Shedding light on organ donation
DONATING your organs, whether by pledging to use them after your death or by donating them while you are alive, is a most noble act. This often means that you are literally saving the life of the organ recipient!
The sad truth is that the vast majority of patients on the transplant list die while waiting for a new organ. The main reason for this is the insufficient number of donors pledging their organs. Simply put, the demand for donated organs far exceeds the supply.
From 1997 to April this year, there were a total of 2,641 solid organ transplants performed in Malaysia. Solid organs are those that have the consistency of firm tissue and are not hollow, eg stomach and intestines, or fluids (eg blood).
The vast majority were kidney transplants, of which 2,403 procedures have been performed over the past 25 years. The other transplants involved the liver (198) and the cardiothoracic system (heart and lung) (40).
Most of these organs were donated by living donors (1,752 for the kidney and 92 for the liver). The remaining organs came from deceased donors, numbering 767.
Like all other areas of health, organ transplants in our country have been strongly impacted by the Covid-19 pandemic. Not only have living donor transplants been halted for some time due to fears of transmitting the SARS-CoV-2 virus to affected parties, but the number of deceased organ donors has also dropped dramatically.
For example, there have only been seven deceased organ donors for the whole of 2021. This is likely due in large part to restrictions imposed by the Movement Control Order (MCO), as most donors of eligible deceased organs in Malaysia die as a result of traffic accidents. .
Fortunately for those on the organ transplant waiting list, the number of transplants for this year has already exceeded last year’s total.
From January to April this year, 69 transplants were performed, 59 involving the kidneys and 10 involving the liver.
Most of the donors were alive, with 41 donors donating their kidneys and one donor part of their liver. The remaining 12 donors had died.
However, there were still over 10,455 patients on the organ transplant waiting list in Malaysia as of April 2022, representing a great need for more donors to come forward.
As stated above, there are two types of organ donors – living and deceased. In Malaysia, healthy adults can donate one of their kidneys or a lobe of their liver to their spouse or a first- or second-degree relative.
First-degree relatives are a person’s parents, children, or full siblings. Second-degree relatives are a person’s grandparents, grandchildren, aunt, uncle, niece, nephew, and half-siblings.
In rare cases, a person may donate to a more distant relative or non-family member. However, this is subject to evaluation and approval by an independent committee appointed by the Ministry of Health.
Children, adults with mental and/or physical disabilities and inmates are not permitted to become living donors, with the sole exception if an inmate wishes to donate to a close relative who is in a life-threatening situation. at risk due to organ failure.
Deceased donors are those who committed to donate their organs during their lifetime. These donors would usually have experienced brain death, but the rest of their bodies are still functional or maintained by artificial means, in order to harvest their organs for transplants.
These donors can bring multiple recipients back to life, as they can potentially donate many organs, such as their heart, lungs, liver, pancreas, intestines, and kidneys, among others.
As mentioned earlier, most deceased or cadaveric donors in Malaysia die as a result of road accidents. Therefore, their ability to donate their organs also depends on the state of their body at the time of brain death. Only organs that are intact and still functioning well will be transplanted into a recipient.
About 50-60% of those who pledge their organs are in the 18-40 age bracket. This is likely due to increased awareness and acceptance of organ donation among this group.
Unfortunately, there are still some myths that people tend to believe about organ donation. One of the most common myths is that the procedure will result in the mutilation of the body of the deceased. Another is that allowing the removal of organs from a brain-dead donor will delay burial rituals.
However, the medical team that performs the organ removal from a brain-dead donor always does so in a very respectful manner, ensuring that there is no mutilation of the body. The procedure is also done in a timely manner, so that the donor’s family can pick up and prepare their loved one’s body for burial in a timely manner.
It should be noted that organ donation and transplantation are accepted and authorized in all religions practiced in our multicultural and multi-religious country. In Islam, which is Malaysia’s most widely practiced religion, organ donation and transplantation is considered “harus” (permissible), according to the 1970 national fatwa.
The impact of organ donation is immeasurable. Apart from giving the patient a new quality life, it will also have a positive impact on the recipient’s family and friends as they will be able to be with their loved one for a longer period of time.
Likewise, the family of a deceased organ donor may also feel a certain level of comfort that their loved one was able to give life to others as their last charitable act on this earth.
Although living donors are strictly prohibited from receiving any reward or compensation for their organ donation, whether in the form of direct cash or other inducements such as property, cars, stocks or professional promotion, they receive certain benefits from the Ministry of Health.
These include first-class treatment in public hospitals as well as free medical follow-ups related to their organ donation.
The organ donation procedure itself is, of course, also free of charge for the donor. Civil servants are also allowed to take up to 42 days of unregistered leave during their recuperation period.
As a society, it is vital that we make the culture of organ donation a norm in our communities. Choosing to be an organ donor can be one of the most meaningful acts of your life. It costs you nothing to sign up to donate your organs, so go for it.
Equally important, let your family know that you wish to donate your organs after your death, as their permission is also required for the medical team to harvest your organs.
DR HASDY HARON
Senior Clinical Manager of Organ Donation,
National Transplant Resource Center, Kuala Lumpur Hospital