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BBC News – Q&A: Organ Donation

By James Gallagher

Health and science reporter, BBC News

There has been a boom in organ donation in the UK according to figures by NHS Blood and Transplant.

The number of people donating organs after death has risen by 50% to 1,200 people since 2008. It led to about 3,100 transplants last year.

What is organ donation?

For some seriously ill patients, such as those with acute liver failure or a seriously diseased heart, there is no treatment which can save the organ.

The only option to save their life is an organ transplanted from another person.

There are several types of donation.

The latest figures relate to organs taken after a patient had died. A kidney can be taken from a living donor, often a family member.

Which organs can be donated?

The main transplants are heart, lungs, both kidneys, the pancreas, liver and small bowel. Two corneas can also be transplanted. This is why campaigners say one donor can transform the lives of nine people.

Other tissues such as skin, bone, heart valves, tendons and cartilage can also be used.

Meanwhile, more complicated procedures are being developed.

The UK’s first hand transplant took place this year.

Is 1,200 really a success?

Nearly a third of people in the UK, 20 million people, are on the NHS Organ Donor Register.

While half a million people die in the UK each year, fewer than 5,000 die in circumstances which mean they can donate their organs.

Organs can degrade rapidly after death. If the heart stops then oxygen is no longer pumped round the body so tissues die. Most donors are patients already in intensive care who die after a brain haemorrhage, severe head injury, or stroke.

Doctors confirm the patient is brain dead, but a ventilator can keep the blood pumping around the body – preserving the organs for transplant.

Why have the figures gone up?

The increase has been put down to specialist nurses focused on donation who have become a familiar face in intensive care wards.

They approach and support bereaved relatives in hospitals and discuss organ transplants.

Is age a barrier?

No. It is the quality of the organs which count and there have been donations from people well into their 80s. The oldest kidney donor was person aged 85, while the oldest heart donor was 65.

What about poor health?

There are only two conditions which mean people cannot donate – being infected with HIV or having vCJD (the human form of mad cows disease).

A lifetime of heavy smoking is unlikely to leave lungs fit for transplant, however, other organs may still be suitable.

The decision is taken by the surgical team which will access the organs.

Does this affect the presumed consent debate?

In order to be an organ donor you have to opt-in by signing up to the organ donor register.

Some have argued for an opt-out system in which everybody is assumed to be an organ donor unless they state otherwise. This system is in place in other countries and the government in Wales is aiming to introduce presumed consent in 2015.

There is a shortage of organs available for transplant and three people a day still die while on the waiting list. While there has been a surge in donations, it seems unlikely that this will be the end of the debate.

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