'Dad has gone from Sick to Superman'

Organ donation doesn't simply save lives, in the sense of keeping people (barely) alive, but it allows them to lead much fuller, more normal lives, as this inspiring story of a father swimming from Alcatraz to shore to celebrate five years since his double lung transplant shows. It's a great example of how much of a difference a transplant can make to the recipient's quality of life, but also comes with important reminders about the limits of what transplants can achieve "The current average survival period of a lung recipient in the US and Europe is five years. Statistics say that the current 10-year survival rate of a lung transplant patient is 30%, meaning that only one out of every three patients will celebrate their 10th anniversary". Still, even five more years of healthy life is a considerable achievement, and especially valuable for someone like Gavin Maitland with young children.

A Sad, But Positive, Story

One person's death can help many others, as this example of a Norfolk man whose heart, lungs, and kidneys were donated, saving one life and improving the quality of three others. It's good to see positive coverage of the benefits of organ donation - hopefully it will encourage more people to register as donors.

Smoker's Lungs

A tragic story in the news today concerning a 27-year-old cystic fibrosis sufferer who died of lung cancer after being given a transplant from a smoker.

In this case, the family of the deceased are angry that she was not warned that these lungs came from a smoker and of the consequent risks. The Royal Brompton and Harefield NHS Foundation Trust seem to acknowledge this and apologise for not giving her the choice of whether to take these lungs or wait for a match with a non-smoker, though they do note that almost everyone given such a choice opts to take the first healthy match available rather than wait (the woman in question had already been waiting 18 months).

This, of course, raises issues regarding informed consent. It is a dogma of medical ethics that medical professionals should not do anything potentially harmful to patients without their informed consent. What it is for consent to count as 'informed' is a thorny issue, but it is clear that risks - such as those imposed here - should be explained to the patient, before the patient consents to proceed (or refuses).

Obviously the use of 'marginal' organs is less than ideal. Everyone, given the choice, would prefer young and healthy organs. However, according to statistics given in the BBC article, 40% of lung transplants involve lungs taken from a smoker. If all of these were routinely rejected as unsuitable, there would be fewer lungs available for transplant, resulting in longer waiting lists and more people dying on them.

One of the aims of my work on organ policy is to see how donation can be encouraged, in order to combat what I take to be a pressing moral problem. Increasing the supply of healthy lungs (and other organs) available for transplant could save lives. The policy challenge is to find measures that will be both effective and ethically sound. The aim of the workshops I'm organising next year is to explore some of the possibilities.