is wonderful for the lucky few, a report by NHS Blood and Transplant shows that there are currently around 7,000 on the waiting list for organs, with three people in the UK dying every day in need of a transplant. Which is why news that the number of people donating organs after their death has dropped for the first time in a decade is deeply concerning.
‘Last year there was a 12 percent drop in heart transplants because of a shortage of donor organs,’ says Melanie Sturtevant, Policy Manager for Support and Survival at the British Heart Foundation (bhf.org.uk), ‘despite the fact that the number of people waiting for a heart transplant has doubled in the last five years. People are dying waiting.’
The complications of organ donation
So what’s behind this worrying state of affairs? Firstly, the circumstances in which people die are changing. ‘Only around one per cent of deaths are actually suitable for organ donation,’ explains Anthony Clarkson, assistant director of Organ Donation and Nursing at NHS Blood and Transplant. ‘Generally, organs that can be donated come from people who have died in hospital from brain injury or stroke. Healthier lifestyles and medical advances mean survival rates are improving all the time, so this figure is dropping. Which is a good thing, of course – just not for people in need of a transplant.’
Secondly, of the small proportion of deaths that might allow for organ donation, the organs themselves may not always be suitable. In the last 10 years, for example, the proportion of clinically obese donors has increased from 16 to 26 per cent.
All of which means that the need for more people to register as donors is greater than ever before. ‘Surveys suggest that the majority of the UK population supports the idea of organ donation,’ explains Clarkson. ‘And yet the proportion registering as donors remains around 33 percent.’
Harley Street psychologist Dr Becky Spelman (theprivatetherapyclinic.co.uk) isn’t surprised by the contradiction. ‘It’s easier to ignore organ donation than to face the pain of thinking about our own death,’ she suggests.
Being an organ donor
For Michelle Wood, 41, a sign language interpreter from London, registering as an organ donor made sense. ‘I’ve always given blood,’ she shrugs, ‘so it seemed the logical next step. I’d rather my organs went to good use after my death.’
Without people like Michelle, Sharon Adeyeri, 37, might not be alive today. ‘A random health check when I was 27 showed my blood pressure was really high,’ says the HR officer from Surrey. ‘I still don’t know why, but it had damaged my kidneys so badly that I had to start having dialysis. Eventually, my kidney function fell so low I was put on the urgent list for a transplant.’ Sharon got the call she had been waiting for five days before her 30th birthday. ‘It was the best present ever,’ she says, before adding, ‘Obviously there are mixed emotions. The donor was a 31-year-old man who’d died in a motorcycle accident. I think about him often. Particularly his family who made such a brave decision at such a difficult time.’
The same decision Simon Meredith faced in August 2014, when his wife Julie (a mum of three) had a brain haemorrhage aged 48. ‘As Julie lay there on a ventilator, I found myself thinking back to a conversation we once had over a glass of wine,’ he says. ‘Julie’s brother had just died, and she made it clear she wanted to be an organ donor when the time came for her. As traumatic as the situation was, there was no question I wouldn’t respect her wishes. Now it seems fitting that the love and kindness Julie showed in her life continues even after her death. I’ve had several letters from grateful recipients – people who were months away from dying but who are now walking around, alive because of my beautiful wife. Just knowing other families have been spared the pain we’ve been through brings me immense comfort.’
The NHS Blood and Transplant service is calling for everyone in the UK to not just register as an organ donor but, like Julie, to have the conversation with their loved ones, too. ‘Around 60 percent of families refuse to give consent for organs to be donated, despite the deceased’s wishes,’ explains Clarkson. There are a number of reasons why families refuse to give consent for organ donation; it may be that they themselves don’t like the idea of organ donation, or that they can’t accept their loved one is dead. Often, though, they’re simply too shocked or emotionally exhausted to make a decision. ‘Obviously this is an incredibly difficult decision to make under the most terrible circumstances,’ says Clarkson, ‘but we know that if families are already aware their loved one is a registered donor, they’re more likely to give consent.’
The British Heart Foundation is calling for stronger action. ‘We’d like to see a soft ‘opt-out’ system implemented across the UK,’ says Sturtevant. ‘This would mean everyone is considered a donor unless they, or their family, say otherwise.’ A scheme that has recently been adopted in Wales, and which the Welsh Government hopes will raise the number of organ donations by 25 percent.
Dr Spellman can see the merits of the new legislation: ‘Most people would rather not think about the issue, so they ignore it and don’t act either way,’ she says. ‘An opt-out scheme would mean people go along with it for the same reasons, because they’d have to feel very strongly to oppose it.’
Perhaps you’re one of the undecided. If so then all you have to do is ask yourself one simple question: would you accept a donor organ if your life depended on it? And there’s your answer.
To register as a donor, visit organdonation.nhs.uk.