New science can maximise number of transplant organs
In Scotland last year, 550 people were waiting for an organ with 350 transplants carried out.
Dr Iain MacLeod, head of intensive care and clinical lead for organ donation transplant at Aberdeen Royal Infirmary, said: “New science and technology allows us to look at how we can make every organ count and maximise the number of organs we can use.
“We are now able to use organs that would never previously have been considered, such as people who are older or who have had other illnesses.
“That is partly because expertise is getting better, surgery is better and things like the drugs that people take after their transplant are better.
“Organs are lasting longer and they do better that they did previously.”
Dr MacLeod said that hearts and lungs would only generally be taken from patients aged up to 60 or 65 but that kidneys could now potentially be taken from those aged 80 or 85 in some cases.
“We have had donors in their 80s and there are people waiting for kidneys who are in their 70s and 80s. If the kidney is for an 80-year-old transplant patient, then that is a good kidney for them.
“It can leave kidneys from younger donors for younger people.”
Dr MacLeod said there has been growing consideration of using of organs from newborn babies who have not survived following a case in Wales.
Teddy Houlston was a twin who survived for just two hours after being born in Cardiff in April and became the youngest organ donor after his healthy kidneys were transplanted into an adult.
His parents, who knew their son would not survive while he was still in the womb, were originally told it would not be possible to use his organs because it had never had been done before on someone so young.
Dr MacLeod said parent in Scotland had made inquiries about using their child’s organs in light of Teddy’s story.
He said: “This is a new and novel area. It is not going to be possible in many cases but there are babies born who do not survive due to brain injurry and perhaps some of them could be considered.
Dr MacLeod said it was possible for kidneys from a baby to be “grown” inside an adult, who could potentially remain on dialysis until the organ’s function was at the right level.
Dr MacLeod said baby donors could be a “valuable” source of organs but said it was a “very emotive area”.
“We would prefer not to have to do this, but especially for families who are in a horrible, tragic situation, they can sometimes get relief and benefit from knowing that their child has helped someone else.”
He added: “Ethically, if families think it is the right thing to do, I think its a reasonable thing to explore.”
Dr MacLeod said, despite the advances and potential new sources of organs, the real difference will be made by increasing numbers on the organ waiting list.
Grampian has a higher rate of population on the register, at 43 per cent compared to the UK national average of 33 per cent.
However, Dr MacLeod said a key issue was families overturning the wishes of donors after their death.
He said that happened in around four out of 10 cases and that organs could not be sent for transplant.
Families still have to give consent for transplant, even if the register has been signed.
Dr MacLeod added: “You are dealing with families who are grief struck, they don’t know what side is up. You are saying your loved one is dying and that they have said they want their organs donated. It takes about 12 hours for that to be sorted. For some families it is just too much and they say no.”
“Four out of 10 families saying no is not a small number.”
He stressed the importance of potential donors making clear their intention to their families.
While signing the register its legally binding, he said co-operation of families was essential in going ahead with the process.