British Patients Are Dying from Lack of Organ Donations, but Wales Thinks It Has the Answer; as a New Campaign Is Launched to Persuade the Rest of the UK to Follow Wales' Proposed Lead and Support Presumed Consent, Health Editor Madeleine Brindley Examines Whether a 'Soft Opt-Out' System Would Be Accepted by the Public

Article excerpt

Byline: Madeleine Brindley

Q How does organ donation currently work in the UK? A The current organ donation system relies on people opting in by joining the organ donor register during their lifetime.

But even though they may have signed the register and carry a donor card, their relatives can still object and prevent organs being retrieved.

Q Why do people want to change the law? A There have been increasing calls for a change in the organ donor laws in the last few years because of the shortage of organs available for donation.

Despite increases in the number of live kidney transplants and the advent of non heart-beating donation, the organ transplant waiting list is continuing to grow and people are dying while on waiting.

It is estimated three people a day across the UK die while waiting for a transplant. In Wales someone dies every 11 days on the transplant waiting list.

The Kidney Wales Foundation's Time to Save Lives report, which outlines the argument for introducing an opt-out system, states: "There is currently an insufficient supply of donor organs to meet the demand for organ transplantations in the UK and worldwide.

"The UK active transplant waiting list is increasing, and the ageing population and increasing incidence of type 2 diabetes are likely to exacerbate the shortage of available organs."

The campaign for a change in the law has focused on the need to introduce a soft opt-out system in the UK.

Dr Richard Lewis, Welsh secretary of the British Medical Association, said: "The fact is, that people are dying while waiting for an organ transplant.

"It is vital therefore, that we increase the number of donors available, and we believe that a system of presumed consent with safeguards will do this.

"A shift towards making donation the default position would reflect a positive view of donation, demonstrating the very strong support for it within society today.

"Therefore, over time, donation would come to be seen as the norm, rather than the exception."

Q What does opt-out mean? A Opt-out, which is also known as presumed consent, means exactly that.

In the event of a change in the law, instead of opting in by joining the organ donor register, it will be assumed that everyone is a potential organ donor, unless they have opted out during their lifetime.

This may mean signing an opt out register, which would then be consulted at the time of death if organ donation is a possibility.

Campaigners believe a "soft" opt-out system should be introduced. This means that relatives and loved ones would still be consulted and would still have the right to veto.

Q Will it increase the number of organs available for transplant? A A study published by the British Medical Journal this month estimates an additional 2,880 organ donors would have been available in the last 10 years if an opt out system had been in place in the UK.

Belgium introduced a "soft" opt-out system in 1986 and increased the number of transplant co-ordinators at the same time. Just 2% of the population has opted out of organ donation - and the national rate of organ donation rose by 55% within five years.

The latest figures show there were 291 deceased organ donors in Belgium in 2007 compared to only 51 in Wales - Belgium has one of the highest rates of donors per million people in the world.

In Austria, which operates a strict opt out system with no role for relatives, donation rates per million were 21.5 in 2004, compared to 12.3 in the UK.

Kidney Wales, which is at the forefront of the opt-out campaign, believes the link between opt-out systems and more organs for transplant is compelling.

Its Time to Save Lives report said: "In 2003 a study demonstrated that presumed consent was one of four variables which emerged as a significant predictor of cadaveric organ donation rates. …