Organ donation: a second chance at life
He is one doctor who advocates for organ donation from cadavers and from those declared brain-dead.
Dr. Franklin B. Guillano, Davao’s top nephrologist, holds the belief that, “being a lifeline is giving everybody a chance to help other people (in need of organ transplantation), even after they die.”
“We don’t bring our organs to heaven. If we become organ donors, we extend other people’s lives,” Guillano was quoted as saying.
Jonathan, who was given a second chance to live, knows this well. As a teenager, he was one of the most active members of his family. But at age 34, he observed that he always got easily tired and sleepy. From time to time, his blood pressure went up.
At one time, Jonathan visited his physician brother in a hospital. He told him about his problem, so he underwent some tests. The doctor came up with a diagnosis: his brother had a kidney problem.
“I did not know how I got this problem,” Jonathan admitted. The doctor tried to trace why his brother would had such a condition. He surmised that it may be due to an infection that resulted from a wound he got when he was a kid.
For three years, Jonathan was on dialysis. His family knew that he had to undergo a kidney transplant. Fortunately, family members and some relatives were willing to donate his or her kidney to him. They were all tested but only his sister Marianne was considered a match. “I love my younger brother and wanted to save his life,” she reasoned out.
When Jonathan knew about it, he was hesitant at first. “I told him that if the time comes that he wanted it already, I might be too old and unhealthy to undergo an operation,” recalled Marianne, who was then 38-years-old.
Jonathan got convinced. The operation took six hours and was successful.
“This is my second life,” a grateful Jonathan said. “The experienced I had to go through has deepened my thoughts about life and to accept things given to us by God.”
Marianne’s generosity saved the life of her brother. It is inspiring but, sadly, not typical.
“Thousands of Filipinos die every year of organ failure and the lack of organ donors,” deplored the National Kidney and Transplant Institute (NKTI). “Many lives can be saved if more Filipinos will donate a part of themselves.”
Records from the Department of Health show at least one Filipino dies each hour from kidney failure, which is considered the ninth leading cause of death in the country. Some 10,000 Filipinos need kidney transplants from donors every year.
“The survival rate of organ transplants is quite encouraging,” the NKTI said in a statement. Its data showed that the survival rates for kidney transplants during the first year were registered at 90-95% for living-related donors and about 80-85% for diseased organ donors. “These rates are comparable with the survival rates of similar transplants in other parts of the world,” the institute said.
As people live longer, organ diseases and health problems like diabetes— one of the main causes of kidney failure—are expected to rise, creating even greater demand for organ donations.
RELUCTANT TO ASK
There are now reputable Filipino doctors that can perform transplantation. Likewise, there are new drugs and improved surgical techniques that can make transplants safer and more successful.
“We have the expertise to save more lives, but many patients die because of lack of available donor organs. It is a tragedy for everyone,” said Dr. Antonio V. Cayco, who practices in internal medicine and specializes in nephrology at the Makati Medical Center.
One major reason of the shortage of transplantable organs is that the relatives of people who have died simply haven’t been asked.
“Doctors and other health professionals are reluctant to bring the subject of donation to the bereaved family. In some instances, they do not think of organ donation when brain death occurs in their patients.,” said Dr. Enrique Ona, who was NKTI chief transplant surgeon when interviewed by this author.
Another reason is fear. “There is a fear among the living that organ donation (kidney, for instance) might make them weak, shorten their lives, and affect their sexuality or child-bearing,” Ona said.
For the uninformed, transplant doctors do not become involved until all efforts have been made to save a patient’s life, the patient has been declared brain-dead, and consent for organ and tissue donation has been confirmed.
“For a patient to be an organ donor, he has to be confirmed brain-dead by two medical specialists,” Ona added.
The Philippines has passed Republic Act 7170. Also known as Organ Donation Act of 1991. It authorizes “the legacy or donation of all or part of a human body after death for specified purposes.”
But despite the law, there is still low turn-out of organ donation. This is true not only in the Philippines but also in other Asian countries.
“While medical technology and skills have developed at a rapid pace, the attitudes of society towards organ donation have not changed quite so fast,” pointed out Associate Professor K. Prabhakaran, director of the Liver Transplant Program at the National University Hospital in Singapore.
Proper education, it seems, is the key. Perhaps Filipino doctors can learn something from Dr. Ramayee Sinnasamy, senior heart transplant coordinator of the National Heart Institute in Kuala Lumpur. Every time he gives a talk on organ donation, he asks the audience: “When we are alive and in good health, we donate blood as many times as we want. But why aren’t we donating our organs when we are dead and gone? When those organs are not of any use to us anymore?”
ACT OF CHARITY
The NKTI says about 25 organs and tissues may be donated for transplantation. Aside from kidneys, major organs include the heart, lungs, kidneys, liver, bowel, pancreas and stomach. The tissues include heart valves, bone and cartilage, bone marrow, corneas and skin.
The lack of organ donors in the Philippines has led to the development of an ugly side of organ transplantation. There are poverty-stricken Filipinos who are selling body organs for a corresponding fee.
This is “morally unacceptable,” the Catholic Bishops’ Conference of the Philippines (CBCP) said. “The dignity of the human person as an image of God includes not only his or her soul but his or her corporeal being. Hence, our body ought not to be treated as a commodity or object of commerce, which would amount to the… plundering of the human body,” the CBCP explained in a statement released in 2008.
The NKTI has launched a program called Human Organ Preservation Effort (HOPE) which coordinates organ donation. The institute created HOPE specifically for the retrieval, preservation, and allocation of organs and tissues for clinical transplantation.
Among those who can donate their organs are people who are 18 years or older. “A minor or a person under age 18 may become a donor only if a parent or legal guardian gives consent,” the NKTI said.
People who decide to donate portions of their organs once they die are given an organ donor card. “The (organ donor) card identifies your wish to become an organ donor,” the NKTI said.
Although many people believe their religion will not allow organ donations, virtually all major religions support it as a humanitarian act. In the Philippines, the Catholic church allows it for “altruistic motives,” according to the Episcopal Commission on Bioethics of the CBCP.
“We may donate them as an act of charity,” the CBCP said.