The Tribune

By JEFFARAH GIBSON

Tribune Features Writer

jgibson@tribunemedia.net

DONATING AN organ is the ultimate gift anyone can give to someone who needs it, Dr Adrian Sawyer a transplant nephrologist said during Doctor’s Hospital monthly lecture series.

Dr Sawyer along with Michaela Sumner-Budhi, legal counsel, were the speakers during the Distinguished Lecture Series which focused on Organ Donation: Giving the Gift of Life.

Many people around the world undergo the life saving procedure of an organ transplantation. Organ transplants are performed when an organ has stopped working or stopped functioning properly because of disease or injury.

Dr Sawyer specialises in the study of the kidneys and treating kidney diseases. Organs that can be donated or transplanted include, the liver, the heart, the pancreas and the lungs.

“There are a couple of reasons why it is important to talk about organ donation during this time. I would use the kidney as a prototype for organ donation for several reasons. All of us only have one brain, and one heart. The creator in his wisdom decided to give us two kidneys, so they are very important, he said.

The month of December is a historic one for kidney transplants both locally and internationally. The first successful kidney transplant took place in Boston on December 23, 1954. The first kidney transplant locally at the Doctor’s Hospital was performed almost 20 years ago on December 5, he said.

Dr Sawyer said there is a dire need for kidney donation given the high cost replacement treatments.

“There are three forms of kidney replacement treatments: one is going on the machine (hemodialysis), peritoneal dialysis, and of course the best form of kidney replacement treatment is the transplant.   

“The 2013 United States Renal Data System Report released last month showed that a patient receiving hemodialysis reached $87,000 per year, to maintain one patient on dialysis. Peritoneal dialysis is somewhere of almost $70,000 per year and the cost after a successful transplant varies anywhere between $18,000 - $30,000 a year. So obviously transplantation is the winner,” he said.

Donor organs are in demand as there is an increasing number of patients with failing critical solid organs who can have a new life with an organ transplant, Dr Sawyer said.

“There is large gap between the patients that need organs and the supply. The supply of organs lags far behind the need. There is increasing evidence of patient survival rates and the lower cost associated with successful organ transplantation and organ replacement treatments,” he said.

“The types of kidney donors include deceased donors who have either had strokes, head trauma or irreversible brain damage but who in fact still have certain organs that function. This use to be the bulk of donors for a long time. But now living donors consists of two groups, living related and living unrelated. There is also another group which has come about in relationship to the shortage of organs. This is what they call extended criteria donors and these are people who are not quite dead, who have a little bit of high blood pressure, may have a little bit of protein in their urine. These are people you would not ordinarily be considered for donation.”

Dr Sawyer said since the age at which people can donate or accept organs has increased over the years, organs that are not what is considered “ideal”, are used to transplant older people who have a shorter life span or life expectancy.

“The Organisation of Procurement and Transplantation Network in the United States showed that in 2013 of all donor types there were just over 12,000 donors. There were also just a little over 8,000 deceased donors. This is evidence of the fact that living donation is actually taking off,” Dr Sawyer said.

Before donating organs, donors are encouraged to be aware of the World Health Organisation (WHO) guidelines as it relates to organ donation.

“Primary principals are things that the doctors and transplants teams must abide by. First the donation must be voluntary, un-coerced physically, emotionally or otherwise. There should be no harm to come to the donor either in the short term or the long term. There should be evidence of benefit to the recipient, more importantly the recipient’s ability to comply with immune suppressive therapy is important,” he said.