SOUTH Africans do not have a culture of organ donation, leaving thousands of patients who desperately need heart, cornea, pancreas and kidney transplants waiting for many years to find a healthy and matching donor.
This is why medical experts want to educate health care workers and the public about the benefits of organ donation and the low risk to living kidney donors in particular, in a bid to save the lives of patients who, with the gift of a healthy organ, can have the chance of living a long and productive life.
According to Umhlanga physician and nephrologist, Dr Ismail Randeree, local specialists currently have around 120 patients receiving dialysis for chronic kidney disease at the National Renal Care unit in Umhlanga where his patients are treated, and some would benefit from an organ transplant.
But with the shortage of registered donors it is impossible to determine how long a patient might have to search and sit on the waiting list for a possible match.
According to Organ Donor Foundation spokesman, Jooste Vermeulen, there were 4 300 patients on the waiting list for organ transplants in 2015, and fewer than 600 kidney transplants were performed in the previous year.
Vermeulen said there were currently 43 396 registered donors – but this translated into just 0.3% of the population compared to 40% in the United States and 24% in Australia.
Randeree said it was only in special circumstances, such as when a healthy living donor with the same blood type has been found or when an organ donor who has healthy kidneys is brain dead in ICU and their family agrees, that organs can be successfully harvested for a life-saving transplant.
Fear factor But there are many barriers that prevent people from becoming organ donors, including cultural and religious barriers as well the fear factor and a lack of knowledge about the low risk involved.
Randeree said medical research showed that the risks of donating a kidney were minimal and health outcomes were the same as for the general population.
‘In the first ten to 15 years the risks are minimal,’ he said.
‘If I donate a kidney at age 20, at age 35, whether I have donated or not, doctors will look for diabetes, high blood pressure, cholesterol, kidney damage and lifestyle changes causing illnesses, so the risks are that of the general population and age,’ he said.
‘There are people in this world born with single kidneys and there may be people who do not even know that they have one kidney.
‘There are others where one kidney is well formed and the other one is agenesis, and still others may have a horseshoe shaped kidney.
‘There are people with polycystic kidney disease and they never know about it until they do an ultra sound at age 60,’ he said.
However, Randeree added that there were multiple risks for kidney transplant recipients.
‘The person who has had a kidney transplant is an immune suppressed patient, so the risks would include infections, a recurrence of the original problem they had and malignancy.
‘These are things that many patients understand, but they would rather be off the dialysis machine with a transplant because the risk is not the same in every transplant recipient.’
Randeree said medical aid expected doctors to examine and identify the most suitable donor before they would pay for tests and transplant surgery.
‘If the patient is 140kg with a pendulous abdomen, is diabetic and hypertensive with heart problems, then we won’t even entertain them.
‘Key to transplantation donation is no coercion, no financial remuneration and a detailed psychological assessment has to be done,’ he said.
Both donors and recipients receive psychological counselling and medical care before and after undergoing a kidney transplant at no cost to the donor.
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