You might gladly give up a kidney so your child can have chance of a normal life – but could you? And would anyone else? Here’s a look at what’s creating an organ donor dilemma in South Africa.
Kidney disease affects over 500 million people worldwide, and can affect people of any age. When someone’s kidneys fail, they can be treated through Renal Replacement Therapy (RRT), which includes: haemodialysis, peritoneal dialysis, and organ transplantation.
Organ donation refers to when a person allows any of their organs to be removed, legally, with their consent while they’re alive or with their next of kin’s consent if they’re deceased. Every healthy individual can donate some organs or organ parts while alive, such as their kidney, a part of their liver/lung, as well as tissues, blood and bone marrow.
The dilemma of organ donation: why more transplants are crucial
Dialysis is an expensive, ongoing treatment that requires significant time and medical expertise to manage. This makes a kidney transplant the best option of RRT for the patient, both for quality of life and cost-effectiveness.
According to World Health Organization, kidney transplantation is by far the most frequently carried out transplantation globally. The only problem is, organ transplants are few and far between in South Africa – for two main reasons:
1. South Africans are reluctant to donate their organs
Sadly, the negative public perception of organ donation, fed by scandals reported on by the media about illicit the sale of organs, and also religious and cultural beliefs around donation of body parts, mean that organ donors – living or deceased – are few and far between.
Even for registered donors, familial consent is still required in South Africa after brain death, and referrals from ICUs are often halted when families refuse permission.
There are currently about 4 300 South African listed, eligible adults and children awaiting a life-saving solid organ and cornea transplant. In 2017 only 361 solid organ transplants took place across the organ spectrum, of which 249 were kidney-related.
“We have 240 000 donors on our recently-established register and probably three times as many in people who have informed their families of their wishes to donate their organs, but haven’t registered,” says Samantha Nicholls, Executive Director of the Organ Donor Foundation.
“It’s important that people register so we have a true sense of our organ-donor pool and the work that needs to be done to raise awareness so that more patients can access life-saving donor organs.”
Dialysis for everyone – at R250 000 per year per patient, before drug costs and excluding any hospital admissions – would require the national healthcare budget to fund,” says nephrologist Professor Graham Paget.
“Kidney transplants are preferable. And, we have no shortage of unexpected deaths in South Africa, so the potential donor pool is vast. The South African public seem to be simply not open to organ donation, so our hands are tied.”
2. Lifestyle-related chronic diseases are making adults unhealthy donors
A few (though not enough) people are open to organ donation, or would be if it was for their child, parent or a loved one. Humans only use about a quarter of their current kidney function (if the kidney is healthy), so any healthy individual can easily function with just one kidney and still have kidney function in reserve.
This makes donating a kidney a no-brainer – the only problem is, lifestyle-related diseases are making more people too unhealthy to become living organ donors to loved ones in need.
“Poor lifestyle choices are accelerating the progression of Chronic Kidney Disease (CKD) and causing an explosion in its rates,” says Professor Errol Gottlich, a paediatric nephrologist who also works as Clinical Manager of Discovery Health’s KidneyCare programme. This means many potential donors are disqualifying themselves through unhealthy behaviours – and damaging their own kidneys in the process.
Want to actively care for your kidneys?
Follow these 8 lifestyle habits that promote kidney health to keep your kidneys in optimal condition.
“South Africans have to realise that something has to give,” Professor Paget concludes. “Either we must become a super fit and healthy nation, and eradicate Chronic Kidney Disease, or look seriously at becoming a nation willing to providing organs to those in need.”
Remember, every organ donation is a gift of life for somebody in need. For more information on how to become an organ donor, call the Organ Donor Foundation of South Africa on their toll-free number on 0800 22 66 11 or visit their website.
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Brian Anderson, is a minor walking miracle. He's had 93 operations, including two kidney transplants and been on intermittent dialysis for 22 years. He's passionate about raising awareness around Chronic Kidney Disease and organ donation.
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