In recent weeks, HSE has released preliminary figures for organ donation and transplantation in 2024.
During the year, 241 transplants were performed in Ireland (175 kidneys, 9 hearts, 13 lungs, 40 liver, and 4 pancreatic transplants). Furthermore, 22 donated organs have been transplanted overseas due to lack of proper match in Ireland. This was all possible through the spirit of 84 deceased donors and their families, 30 living kidney donors, and the commitment and expertise of clinical staff nationwide.
There are 500-600 people on the port waiting list at any time. Some die on these lists every year. Therefore, it is very important that all potential donations are identified and promoted. These potentially life-saving donations are relatively small as many people do not die in ways that allow organ donation to be possible.
The Human Organization Act (not yet launched by the law) provides for a “opt-out” system of organ donation. Those who do not register to opt out of donation will be deemed consent, but their families will still be consulted before the donation progresses. It is essential for individuals who want to become organ donors to let their loved ones know about this.
In response to the 2024 figures, the Irish Kidney Association (IKA) has told us the generosity of donors and families and the commitment of healthcare professionals. It also noted that for the first time a national potential donor audit could enable best practices to be identified and replicated, highlighting areas that need improvement.
However, the broader data said it shows that Ireland is losing ground rather than developing additional implant capabilities. For example, the number of people on dialysis in 2023 was 2,502 compared to 1,804 a year ago. In 2023 there were 189 kidney transplants compared to 185 in 2013 (these figures included 38 kidney donor transplants in 2013 and 30 in 2023. The HSE has previously set targets for 50 live kidney transplants).
IKA welcomed the 2 million euros allocated for HSE organ donation and Irish transplants in 2025, but said “more investments will be needed.” Squid CEO Carol Moore highlighted the need for infrastructure needed, including theater spaces, beds, information technology and staff.
Ika's statement referenced articles published in Medical Independence (MI) December 2023 ('“Pooled infrastructure” leaves “vulnerable to failure” services.”). This article reports on the internal HSE review that was confirmed in December 2022. This explained the “slow” of dedicated infrastructure and specialized staff for port services.
At the time, HSE had finalized its strategy for organ donation and transplant services. HSE notified this month mi The strategy has been approved and its launch is expected in the “next few months.”
The field of porting has changed dramatically over the past decade, increasing complexity and resource requirements. For example, many kidney donations are from older donors who currently have a history of more comorbidities. Kidney transplants arising from donations after circulatory death increased from zero in 2010 to almost 30% of activity in 2023.
While the results of patients who have undergone such transplants remain excellent, this evolution of organ utilization places additional demand in systems that are already under-resourced.
Field experts say adequate infrastructure and staffing of experts and conducting potential donor audits are key requirements to encourage improvements in donation and transplant rates.
There is clearly a range of improvements. Many European countries share the challenge of increasing medical complexity in organ use, but have higher transplant rates than Ireland (see Newsletter Porting – International Numbers on Donations and Porting 2023Council of Europe/organizations of the Nacional de trasplantes).
A firm commitment from the upcoming government to properly fund this life-saving provision will be welcomed by patients and clinicians.
