Organ Donation

I went for a very illuminating tutorial today regarding organ donation.

For someone who hardly reads the newspapers (occasionally I still do - that is the free metro paper from the bus) and never ever watches tv news over here in the UK (in Malaysia I get daily Star Newspapers ok, so I am not all that Uninformed), I guess my knowledge on organ donation is pretty limited.

So when the tutor asked us to comment on the above mentioned topic, I naturally did what I did best - sit there and look pretty. Pretty dumb. Works all the time.

But of course, being in medical school there ARE smart and very knowledgeable people who would answer questions. Not everyone plans to faff their way thru medical school like me. So, rest assured, there are some good, sorry, smart, doctors out there yet. (I aim to be a Good Doctor, alright)

Apparently, Spain has the highest amount of organ donors, coming to 34 donors per 1 million of the population. That's 3 times of UK's which only comes at 13 donors per 1 mil. Yeah, I know boring, boring stats and all that, but then when your loved one or you urself is in dire need for an organ, these stats become important. Immediately. Same goes for government funding where it takes 20,000 pounds to haemodialyse a patient per year when it only costs 10,000 pounds for a transplant per patient per year. That's loads of money AND the patient gets a new lease in life!! Don't know much about haemodialysis? Basically when your kidney fails, and u'll need to attend the hospital 3 times a week for the rest of your life for 4 hours of fluid exchange. In other words, no life.

But the million dollar question is why does Spain have such a huge number of donors?

That is because in Spain, the people that pursue prospective organ donors are the doctors themselves. In the UK, specialist donor nurses do it. They are informed of a prospective donor and they follow it from there, approaching the family and getting all the relevant bits of information. But in Spain, the almighty doctor does it. And like it or not, doctors are much, much, much more influential over people compared to nurses. They do the ward rounds everyday, monitor the patient's progress and know when it is when the patient is going to die, hence being able to get all the information and consent from the patient before doomsday and their family members. They are also on deck when someone comes into A&E brain dead and can start reperfusion almost immediately to maintain tissue and organ viability before it becomes oxygen depleted, hence making it suitable once again, for donation. If you wait for the nurses to come, bla bla... the organ/tissue dies.

Just for information sake, heart and lungs are only viable up to 4 hours without oxygen. Kidneys can last 20 hours and livers, 12 hours. To gain optimum organ function once transplanted, organs have got to have a continuous blood supply before they are removed from the donor. So a window of 5 mins without oxygen can already damage tissues, rendering the organ less viable. That's why you need decision makers (aka doctors) in the acute setting to decide to reperfuse. Fast.

Phew.

And apparently in America, doctors are given extra cash when they bring in new donors. Like how GPs are paid more in the UK per patient of theirs that successfully quits smoking.

I wonder what Malaysia's donor register is like.

Donate your organs, you could save lives.