Today, 600 people have put their lives on hold waiting for that one phone call.
For this group and their families, social distancing, wearing masks and washing hands were part of daily life long before COVID-19 became a hot topic.
Some in this group are only able to work four days a week in practice, with three days reserved for long drives and dialysis. Add to this the medications, medical check-ups, oxygen, hospitalizations, frequent clinic appointments, blood tests and constant worry, and you can get a sense of the limitations this places on their lives.
Once you are on the organ transplant list, that call becomes your life.
This column could have been copy and pasted from last year because, even as Organ Donation Awareness Week approaches, another year has passed without any action being taken on the Bill to introduce a soft opt-out system for organ donation in the country.
Ireland was a leader when it first introduced the soft opt-out approach, whereby people are automatically assumed to consent to organ donation unless they indicate otherwise, but families have the final say.
This system will make it easier for families to make another difficult decision in times of extreme distress, but it will also increase the number of people receiving life-saving heart, lung, liver, kidney and pancreas transplants each year, as other countries have shown.
When then Health Minister Simon Harris outlined the Human Tissue (Transplantation, Post-mortem, Autopsy Examination and Disclosure) Bill in May 2019, he referred to the late Senator Fergal Quinn, who had introduced a similar private member's bill more than a decade earlier.
“Senator Quinn has been a staunch supporter of organ donation, and while it has taken a while, I believe the announcement and beginning of the drafting process of the Human Tissue (Transplantation, Post-Mortem, Autopsy Examination and Public Release) Bill is a fitting tribute to Senator Quinn at this time,” Harris said, referring to the 2008 bill.
This time last year, this column highlighted the estimated 240 people who had died while waiting for an organ transplant since the then Government launched a consultation process with a view to introducing soft opt-out organ donation – an average of 30 people a year.
On average, that number comes to 270 people: mothers, fathers, sons, daughters, aunts, uncles, friends, coworkers, etc. who didn't make it to the top of the list.
As in other regions, COVID-19 has had a severe impact on transplant volumes: 63 deceased donors in 2020 and 64 in 2021, down from an average of 85 per year in the five years up to 2019.
The number of living donors was also down to 35, down from the five-year pre-pandemic average of 43. These generous donations led to 203 transplants last year, down from the five-year average of 284 from 2015 to 2019.
According to the Irish Kidney Association, the pandemic has only exposed vulnerabilities in the country's organ donation and transplant programme.
The weakness in transplant services was revealed in November last year when a patient was called for a transplant but the operation could not be carried out at Matar Hospital due to a shortage of intensive care unit (ICU) beds.
Jim Egan, director of the Irish Organ Transplant Institute (ODTI), said the pressure on ICU capacity was “significant”, writing in its 2020 annual report that “demand for organ donations has highlighted shortfalls in ICU bed capacity infrastructure”.
“Furthermore, unscheduled acute care at the three major acute hospitals providing transplant services threatens the provision of specialised transplant surgical services,” he said.
Campaigners, including Philip Watt, chairman of the Irish Donor Network and CEO of the Irish Cystic Fibrosis Society, are also calling for the reservation of intensive care unit beds and dedicated operating theatres for lung and heart transplants, which, unlike the passing of the Bill, can be done relatively quickly with the right resources and staffing.
“When an organ becomes available, we may call seven or eight people for that organ to find the best match, sometimes multiple times,” Watt said.
“There is no doubt that there are people right now who are dying waiting for organ transplants and I think what would help them is a dedicated operating theatre at Matter Hospital for heart and lung transplants, for example.”
Of course, it's hard to improve any service if you don't know where you're starting from.
Introducing an annual audit that provides detailed data and analysis of donations for each hospital across the country would provide valuable information on areas where improvements can be made.
“We need more clarity about why so few transplants are being carried out in Ireland,” said Carol Moore, of the Irish Kidney Association.
It may be a difficult conversation, but the reality is that you are three times more likely to need a transplant than to be an organ donor.
With a soft opt-out system yet to be legislated, campaigners plan to mark National Organ Donation Week, which starts on April 23, by renewing their urging on people to “have the conversation” with their families.
Hopefully, one day the long-awaited “human tissue bill” will be passed into law. Until then, the 600 people on the list will have to rely on the #ShareYourWishes hashtag and the generosity of grieving families.
April 14: The Belfast-built Titanic sinks. As news of the disaster began to reach land, the Cork Examiner reported, “From news received just before going to press, it is highly probable that we must record one of the most terrible disasters in the history of the sea.” The article detailed conflicting reports that the ship had sunk, as well as other indications that the ship's watertight compartments were so good that it was able to make its way to Halifax, accompanied by several liners.
On the first day of the ESB strike, the country came to a complete halt. In Leinster House, politicians were forced to work by candlelight. [not me] Of course, most members of Congress agree with the general idea that they “don’t know anything” anyway,” Anthony Ring wrote. He reported how the candles were collected for Leinster House.
17 April: A short, one-column article on the front page reported that Ireland's quest for alternative energy has taken a “major step forward” with “the simple planting of trees at Clonthurst Peat Works in Bord na Móna.” The article stated that “this will mark the beginning of a large-scale Irish and EEC experiment in generating electricity from biomass.” The article also advertised a four-part Cork Examiner series aimed at investigating “how Ireland plans to generate energy from natural alternative sources such as wind, waves, sun and plants.”
17 April: The authors of the Hanley report on health reform say “all kinds of politics” are being played out ahead of the local elections. David Hanley recommended that emergency departments and acute medical services at Ennis and Nenagh hospitals should be transferred to Limerick Regional Hospital. However, with Fianna Fáil under pressure ahead of the local and EU elections, it is announced that eight doctors will be appointed to the emergency departments at both hospitals.
The House of Commons and the House of Lords are on Easter break this week and next, with MPs returning to work on April 26. However, there will still be business in Leinster House, with several committees due to meet this week.
Minister Simon Coveney will attend a meeting of EU foreign ministers on Monday where sanctions were discussed, and then appear before the Foreign Affairs and Defence Committee to debate the Defence Forces (Evidence) Bill 2019, which is at committee stage.
The weekly Cabinet meeting was postponed for a day while the House of Commons is in recess. Ministers are expected to approve cost-of-living measures put forward by Green Party leader Eamon Ryan, which would include scrapping the current PSO levy on energy bills.
The Agriculture Committee will have a full day of discussions, with members meeting Minister of State Pippa Hackett and several stakeholders in the morning to discuss the reforestation and forestry sector. After lunch the committee will look at the challenges facing the pig industry, and in the evening members will meet with representatives of the Irish Co-operative Organisations Society (ICOS) to discuss fixed price milk contracts.
Comhchoiste na Gaeilge is also due to meet on Wednesday to consider ways of further promoting publishing and reading in the Irish language.
The three government leaders and Foreign Secretary Simon Coveney will be in Dublin Castle for the 2022 Global Ireland Summit.
Returning to Leinster House, the Joint Committee on International Surrogacy will hear from Dr Andrea Mulligan, Associate Professor of Law at Trinity College Dublin, and Professor Mary Wingfield, Clinical Director of Merrion Fertility Clinic.
“On The Plinth” is on every Tuesday (Print and online versions). Stay on top of major political news by signing up to the On The Plinth politics newsletter. here.
