"Organ transplants give people a second chance at life, and donated tissues help people with a variety of diseases and conditions. Unfortunately, each year hundreds of Australians die waiting for organs to become available because too few people register their desire to donate. By registering with the Australian Organ Donor Register, you might give another person the gift of life."
Dr Christine Bennett
Chair, Medical Advisory Panel, Bupa Australia
Who benefits from organ and tissue donation?
Transplanted organs and body tissue help save and improve lives. At any given time thousands of Australians require organ and tissue transplants, with several hundred at risk of dying if they're unable to receive a transplant. There are many more whose lives can be improved, such as people on kidney dialysis awaiting a transplant. The organs or tissues that may be considered for donation include:
- kidneys
- liver
- lungs
- heart
- heart-lung
- pancreas
- pancreas islets
- intestine
- corneal grafts and other eye tissue
- skin
- bone
- muscle tissue
- bone marrow
- heart valves.
Organ donation in Australia - facts and statistics
The need for organ donors
- Around 1,700 people are on Australian organ transplant waiting lists at any one time.
- On average, people on the transplant list must wait between six months and four years.
Many Australians don't know the donation wishes of their loved ones
- Forty per cent of Australians do not know the wishes of their loved ones regarding organ donation.
- Fewer than one in five Australians remember discussing the subject with their loved ones.
- Only 58 percent of families consent to organ or tissue donation.
Australians gifting life
- In 2010, 309 organ donors gave 931 Australians a new chance in life.
- In 2010, the Australian population had 13.8 donors per million people, which is an improvement on previous years.
Despite the improvement in 2010, Australia still falls well below other developed countries for rates of organ donation. Top of the league is Spain which has a system whereby people have to opt out if they don't wish to be donors, rather than opting in.
Research indicates that 77 percent of Australians would be willing to donate organs. The problem is many of us don't discuss our wish with our families before it's too late.
One donor can save many lives
One organ and tissue donor can save up to 10 lives and improve the lives of many more recipients. Australia has one of the world's highest transplant success rates - but is meeting only a third of its transplant demand. In 2009, the Australian Government launched a $150 million package of reforms to try and boost the number of organ donors by funding specialist staff, supporting families and raising public awareness of the need to discuss organ donation.
Who can donate, and who cannot?
Almost anyone can donate organs and tissues, regardless of age, state of health or lifestyle factors such as smoking and drinking. What's important is the place and cause of death and condition of the organs and tissues. People who drink or smoke may not be able to donate their liver or lungs but may still be able to donate other organs and tissues. Elderly people have saved the lives of young people. People with cancer have been able to donate tissues.
Only a few medical conditions, including transmissible diseases like HIV, may prevent someone being a donor. A person may not be able to donate for 12 months after having a tattoo.
When can a person donate?
Some organs or tissue can be donated by a living person, for example bone marrow, a kidney, part of the liver or a lung.
Donation of organs from a person who has died can only take place after death has been certified. This usually means when the person has died in an intensive care unit and been declared brain dead by two medical practitioners, or when the heart has stopped beating. Corneal grafts may be donated even 12 hours after a person dies.
What is the difference between cardiac death and brain death?
Cardiac death occurs when the heart has stopped beating so it no longer circulates blood and oxygen to the brain and other organs of the body, causing the person to die. Most people have a cardiac death and it means organs are deprived of oxygen so cannot be donated. Tissues can still be donated, however, and help many people.
Brain death occurs when the brain no longer functions, usually after it's unable to receive blood and oxygen because of damage caused by an event such as a stroke, trauma (for example, a car accident), asphyxiation (from an event such as drowning), or infection. Other organs are less sensitive to loss of blood flow and oxygen and can survive for a while without losing their function, but not the brain.
If brain death occurs in a hospital, the heart may still be beating because the person is on mechanical ventilation - life support. A ventilator is a piece of medical equipment which artificially pushes oxygen in and out of the lungs, taking over breathing completely or assisting the person's breathing.
The heart has an inbuilt pacemaker and doesn't rely on the brain to beat. It still needs oxygen, which is supplied by the hospital's ventilator via the lungs. So, even though the heart is still beating and the other organs may be working, when the brain has died, the person is considered dead as they can't breathe on their own.
Brain death is diagnosed in the intensive care unit when someone is being supported on a ventilator and tests have shown that there is definitely no brain stem function. The brain stem controls breathing. Two senior doctors must confirm separately that brain death has occurred. The time of death is recorded by the second doctor, who confirms death has occurred and records the time on the death certificate. At this time the family will be consulted regarding organ donation and the deceased person's wishes will be discussed. Only then, with permission, can organs be removed under surgical conditions.
Organ donation is more likely to take place when death has occurred in a hospital, because organs such as the heart, liver and kidneys can be kept supplied with oxygen with a ventilator until they can be removed for transplant.
What is the process of donation?
When a patient dies in a way that makes them suitable to donate organs or tissues, the Australian Organ Donor Register is checked to see whether the person had registered consent or objection. If there is no written or verbal objection or the person had not registered, the family will be given information about the process and asked whether they agree to donation. Donation will not go ahead without the family's consent.
If donation is agreed to, a number of things happen:
- a medical assessment will be made regarding the donor's health and any lifestyle risks to ensure the safety of transplanted organs and tissues and prevent transmission of disease
- blood tests are performed to check any of those risks
- the donor continues to receive all the care necessary to preserve organ function
- with family consent, and often independent of the decision to donate, an autopsy may be carried after the donor dies out to make sure the donor had no conditions (such as cancer) that could affect the health of the recipient/s
- the family will be kept informed and supported throughout by experienced staff and offered bereavement counselling. Funeral arrangements are not affected by organ donation and the donor is cared for during the operative process as respectfully as if he or she were a live patient.
How can I become a donor?
Join the Australian Organ Donor Register, the national register administered by Medicare Australia. To join the register, go to www.medicare.gov.au or www.donorregister.gov.au, call 1800 777 203 or visit any Medicare office.
It is vital that you discuss your consent to donation with your loved ones so they know that is your wish in the event of your death.
Further information
DonateLife
www.donatelife.gov.au
Transplant Australia
www.transplant.org.au
Sources
DonateLife. Facts and statistics. [online] Canberra, ACT: Commonwealth of Australia. 2010 [Accessed 30 Jun 2011] Available from: http://www.donatelife.gov.au/Discover/Facts-and-Statistics.html
Transplant Australia. The facts about donation. [online] North Sydney, NSW: Transplant Australia. [Accessed 30 Jun 2011] Available from: http://www.transplant.org.au/The-Facts-About-Donation.html
Senator the Hon Jan McLucas, parliamentary secretary to the minster for health and ageing. World's best practice national reform plan for organ and tissue donation for transplantation. [Online] Sept 2008 [Accessed 1 Jul 2011] Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/FC2D545FF29C6E7ACA25768C0077D876/$File/Newsletter%20-%20Edition%201%20-%20September%202008.pdf
Last published: 30 July 2011
