NZ donor shortage means organs may be diseased

Andy Tookey

Some New Zealand transplant patients are given old or diseased organs because of the shortage of donors, an organ donation campaigner says.

Doctors say recipients are not put at risk, although some suggest that young, healthy donors would be preferable from the recipients' perspective.

The Australia and New Zealand Organ Donation Registry 2006 report again puts NZ among the countries with the lowest organ donor rates.

Just 29 people became donors after death last year, compared with a usual tally in recent years of around 40.

Campaigner Andy Tookey said the number would have been much lower last year, "if doctors had not resorted to using older and diseased organs for transplant".

His comments come after Parliament's health select committee called for submissions on a bill intended to create a national register of potential donors and to end the veto power of families over the wish of relatives to become donors after death.

Mr Tookey highlighted figures showing organs were used from four people with hepatitis antibodies (including three livers), two with type 2 diabetes (including all their kidneys), and one with brain cancer (both kidneys). Nearly a third of the donors were smokers when they died, and the median age was 48.6, compared with 35.9 in 1998.

In January this year, 379 people were waiting for an organ transplant, mostly a kidney.

Organ Donation NZ clinical director Dr Stephen Streat said yesterday that all the donation cases cited by Mr Tookey, including donors with health conditions, were safe.

"And if the number of organ donors increased they would continue to be safe and they would continue to be used."

Intensive care specialist Dr Tony Smith said if there was a surfeit of potential donors, organs would only be used from young, fit, healthy people, but that state existed nowhere, so it was necessary to use organs from people who were older, smoked and had diseases.

Professor Stephen Munn, head of the New Zealand Liver Transplant Unit, said it depended on the organ whether using ones from older patients could cause problems. Livers from elderly patients performed well for "many, many years" in younger patients because of the organ's capacity for regeneration. Only the liver could do this.

"If you take an older kidney, especially from a diabetic smoking owner, then that kidney has been damaged and that damage can't be reversed and, yes, that could limit the life expectancy of that kidney in that recipient.

"But ... beggars can't be choosers and we use those."

The risk of such kidneys was carefully assessed before they were placed. Sometimes one from an older donor might be put in an older recipient where it did not have to last as long.