Coordination key to boosting organ donation

MALAYSIA - We are always touched by stories about how organs are successfully transplanted from one body to another. More so when the circumstances are dramatic and heart-wrenching, restoring our faith in humanity.

But organ transplants are not always headline-grabbing news and countries have struggled over how best to match growing needs with limited supplies.

National Transplant Resource Centre head Dr Lela Yasmin Mansor has spearheaded passionate campaigns to increase the number of Malaysian organ donors.

But to date, fewer than 215,000 or 1 per cent of the population, have made that pledge.

But the numbers in itself is only a fraction of the story.

Even if we can increase the number of voluntary donors, the actual conversion rate is minimal due to a variety of reasons.

Most countries, like Malaysia, practise the "opt-in" system where people are organ donors only if they explicitly sign up to do so. Some countries have put in place the "opt-out" system under which there is "presumed consent" unless stated otherwise.

But studies have shown that even with both systems, there is no guarantee of actual fulfilment because there is no guarantee that family members will agree to fulfil the pledge. Doctors tend to defer to the wishes of the next of kin rather than the explicit wish of the dead person.

Currently there are 16,000 people on the waiting list for an organ transplant, but fewer than 50 actual donors emerge each year.

The Health Ministry is now looking at how to harvest organs and tissues from road accident and homicide victims.

In the last decade alone, some 70,000 Malaysians perished in road accidents with the majority being in the 16 to 25 age group. Even a small percentage from this group can make a big difference.

The legal issue, on whether it can be made compulsory for the organs of road accident victims to be harvested, is probably the easiest to address.

The best of intentions will simply fall by the wayside if other obstacles are not properly addressed.

Time is of the essence even if procedures have to be followed. There are many parties involved and coordination among the various agencies is paramount.

The ministry has taken a step forward in engaging the police and judicial officials to play a more effective role in ensuring effective harvesting of the organs.

But it must look within to prime up the must-do list for all government hospitals. We can learn from countries like Spain and Italy that have experienced the biggest donation increases in recent years.

The health authorities there hired more transplant coordinators, started public awareness campaigns, installed 24-hour organ retrieval teams at hospitals and improved training for doctors who talk to grieving families.

And studies have shown that countries with high procurement rates owe their success to proper coordination, specifically in logistics and process management, where even before the clock starts ticking, everyone already knows what to do.

Getting more Malaysians to pledge their organs is just the initial step. Unless we can have in place an efficient set-up, it will just be an altruistic intent, and nothing more.