[Viewpoint]The gift of life
Jan. 2 of this year marks the first anniversary since boxer Choi Yo-sam became an eternal champion by donating his organs. The brave decision by Choi and his family served as a detonator, and organ donation by the brain-dead began to rise. This year alone, 250 people participated in organ donation programs, and more than 1,100 patients received transplants and were given the gift of new life.
There are, however, still many patients waiting for organ transplants. In the case of kidneys, patients can live for years with the help of dialysis, but those in need of a liver, a heart or a lung often die in hospital beds because no transplant organ is available. Last year alone, 989 died while waiting for organ transplants.
Recently, more and more patients have been traveling overseas for organ transplants, but the countries where they go often have poor health facilities. Moreover, some procedures often violated ethical codes. As a result, the Transplantation Society and the World Health Organization have tried to stop such practices.
In July of last year, the Istanbul Declaration announced that countries must try to increase organ donations domestically and that a fair system to distribute donated organs should be established. For Korea, 5.3 of every 1 million people donated organs last year, but the number is far lower in number than 25.2 in the United States and 35.1 in Spain.
With active promotions by the government and civic groups, many signed up as organ donors, but actual donations did not increase much.
What, then, will prompt actual change?
First, medical staff must change their attitude so that they actively recommend organ donation. In some countries, laws required that potentially brain-dead patients be reported to the government. That could be a starting place for Korea.
Some of the nation’s largest general hospitals have studied the ratio of brain-dead patients to organ donors among their neurosurgery patients. Of the brain-dead, about 36 percent could be organ donors. And yet, actual donations took place only 14.7 percent of the time.
A recent survey showed that over 70 percent of the nation considers brain-dead patients to be actually dead, showing a changed perception. If medical staff make efforts to recommend organ donation, the actual donation rate will increase dramatically.
It is also necessary to establish an efficient system to manage brain-dead patients. Some hospitals are currently authorized as specialized institutions to manage the brain-dead. Yet, only one or two specialized coordinators work in each hospital and they all work separately. Such a system is extremely inefficient.
In foreign countries, organizations are established that specialize in securing organs for transplant, and a special task force systemically pursues this goal, such as by contacting the families of potentially brain-dead patients, doing the paperwork to officially pronounce someone as brain-dead, managing brain-dead patients, extracting and transporting organs and comforting families after the procedure.
The current system in Korea lacks an ability to manage such tasks when the number of organ donations increases in the future. An independent organ donation and transplant authority should be established to designate specialists who work on this task systematically and effectively. Then, each hospital will be able to concentrate on transplantation surgeries and managing patients.
In order to establish the authority, the state must invest. The medical cost for a patient suffering from kidney failure will be reduced by 20 million won ($15,100) a year if he receives a kidney transplant.
More organ transplantation means a reduction of medical cost for the entire nation. It is a project worth the state’s investment.
Furthermore, it is never enough to emphasize the importance of education and promotion. It has already been proven in other countries that education about organ donation during childhood is crucial for active participation as organ donors. The textbooks must include content about organ donation.
It will also be helpful to educate youngsters by building a memorial for organ donors that celebrates them as heroes.
The writer is a professor of Seoul National University’s College of Medicine.
by Ha Jong-won