Dáil Éireann debate -
Tuesday, 14 Mar 1995

Vol. 450 No. 6

Adjournment Debate. - Organ Transplant.

Dr. Upton

I thank the Chair for allowing me to raise this matter and the Minister of State, Deputy O'Shea, for coming to respond.

I am raising this matter in response to representations I received from a 17 year old on a waiting list in a London hospital for a heart and lung transplant. She is an exceptionally talented and gifted student academically. She is also gifted in the arts and drama but is currently unable to attend school, take part in sports, socialise with her friends or do anything which requires physical effort as she needs a constant supply of oxygen. Last year she spent seven months in hospital, two of them in intensive care.

She set out all the difficulties she has experienced in a letter she wrote to me shortly after Christmas. She informed me that the average waiting time for a heart and lung transplant is 14 months. In deperation she asked me to raise this matter to see what can be done to secure more organs so that people who find themselves in this terrible predicament can be treated.

She asked me to raise two points in particular, first that all members of the public should be considered as donors unless they state specifically that they wish to opt out. I understand that the level of organ donation in this country is exceptionally high by international standards and that the number of organs available is adequate to meet our needs. The difficulty relates to the provision of finance to carry out heart and lung transplants.

The second point that she asked me to raise relates to a study in which she was involved which found that members of the public who have a knowledge of diseases which are effectively incurable and can only be treated successfully by way of organ transplantation have a greater tendency to carry donor cards. It seems to follow, therefore, that there are extra benefits to be gained in making the public more aware of the necessity for organs to be donated. I ask the Minister of State to consider this point in the context of information campaigns. Although I accept that the campaigns conducted here are good and that those who conduct them are to be commended there is always room for improvement. I hope something can be done to help this individual and others like her who find themselves in difficult circumstances.

Minister of State at the Department of Health (Mr. O'Shea)

I thank my colleague for raising this important matter in response to correspondence he received from a young person in need. His correspondent asked him to raise two points in particular, the first of which is that all members of the public should be regarded as organ donors unless they state specifically that they wish to opt out. While I see difficulties this suggestion will be fully considered. The second point relates to the study in which the young lady was involved which shows that members of the public who have a knowledge of disease are more likely to carry donor cards.

Transplantation in Ireland has a particularly high public profile. Credit for the favourable public perception regarding transplantation is particularly due to the success of national donor card campaigns.

These campaigns have been promoted by the Irish Kidney Association, a voluntary support organisation for patients with renal disease and their families and funding for the national donor campaigns is met from the health allocation of the national lottery. Since it was founded in 1978 the Irish Kidney Association has grown to be one of the most successful patient support organisations with a high national profile and with 25 branches in existence throughout the country. I would like to take this opportunity to thank the association for the invaluable help it has given to newly diagnosed renal disease patients as well as continuing help to those already being treated. I am very conscious of the need to further develop services for kidney patients and I am glad to make an additional £600,000 available this year for improving kidney dialysis units and services for transplant patients.

Initially only cards relating to kidney donation were produced; however, in recent years, the Irish Kidney Association has developed multi-organ donor cards. The use of multi-organ donor cards, as well as the inclusion of a similar provision on driving licences, has motivated the public to multi-organ donation and Ireland is practically unique among European countries in that it is essentially self-sufficient in availability of organs. The total number of organ transplants carried out in 1994 was as follows:

Kidneys	—	138
Hearts	—	16
Liver	—	24
Cornea	—	140

I understand the transplant community in this country would be reluctant to change the present voluntary and altruistic character of organ donation as this contributes to existing high rates of organ donation. There have been occasional calls for computerised databases to be maintained of people wishing to make organ donations. However, the cost of maintenance of such systems and their likely marginal net effect would suggest that the present system is adequate for current requirements.

I should also mention that the present code of practice concerning organ transplantation is based on the principle of informed consent of donors and/or their next of kin. It is, therefore, considered highly desirable that the relatives of deceased persons whose organs would be suitable for transplantation should be fully involved in the donation process.