Call to pay donors for their organs

Call to pay donors for their organs
By TOM HUNT - The Dominion Post
Last updated 05:00 08/04/2010

Paying people $5000 to part with their kidneys would help tackle poor organ donor rates, a health expert says.

Auckland Renal Transplant Group clinical director Stephen Munn said yesterday that health officials should look at following Iran's lead with the "commercialisation" of organs harvested from living donors. New Zealand has one of the lowest organ donor rates.

He spoke out as the Future of Organ and Tissue Donation seminar began at Victoria University.

Work and Income currently pays living donors up to 12 weeks' sickness benefit and some related costs during and after the operation.

Professor Munn proposed that New Zealanders who donated part of their liver or a kidney receive an incentive of about $5000 as well as expenses. "We should have the balls to think about it," he said.

He was aware of a small number of patients going to China or India for blackmarket transplants. The commercial value of a kidney in the United States was about $140,000.

Health Minister Tony Ryall was unavailable for comment last night.

Waitemata District Health Board chief medical officer Johan Rosman said he supported New Zealand sanctioning "organ tourism", where New Zealanders paid money for organs in Third World countries.

He was aware a small number of New Zealanders were doing it illegally. Problems could include easily contracting diseases such as HIV or returning home with no knowledge of the operation or donor.

"If this is going to happen we better have some control over it," Dr Rosman said.

The proposal flies in the face of the 2008 Declaration of Istanbul, an international agreement that concluded transplant commercialism and tourism and organ trafficking should be prohibited. New Zealanders took part in its formation.

China was seen as a leading destination for organ tourism, largely from executed prisoners, Dr Rosman said. Its deputy health minister Juang Jiefu has said more than 90 per cent of organs come from executed prisoners.

THE NUMBERS

* There were 43 deceased donors of organs in New Zealand last year, 31 in 2008 and 38 in 2007.

* In 2009, a total of 171 organs - from deceased and living donors - were transplanted.

* About 525 Kiwis are waiting for organ donations, mostly kidneys.

* About one in 10 will die on the waiting list.

* New Zealand has the second- lowest donor rate in the Western World, with about eight people per million donating organs.

* Just under half of New Zealanders who hold a current driver's licence are listed as donors on their licence.

Source: Organ Donation New Zealand

THE PATIENT

Danielle Koveskali used to take karate lessons before her kidneys failed when she was 13. "I was a typical 12-year-old girl," she said yesterday from her Titahi Bay home, a few hours after her latest dialysis session.

"I lived a normal life. The last few days I've been feeling like absolute crap. It makes you feel so drained."

Ms Koveskali will turn 21 this month. It is six years since a kidney transplant saved her life but her new kidney has failed and she is back on the organ-transplant waiting list. She has a partner and wants children in the future but for the past year has been on a dialysis machine for about five hours every day.
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"I've met people that have been on it for 20 years now and I'm thinking, `Please don't let me be one of those people'."

THE DONOR

Faced with the prospect of donating a kidney for her sick husband, Paula Martin had no hesitation. "When it happens to you or someone you love it's not a hard decision."

Hers was a sentiment shared by several speakers at The Future of Organ and Tissue Donation seminar at Victoria University.

When she went into surgery to give her husband, Michael Papesch, one of her kidneys in 2006, it was quite scary, Ms Martin said.

Waking up after the operation she "felt like crap". But most of all she was "just incredibly grateful we were able to do it".

"In many parts of the world he would have been dead long ago." Neither she nor her husband had suffered major health complaints resulting from the transplant.

THE RECIPIENT

The Wellington man was diagnosed with renal failure in his mid-30s and after kidney failure in 2005 had to go on dialysis – essentially a four-hourly "oil change" for the kidneys.

"Life is in four-hour blocks," he said, holding up a small cup of coffee to show how much liquid he was allowed to drink each day.

Four years ago, his wife donated a kidney to him and it changed his life, he said. "You go from a regimented life ... until basically you are normal. You get your life back."

He and his wife went into surgery on the same day. "It was like I had a second chance."

AROUND THE WORLD

* In most countries, organs cannot be refused or requested based on religion, ethnicity, gender or age. Britain and New Zealand have just released guidelines on this.

* Most of Europe follows a system where a deceased person is assumed to be in favour of donation. But family members are consulted on the person's wishes.

* In New Zealand, the deceased is assumed to be against donation. There has to be evidence that the person wanted to be a donor.

* Some states in the United States are considering incentives for organ donors, such as payment towards funeral expenses or lost wages for live donors.

* In China, it is claimed about 90 per cent of organ donations are sourced from executed prisoners.

* Iran is the only country that legally allows the sale of kidneys directly from one person to another.

* In Israel there is a shortage of organ donors because of religious objections by some rabbi who oppose all organ donations.

* Muslim law allows organ transplants where it is necessary to save life. It is not condoned where the quality of life of the donor is compromised.

* A human kidney has been reported to cost as little as $2000 in Manila.

* Operations cost about $15,000 in Latin America and about $140,000 in the US.

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