How donations of other organs match up

While local corneal donations have gone up, the number of deceased organ donors for kidneys, livers and hearts has not followed suit.

An annual average of about 16 deceased liver transplantations and 28 deceased kidney transplantations were performed from 2011 to 2015.

Heart transplantations are even harder to come by. Each year, the National Heart Centre Singapore — the only healthcare institution here that performs heart transplants — receives about 20 referrals for the procedure but only an average of three will eventually receive them.

However, Dr Alfred Kow, consultant at National University Centre for Organ Transplantation at the National University Hospital, noted an upward trend in living donor kidney and liver transplantations.

He attributed it to the lack of cadaveric organ donors in Singapore despite the implementation of the Human Organ Transplant Act, which allows for the kidneys, liver, heart and cornea to be recovered in the event of death, for the purpose of transplantation.

“In addition, as the operations for the live donors can now be done very safely, with minimal morbidity, this becomes an acceptable option for recipients who urgently need an organ transplantation,” said Dr Kow.

He added that potential cadaveric donations of vital organs such as the kidneys, heart and liver are only possible in instances of brain death. In contrast, tissues such as the cornea, bone, skin and heart valves can be donated within 24 hours of cardiac death, which is when the heart stops beating irreversibly.

Brain death, which occurs when the brain stops functioning before the heart, is accepted as the legal definition of death in Singapore and other advanced countries, according to the Ministry of Health website. With life-support technology, other organs such as the heart, lungs, kidneys or liver may continue to function for a brief period after brain death.

“Family members may feel that as long as the patient has not stopped breathing, there is a chance that he or she may recover. However, they don’t realise that the breathing process is entirely assisted by the ventilator machine. Without the machine to help breathing, a brain dead patient will stop breathing completely (which is a criterion in brain death testing),” said Dr Kow.

“Particularly in an Asian culture like ours, it could also be a case where they are not sure about the patient’s thoughts on organ donation as the topic was never discussed,” he added. “As a result, a potential donor will pass away and we will lose the chance to help save the lives of other patients who need organ transplantation.” EVELINE GAN