PRESS RELEASE                                           29^th December 2021

IKA APPRAISAL OF PRELIMINARY END OF YEAR FIGURES FOR ORGAN DONATION AND TRANSPLANTATION

The Irish Kidney Association (IKA) acknowledges the kindness of the 64 deceased donors, and their families, who, in a time of great sorrow which has been accentuated by the uncertainties and restrictions of the pandemic, have thought of those in need of an organ transplant. The 35 living kidney donors should also be applauded for stepping forward to help a family member or friend.

Unfortunately, as can be seen in the table below, as with 2020, COVID-19 has had a negative impact on organ donation and transplantation in Ireland in the last 12 months as borne out by preliminary end of year figures for 2021 released by the HSE’s Organ Donation Transplant Ireland (ODTI) today. The impact has also exposed some shortcomings in the provision of dialysis through hospital and satellite for over 2,000 kidney patients.

The IKA welcomes the announcement by the Minister for Health Stephen Donnelly TD for additional funding of €1 million in 2022 to continue to improve our organ donation and transplant services.

The IKA believes that while the pandemic has exposed the vulnerability of the national organ donation and transplant programmes, some lessons have already been learned. Beaumont Hospital has put in place a robust Covid-19 secure pathway for kidney transplantation to continue after they were obliged to suspend the programme between March and May 2020. There has been a call by the ODTI and the IKA for organ donation and transplantation to be recognised as important life giving/saving services that must not be compromised by outside forces.

Commenting on the 2021 preliminary figures, Ms. Carol Moore, Chief Executive of the Irish Kidney Association said, “I commend all those involved in the health service for the continuance of transplant activity throughout COVID-19 under hugely difficult circumstances. The generosity of spirit of the families of 64 organ donor families has made it possible in their time of grief for 168 people to receive transplant operations in 2021. We also recognised the spirit of the 35 living donors who stepped forward to transform the lives of their family members / friends. As a result of both deceased and living donation, a total of 203 organ transplant operations took place throughout 2021 up until 29^th December. Year to date 34 liver, 10 heart, 20 lung and 2 pancreas transplants have taken place, and also 137 kidney which included 35 kidney transplants from living donors.

“A decline in organ donation and transplantation has been a global experience throughout the pandemic. However, the US announced earlier this month that they topped 40,000 life-saving transplants in a year for the first time (based on Organ Procurement & Transplantation Network figures). Looking at 2020 figures, Ireland experienced a greater decline than many of our European neighbours as can be seen in the Newsletter Transplant figures (Newsletter Transplant 2021 now available | EDQM – European Directorate for the Quality of Medicines). The European figures demonstrate that while the decline in kidney transplantation carried out at Beaumont Hospital per million of population between 2019 and 2020 was just under 1% less than the European average, the decline in heart, lung and liver transplants in Ireland was significantly greater than the European average.”  (as shown in the table below).

 “The fragility of the transplant service in Ireland was exposed in November 2021 when a transplant did not proceed at the Mater Hospital, due to the unavailability of an ICU bed. We hope this unfortunate incident will not be repeated and will be the catalyst to effect change as soon as possible by ring fencing of resources including ICU beds for transplant activity. We welcome the HSE investigation into this incident.”

Ms. Moore stated, “The Irish Kidney Association is calling for detailed data on seeking consent for organ donation in our hospitals nationwide and also more transparency around transplant waiting lists. We need more clarity about the reasons why more transplant operations are not taking place in Ireland. For example, was the decline in 2020 and 2021 due to a lack of ICU beds in the donor or transplant centres, or were all suitable donor families approached? There were no (deceased) kidney transplant operations in the months of March and June 2021.

“In the UK, a detailed report is available on each step of the process that result in transplantation. From this report, we can see that in the year to April 2021, one transplant operation did not proceed in the UK due to the lack of a critical care bed. (See extract below). No such data is published in Ireland. This means we do not know what key actions are required to improve transplant rates.”

Today’s press release by ODTI states ’Over 600 people are waiting for an organ transplant in Ireland’. The Irish Kidney Association believes that there is a need for increased transparency on the criteria for patients to be accepted or removed from transplant waiting lists for heart, lung, liver, kidney and pancreas. For example, there are over 2,300 patients with End Stage Kidney Disease in Ireland. At the beginning of the year (2021) there were 415 patients with End Stage Kidney Disease (ESKD) active on the transplant waiting list, while in October 2021 there were 389, but this drop needs to be fully explained. For example, how many people were newly diagnosed with ESKD, how many died whilst on the waiting list, how many were removed from the transplant list? http://www.beaumont.ie/kidneycentre-aboutus-ourtransplantstatistics

“The HSE’s National Renal Office has reported that since the arrival of COVID-19 that one in three patients that end up in ICU as a result of COVID-19 have Acute Kidney Injury and require temporary dialysis. Some of these patients will not recover their kidney function and will end up on long-term dialysis or will hopefully get a transplant, particularly those with pre-existing kidney disease. The pandemic has also highlighted the vulnerability of people on dialysis and thus the need to focus resources and innovation on improving their situation.

“Because people on dialysis typically have to attend a hospital / dialysis unit for treatment three times a week, every week, for many of them holidaying with their family within Ireland is not an option due to all the dialysis units in the country operating at or near full capacity. This means no visiting family/friends outside of the catchment area of their regular dialysis unit. For some people, this means not being able to visit elderly parents. Ironically, holiday dialysis abroad is very possible in countries across the European continent and beyond, but such holidays are not within everyone’s financial reach. The IKA facilitates the required paperwork for holiday dialysis for those who can afford such breaks and in 2021 we facilitated 20 holidays abroad.”

Ms. Moore concluded, “The IKA’s key message to the public will continue to focus on the importance of sharing your organ donation wishes with your family as they are the people who will be asked for final consent for organ retrieval to take place”.

Organ Donor Cards can be obtained by phoning the Irish Kidney Association on 01 6205306 or Free text DONOR to 50050. You can also visit the website at www.ika.ie/get-a-donor-card  cards or download a free digital organ donor card APP to your phone.  You can also indicate your decision to donate by having Code 115 added to your Driver’s License.

-ENDS-

UK Extract from Annual Activity report from 1April 2020 to 31^st March 2021

See full report at  Annual Activity Report – ODT Clinical – NHS Blood and Transplant 2020/2021