Transplants are the best form of organ replacement therapy.
By Professor William Hwang
Director, SingHealth Transplant
Medical Director, Singapore Cord Blood Bank
Transplants are the best form of organ replacement therapy. When an organ fails, there is no better treatment for the patient than an organ transplant.
In fact, transplants are a more effective solution than long term management of many diseases. The benefits are clear when you compare kidney transplants to long term dialysis, or when you compare corneal and skin transplants to the human cost of blindness and burns.
In Singapore, there is a profound shortage of donor organs for transplantation – the number of patients requiring an organ for transplantation is close to 100 times more than the number of organs available.
The Human Organ Transplant Act (HOTA)
presumes consent for suitable donors in Singapore. However, the nation’s organ donation rate at 6.5 per million population still lags significantly behind those of countries like Spain (approximately 40), the USA (more than 30) or the United Kingdom (20).
Over the past year, we at SingHealth Transplant have carefully studied the models for organ donation in these countries and have learnt that the most important factor to increase organ donation is engagement, training and enabling our own staff on the donation process.
We have also realised the importance of helping people understand that organ donation is not just about getting organs to patients. It is also about helping potential donors achieve fulfilment beyond this life. In a sense, live on after they have passed on.
As such, our transplant awareness programmes over the next few months will focus significantly on our own staff – so that we can be fully engaged in facilitating the fulfilling process of organ donation.
"Organ donation is not just about getting organs to patients. It is also about helping potential donors achieve fulfilment beyond this life. In a sense, live on after they have passed on."
First of all, we need to be more prepared and accepting to identify donors and make patients ready for transplantation. We also need to learn how to approach relatives of potential donors the right way and engage patients for that first crucial conversation on organ donation.
Our next key focus is on quality – quality beyond the mere areas of efficiency, speed and customer satisfaction. A very important part of it is consistency in doing exactly what we are supposed to and in how we say it.
A cluster-wide effort is necessary, and mutual internal audits can play a part in providing learning opportunities. We hope to reach standards that go way above even those set by JCI. We need to think, live and breathe quality.
Finally, we need to grow and develop the members of the multidisciplinary team in transplantation. Medical social workers, nurses, senior nurse mentors, pharmacists and intensivists are some of the key people in the team that can optimally introduce and manage organ donors and transplantations.
They are at the forefront, equipping families with the right tools, stepping in to identify potential donors and introducing the process and providing bereavement support when necessary. Transplant coordinators will also be developed further to facilitate the transplantation cycle and manage patients better.
Organ donation is a form of sharing between humanity, a gift of life. We look forward to being a part of it while we get surgically ready, learn to reach donors and up our game in managing rejection.
The end of life can mean more than a final goodbye.