Australia: Lifesaving change for transplant checklist

[okarol]

Australia: Lifesaving change for transplant checklist

Caroline Marcus From: The Sunday Telegraph January 02, 2011 12:00AM

TRANSPLANT patients are being given the healthy organs of pack-a-day smokers, heavy drinkers and the elderly to give more people on the waiting list a chance of survival.

Surgeons are also transplanting the unaffected body parts of cancer patients and have begun a new registry for donors with hepatitis C.

While donor rates in NSW have risen by a quarter this year - due to reforms and a public awareness campaign - Australia still lags behind many countries, leading doctors to extend the criteria for acceptable donors.

Professor Jeremy Chapman, immediate past president of the worldwide Transplantation Society and director of Westmead Hospital's renal unit, said it was important to get the message across that while not ideal, heavy smokers, drinkers and even cancer patients could still be organ donors.

"We extended the criteria in July so we now evaluate organs from a wider criteria to have more potential donors," he told The Sunday Telegraph. "We are looking at older donors, looking at donors who have had a previous infection with hepatitis C and looking at donors that we might not previously have considered.

"But it does mean that we have to increase the number of times when we have to evaluate whether every organ is suitable or not.

"It is much better to let the transplant donor program evaluate the donor suitability [rather than letting] individual donors decide what is suitable or unsuitable."

About 1700 people are on the official organ transplant waiting list, with two people a week dying while waiting.

Professor Chapman said they could save more lives if they used organs from donors who had not previously been considered as "ideal". He explained: "An 'ideal' donor would be a very fit young man who's had an isolated head injury and nothing else.

"Fortunately, that type of donor is disappearing because we're getting very much better in Australia at [reducing the number of] traffic accidents and the care of patients who have head injuries."

Donors will also now include people who have died from cardiac arrest, rather than only brain-dead victims.

He said organs were assessed on quality rather than the lifestyle of the donor.

Professor Chapman also encouraged more over-65s to consider becoming a donor.

NSW Organ and Tissue Donation Service spokeswoman Kerry McKay said: "When donations are low, the criteria will be extended because of demand being so much higher."

http://www.dailytelegraph.com.au/lifesaving-change-for-transplant-checklist/story-fn6b3v4f-1225980119424

[RichardMEL]

Makes me wonder if Danny was one of these extended criteria, since they kept bandying around the word "suboptimal" - though I would have hoped they'd tell me if it was EC!

[Zach]

Makes me wonder if Danny was one of these extended criteria, since they kept bandying around the word "suboptimal" - though I would have hoped they'd tell me if it was EC!

What are the differences between extended criteria and just "suboptimal?"

[RichardMEL]

I don'tknow but the more I think abut it I think by suboptimal for me they meant there was zero matching antigens plus it was a "non beating heart" donor (as in some donors organs are taken when they are declared brain dead, but still on life support etc, but this person had apparently already passed). I don't THINK it was extended criteria.