INDEPTH: HEALTH
The gift of life
CBC News Online | March 22, 2005
Organ transplants save lives, or at least extend the lives of people otherwise facing a death sentence from medical calamity.
This has been demonstrated since the infancy of organ transplantation, when Dr. Joseph E. Murray performed the world's first kidney transplant in Boston in 1954, taking the kidney of an identical twin and successfully transplanting it to the body of his brother, giving him eight more years of life.
Thirteen years later, in 1967, Dr. Christiaan Barnard of South Africa made global headlines when he performed the first heart transplant on a 54-year-old grocer named Louis Washkansky. Washkansky died of pneumonia 18 days later, but Barnard's surgery stunned the world of medicine, giving hope where none existed.
Now, decades later, the focus has shifted. There's a good chance someone you know, in your family or neighbourhood, has had a heart, lung, kidney, liver or cornea transplant. It's still a big deal, but not the big deal it used to be. The focus now is on a shortage of organs, growing waiting lists for transplants, and how to persuade more people to donate organs.
Recent studies show a third of patients waiting for an organ transplant die on the waiting list. In Ontario, despite a concerted effort to encourage people to sign organ donor cards, the number of donors has declined while the number waiting for transplants has tripled. But the problem – or challenge – goes beyond donors and has much to do with the cumbersome hospital procedures.
An Ontario task force investigation has discovered other barriers to organ and tissue donations, among them:
- Hospitals do not put a top priority on transplants because they don't get paid for doing them. Transplants are labour- and equipment-intensive, requiring hours of surgery and up to five surgical teams.
- Transplants make extra demands on an already short supply of operating rooms and intensive care beds.
- Most hospital workers receive no training on organ donation.
- Medical staff often are unskilled in persuading families to donate relatives' organs.
Canada has much to learn from the lessons of Philadelphia, which has the most successful transplant program in the United States, called the Gift of Life.
The Philadelphia program services an area with about the same population as Ontario, yet has a donor rate of 33.1 per million compared with Ontario's 13 per million.
The law in Pennsylvania stipulates that every death in a hospital must be referred to Gift of Life in order to determine if the person's organs are suitable for transplant. It is not up to medical staff – doctors and nurses – to persuade families to allow relatives' organs to be used for transplants. If there is a suitable donor, a trained co-ordinator from Gift of Life visits the hospital to seek the family's approval, but only after the attending physician has told the family the patient is dead.
Another problem in Canada is the donor card, which frightens some people who believe if they sign they won't receive as good care as someone who has declined to donate organs by not signing. Also, even if a person signs a donor card, hospitals in Canada and the United States won't accept organs without the family's permission.
Experiments with systems that regard all organs as available unless a person signs a document refusing to donate organs have not proved successful. The problem again comes down to the emotional situation of death and the family's refusal to allow a relative's organs to be used. To overrule these objections is to risk costly litigation.
But people dying while waiting for a vital organ is only one of the dangers of awkward, cumbersome transplant procedures. The more cumbersome the regulations, the more desperate people become, encouraging a black market system in which the wealthy pay to harvest the life-saving organs of the poor.
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| DEFINITIONS: |
INOCULATE: To impregnate (a person or animal) with the virus or germs of a disease specifically for the purpose of inducing a milder form of the disease and rendering the subject immune from its ordinary attacks. Usually done with a syringe.
VACCINE: A preparation of the causative organism or substance of a disease (or its products) that has been specially treated for use in vaccination.
VACCINATE: To inoculate an individual or group with a vaccine.
Source: Oxford English Dictionary
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On The Current Anna Maria Tremonti talks to David Klein, a lawyer who represent parents in a class-action suit claiming neurological damage from vaccines. (Feb 27, 2003 - Runs 5:24)
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