Organ Transplantation: Comparison in the US and UK

Organ
Transplantation:
Comparison in
the US and UK
Amanda Goodwin
Summer 2011
N4003: Comparative Healthcare:
Nursing in Northern Ireland

Sunday, May 29, 2011

1. Organ Donation Basics
2. The Organ Shortage
3. Statistics Objectives
4. Awareness
5. Conclusion


Organ Donation
Basics


Basics
• Organ donation is a critical form of treatment for
end-stage diseases all over the world.
• Organ donation saves and transforms lives.
• The US and UK share similar and dissimilar
problems regarding organ donation.
• Both the US and UK have ways of raising donation
awareness, which is critical to continuing organ
donation.
• There are large organ shortages in both countries,
and as a result, people are dying daily.


The Organ Shortage


The World Health
Assembly is concerned
“at the growing
insufﬁciency of available
human material for
transplantation to meet
human needs.”


The Organ Shortage
• Not enough organs =
patients die on the waiting
list = countries’ death rates
increase = problem on two
different levels, affecting
people and politics.
• Not enough organs =
people start devising
illegal programs of organ
procurement


Causative Factors
• Not all organs are transplantable due to factors related to type/
timing of death
• Due to improving health care and technology, more people
needing organs are alive when typically they may not have
survived.
• Many people postpone registering and telling their families their
wishes
• Not enough organ transplant sites - lack of ease of access,
organ viability after harvest becomes more difﬁcult. (Ex. - In
Ireland transplants can only occur in Dublin)
• Uneducated staff - in Causeway Hospital in 2010, 11
transplantable patients were overlooked


UNOS & the NHS Organ Donor Register

• NHS Organ Donor Register - conﬁdential,
computerized database which holds the wishes of
over 11 million people. It is used after a person has
died to see if they wanted to be an organ donor, and
if so, which organs.
• Donated organs can go to anyone in the entire UK.
• NHS Organ Donor Register is the equivalent to the
US’ UNOS (United Network of Organ Sharing)
• There are 11 regions in US. Organs go to candidates
in the donor’s own region.


Illegal Organ Transplant

• World Health Organization estimates
$100-200,000 is paid for “underground”
purchases of healthy organs
• Ethical breach risks at all stages
• Theft of cells, tissues, and organs
• Cells, tissues, and organs should all be
donated freely with no beneﬁt of money or
other forms of payment.


Global Connection

• Theory that initiating global organ transplant
would provide more organs producing a higher
rate of transplants + ability to procure organs
that are more speciﬁc recipient matches
• Organ viability time/travel distance limits these
efforts
• Makes the consideration of shipping/storage
important to remember


Deceased vs. Living Donors
• In the US, the number of renal/kidney transplants from
live donors exceeded those from deceased donors for
the ﬁrst time in 2001.
• There is a need for more epidemiological data and more
global transparency “especially with regard to the
longterm health, psychological, and socioeconomic
consequences for both living donors and recipients.”
• The US has shown progress for self-sufﬁciency in
transplants by meeting these needs via altruistic
donations.


Statistics


US vs. UK Statistics

• The US leads the world - including all of Europe -
in number of transplants performed.
• 111,375 people in the US are waiting for organs.
6500 die each year waiting.
• 10,000 people in the UK are waiting for organs.
1000 die each year waiting.
• 40% of US population are registered donors.
28% of UK population are registered donors.


US vs. UK Statistics cont’d

• The only Irish hospital that performs all types of organ
transplants is located in Dublin.
• Over 200 hospitals in the US perform all types of
organ transplants.
• Both the US and Northern Ireland’s goals are to
double their donor list by 50%.
• The US has increased their list by 37% since 2007.


Awareness


Problem

• In the UK, 600-700 liver transplants occur per
year. In the past 20 years, the number of people
needing transplants has increased by 90% but
the number of available donor organs has
remained the same.

• Q. What do experts believe the problem is?


Advocating Organizations

• In the United States, one non-
proﬁt organization per region
(eg, Lifebanc in NE Ohio)
advocates awareness
• In Great Britain, the
government’s Public Health
Agency promotes the Organ
Donor Register, in addition to
independent charities.


NE Ohio’s Lifebanc
Annual Gift of Life Walk & Run, 2010

Without A Transplant


Conclusion

• Similarities?

• Differences?


Discussion

• Which country has the best system for organ donation/
transplantation?
• Which country would you rather live in, if in need of a
life-saving transplant?
• How would you help decrease the organ shortage?
• What are the highs and lows of both countries’
programs and policies?
• What are your questions about organ transplantation?


References
• www.unos.org
• www.en.wikipedia.org
• www.donatelife.net
• www.organdonation.nhs.uk
• www.dk.gov.uk
• www.transplantliving.org
• optn.transplant.hrsa.gov
• Mary McAfee, specialist nurse, NHS Blood & Transplant
• Photos: Amanda Goodwin


Organ Transplantation: Comparison in the US and UK

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