Organ donation: a second chance at life

ORGAN FAILURE
“Thousands of Filipinos die every year of organ failure and the lack of organ
donors,” deplored the National Kidney and Transplant Institute (NKTI). “Many
lives can be saved if more Filipinos will donate a part of themselves.”

Records from the Department of Health show at least one Filipino dies each
hour from kidney failure, which is considered the ninth leading cause of death
in the country. Some 10,000 Filipinos need kidney transplants from donors
every year.

“The survival rate of organ transplants is quite encouraging,” the NKTI said in
a statement. Its data showed that the survival rates for kidney transplants
during the first year were registered at 90-95% for living-related donors and
about 80-85% for diseased organ donors. “These rates are comparable with
the survival rates of similar transplants in other parts of the world,” the institute
said.

As people live longer, organ diseases and health problems like diabetes—
one of the main causes of kidney failure—are expected to rise, creating even
greater demand for organ donations.

RELUCTANT TO ASK
There are now reputable Filipino doctors that can perform transplantation.
Likewise, there are new drugs and improved surgical techniques that can
make transplants safer and more successful.

“We have the expertise to save more lives, but many patients die because of
lack of available donor organs. It is a tragedy for everyone,” said Dr. Antonio
V. Cayco, who practices in internal medicine and specializes in nephrology at
the Makati Medical Center.

One major reason of the shortage of transplantable organs is that the relatives
of people who have died simply haven’t been asked.

“Doctors and other health professionals are reluctant to bring the subject of
donation to the bereaved family. In some instances, they do not think of organ
donation when brain death occurs in their patients.,” said Dr. Enrique Ona,
who was NKTI chief transplant surgeon when interviewed by this author.
Another reason is fear. “There is a fear among the living that organ donation
(kidney, for instance) might make them weak, shorten their lives, and affect
their sexuality or child-bearing,” Ona said.

PROPER EDUCATION
For the uninformed, transplant doctors do not become involved until all efforts
have been made to save a patient’s life, the patient has been declared brain-
dead, and consent for organ and tissue donation has been confirmed.

“For a patient to be an organ donor, he has to be confirmed brain-dead by two

medical specialists,” Ona added.

The Philippines has passed Republic Act 7170. Also known as Organ
Donation Act of 1991. It authorizes “the legacy or donation of all or part of a
human body after death for specified purposes.”

But despite the law, there is still low turn-out of organ donation. This is true
not only in the Philippines but also in other Asian countries.

“While medical technology and skills have developed at a rapid pace, the
attitudes of society towards organ donation have not changed quite so fast,”
pointed out Associate Professor K. Prabhakaran, director of the Liver
Transplant Program at the National University Hospital in Singapore.

Proper education, it seems, is the key. Perhaps Filipino doctors can learn
something from Dr. Ramayee Sinnasamy, senior heart transplant coordinator
of the National Heart Institute in Kuala Lumpur. Every time he gives a talk on
organ donation, he asks the audience: “When we are alive and in good
health, we donate blood as many times as we want. But why aren’t we
donating our organs when we are dead and gone? When those organs are
not of any use to us anymore?”

ACT OF CHARITY
The NKTI says about 25 organs and tissues may be donated for
transplantation. Aside from kidneys, major organs include the heart, lungs,
kidneys, liver, bowel, pancreas and stomach. The tissues include heart valves,
bone and cartilage, bone marrow, corneas and skin.

The lack of organ donors in the Philippines has led to the development of an
ugly side of organ transplantation. There are poverty-stricken Filipinos who
are selling body organs for a corresponding fee.
This is “morally unacceptable,” the Catholic Bishops’ Conference of the
Philippines (CBCP) said. “The dignity of the human person as an image of
God includes not only his or her soul but his or her corporeal being. Hence,
our body ought not to be treated as a commodity or object of commerce,
which would amount to the… plundering of the human body,” the CBCP
explained in a statement released in 2008.

The NKTI has launched a program called Human Organ Preservation Effort
(HOPE) which coordinates organ donation. The institute created HOPE
specifically for the retrieval, preservation, and allocation of organs and tissues
for clinical transplantation.

Among those who can donate their organs are people who are 18 years or
older. “A minor or a person under age 18 may become a donor only if a
parent or legal guardian gives consent,” the NKTI said.

People who decide to donate portions of their organs once they die are given
an organ donor card. “The (organ donor) card identifies your wish to become
an organ donor,” the NKTI said.

Although many people believe their religion will not allow organ donations,
virtually all major religions support it as a humanitarian act. In the
Philippines, the Catholic church allows it for “altruistic motives,” according to
the Episcopal Commission on Bioethics of the CBCP.