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Statement on transplant and donation figures for 2020, future legislation and vaccine reprioritisation

The Irish Kidney Association welcomes the HSE’s announcement of end of year figures for 2020 on organ donation and transplantation and pays tribute to organ donors and the dedication of transplant teams in very challenging times.

While applauding the continuance of transplantation programmes in very difficult circumstances, Chief Executive of the Irish Kidney Association, Carol Moore, stated that, “The Irish Kidney Association looks forward to working with the Health Minister in the near future to ensure that the Human Tissue Bill delivers transformative legislation and maximises the potential for organ donation in Ireland. The IKA’s key message to the public will continue to focus on the importance of sharing your organ donation wishes with your family.”

Ms Moore has also asserted that, “2020 was a very difficult time for all kidney patients who are in the ‘extremely high risk’ category for Covid 19 and therefore renews its calls supported by the National Renal Office (NRO) for the re-prioritisation of kidney patients in the rollout of vaccines”.

Referring to the 2020 figures for organ donation and transplantation, Ms. Moore said, “When we look at the end of year figures for 2020, as published by Organ Donation Transplant Ireland (ODTI), we are truly grateful to the donors, their families, our hospital’s transplant teams and all those involved in making organ transplantation a reality”.

“In 2020, thanks to the generosity of 62 deceased donors and 28 living donors (kidneys) there were a total of 190 organ transplants. With 84 less transplants than in its previous year, 2020 has been a challenging year for organ donation and transplantation. The transplant figures for 2020 are down on previous years as the pandemic led to a reduced capacity within our hospitals to deliver the service and there were the obvious safety concerns given the vulnerability of patients in the immediate post-operative period. The kidney transplant programme at Beaumont Hospital was put on temporary pause earlier in the year and this obviously left many patients in limbo wondering what the future held.. Despite all that has been going on with the pandemic, we must acknowledge the dedication of the teams in Beaumont, the Mater, St. Vincent’s and Temple Street hospitals in ensuring the continuation of the transplant programmes. It has been very inspiring to hear feedback from transplant recipients throughout the year about the level of care and professionalism they experienced.”

“There are currently approximately 590 patients in the transplant pool waiting for organ transplants and over 2,000 people receiving kidney dialysis treatment. The pandemic has seen an increase in the demand for dialysis as the virus can impact the functioning of the kidneys with one in three people who end up in ICU experiencing kidney failure and requiring dialysis treatment. With people on dialysis and transplant recipients in the ‘extremely high-risk’ category in relation to Covid-19 the Irish Kidney Association has been advocating for the prioritisation of renal patients in the vaccine roll-out. At present adult transplant and dialysis patients are prioritised in 7th position while Under 18s, many of whom are at school going age, are in 15th position for the vaccine rollout in Ireland.”

“The dialysis and transplant population has been rightly placed in the ‘extremely high-risk’ group in relation to Covid-19, as international experience showed a higher risk of death. As a consequence, the Irish Kidney Association has added its voice to that of the National Renal Office in calling for the re-prioritisation of this cohort in relation to the roll-out of the vaccine programme. This position has also been taken by the likes of the American Society of Nephrology and the British Renal Society with particular emphasis on people on dialysis. The Irish Kidney Association has also joined the IPPOSI led initiative that has seen 19 patient organisations come together to urge the Government to prioritise people with chronic and rare diseases, of all ages, in the roll-out of COVID-19 vaccines.”

“The Irish Kidney Association is pleased to read of the Health Minister’s determination to address the Human Tissue Bill as a matter of priority. The Bill shines a much-needed light on an area of medicine that is so transformative. The donation of an organ not only impacts on the life of the recipient, their family, their social network and society at large benefits from the gift that keeps on giving – there is very much a ripple effect.”

“As it currently stands, the proposed legislation talks of introducing an ‘opt-out register’ where those who do not wish to be considered as potential organ donors can record their wishes. Those who do not sign the register are deemed to be potential donors but the consent of the family is still required. The Irish Kidney Association is asking the Health Minister to take one further step in the legislation and add an ‘opt-in’ option alongside the ‘opt-out’ one proposed. This will ensure that the public’s positive engagement with organ donation can continue to be active rather than passive. A record of a person’s wishes in relation to organ donation would offer their family reassurance in the event of them being approached for consent. An Irish report on the 2008 national audit of potential organ donors, indicated among potential donors there was a 31% rate of refusal to consent to organ donation by next of kin. The most common reason given was uncertainty in relation to the potential organ donor’s wishes with regard to donation.

“The proposed legislation, as with legislation in so many other countries, acknowledges the centrality of the role of the family in the process of organ donation. Whilst it talks of an ‘opt-out’ system it is clear that the family would still have the final say in whether organ donation goes ahead. The bill highlights the importance of having a family discussion around organ donation so that in the event of one being a potential organ donor, your next of kin will know your wishes and can ensure that they are carried out.”

“Since its foundation in 1978, the Irish Kidney Association has been promoting the Organ Donor Card as a means to facilitate that conversation. This clear ‘call to action’ to engage the public actively with the topic has been acknowledged as an important public service in promoting the life giving act that is organ donation.”

“Over one million full and provisional driving licence holders have proactively indicated their consent to organ donation by having the code 115 added to the licence. This existing database enables the creation of a “yes” registry at a much lower cost and will reduce the rate of next of kin refusals due to uncertainty about their loved one’s wishes.”