Sir, - The Department of Organ Procurement and Transplantation, Beaumont Hospital, wishes to clarify a number of issues raised in the article entitled "Kidney Association hopes for more donations" (March 26th). Whilst acknowledging the excellent work done by the Irish Kidney Association and its members over the years, we feel it is important to emphasise the following points in order to:
1. Allay the fears of patients awaiting transplantation that their chances of receiving an organ have been diminished and:
2. Ensure that the numerous hospitals around the country who co operate tirelessly with the organ procurement programme do not become discouraged.
It is well recognised within informed transplantation and organ procurement centres that there is a seasonal yearly variation in organ procurement rates. We have stressed this point in the past and feel that figures relating to an isolated period of time do not truly represent overall donor and transplant activity.
When the number of organ donors and renal transplants are reviewed over the extended period of the last decade, there has been an 83 per cent increase in the number of renal transplants performed. The number of transplants performed in 1995 was exceptional in that 149 renal transplants were performed which represents an increase of 25 per cent when compared to the annual average for this decade.
Furthermore, the number of transplants performed in any one given year does not reflect accurately, the actual organ donor referral rate. In 1996, which was the year mentioned specifically in your article, there were 97 organ donors referred, of which only 65 were actually procured because of failure to consent or specific medical unsuitability. In reality, this reflects an organ donor referral rate of 30 per million/population which translates into one of the highest in the world. We have already had 26 donors for the first 12 weeks of 1997. This can be extrapolated to 120 donors by the end of the year, which would be a 30 per cent increase over our previous best year of 1995. We do, however, realise that this probably will not be sustained and that by the end of the year we will have evened out to approximately 80 donors.
In this country, we are unique in that the average waiting time for cadaveric kidney transplantation is currently only nine months, with 15 per cent of patients transplanted within one month of going on the waiting list. Because of our excellent supply of cadaveric organs, we in Ireland are in an enviable position in the world of kidney transplantation, in that we meet our transplant needs every year. This is in stark contrast to most of the other developed countries, where the transplant waiting lists and number of people going on renal replacement therapy have increased dramatically over the last ten years, while the number of organs procured and transplanted has actually stayed stable
We are very grateful to the hospitals who participate in organ procurement, without whose very active support our transplant programme would not achieve this record level of service. We must express our profound gratitude to the families of deceased donors who, in their time of grief, offer to donate their loved ones' organs for transplantation. - Yours, etc.,
Consultant Transplant Surgeon,
Transplant Co-ordinator,
Beaumont Hospital,
Dublin 9.
