12 transplant facts

Organ donation – not something most people think about until they themselves or a friend or family member desperately needs a new heart, a kidney, a liver or a cornea.

During her talk on "Organ Transplantation in South Africa" at the Health Care Expansion Congress in Cape Town in 2007, Dr Elmi Muller, transplant surgeon from the Groote Schuur Hospital had many interesting things to say on the topic.

Here are some of the more fascinating facts on organ transplantation in SA:

• By far the highest number of people on the waiting list for organs are wanting a kidney transplant (1400), followed by corneas (420), livers (100) and hearts (90).
• On average for every donor referral, two patients on the waiting list die.
• To put someone on kidney dialysis costs in the region of R12 000 per month, whereas the total cost of a kidney transplant is over R40 000.
• There are two types of donors: living donors and deceased donors.
• Living donors can donate one of their kidneys, as they have two.
• Deceased donors can be both brain-dead and non-brain-dead. The brain-dead donors have no brainstem reflexes, are on ventilators, but still have a spontaneously beating heart. The non-brain-dead donors have some reflexes, a spontaneously beating heart and may be on a ventilator. They cannot be certified dead until both their heart and breathing stop.
• Marginal donors (donors who would not have been considered as candidates before) are now being used for kidney transplants at Groote Schuur Hospital. These include hypertensive donors, donors older than 65 years or under one year, and diabetic donors.
• Eight kidney transplants were done at Groote Schuur Hospital in the year 2006 year. Six were men, and two were women, and their average age was 42,75.
• Families and next-of-kin can give consent for someone to become an organ donor.
• From brain-dead donors the heart, the kidneys, the liver, the pancreas, corneas, skin and bone can be used. From non-brain-dead donors the heart cannot be used (because it has stopped beating), possibly the kidneys and the liver and the pancreas, but definitely the cornea, skin and bone.
• HIV-positive donors can be used for HIV-positive transplant patients.
• The UK is currently investigating a system where people have to 'opt out' if they do not want to be organ donors. Legislation forcing doctors to refer patients in certain categories could also be considered.

(Susan Erasmus, Health24, updated August 2009)

Phone the Organ Donor Foundation, toll free, on 0800 22 6611 or visit www.odf.org.za for more information.