The first successful kidney transplant in the world was performed in 1954 and, given medical advancements in the prevention and treatment of rejection, more successful procedures have since taken place.
Malaysia has an estimated number of 48,000 dialysis patients awaiting transplants, each with an average wait period of 13 years due to the low donation rate. A scoring system, as such, has been put in place, with only about 10,000 patients eligible to receive a kidney from a deceased donor.
These figures are sobering. While the number of organ donations and transplants has risen in recent years – 2020, for instance, saw a 2% increase with 77 transplants and 16 deceased donors – it could certainly be better.
Ongoing efforts by the National Transplant Resource Centre (NTRC) have seen significant results over the past four years, among them:
- increase in transplants involving living donors and recipients in Hospital Kuala Lumpur and Hospital Selayang, owing to the prioritisation of these individuals by the health ministry in 2019;
- increase in deceased organ donations since 2018 following the restructuring of the transplant organ procurement team;
- greater education and awareness among health professionals involved in organ donations, through programmes such as Organ Donation Initiatives in Southeast Asia.
The government, which plays a big part in addressing transplant issues and the welfare of kidney patients, is working on passing a new law to regulate organ transplantation and eliminate trafficking.
And the recent health-ministry initiative of introducing pledger registration through the MySejahtera application has had a significant impact on the number of donors. An average of 1,000 pledges are made a day through the app, which also serves as proof of the deceased’s intent to donate.
While there is no data on the number of kidney pledges by age group, most living donors pledge their kidneys over their liver and other organs, giving hope for those who are suffering from kidney disease.
Myths and mindsets
Even though certain beliefs do not permit organ donation, most religions in Malaysia encourage it, viewing it as an act of kindness. Still, permissibility and mindsets are two challenges that need to be addressed in the bid to increase organ-donation pledges.
According to the NTRC, the most prevalent reasons for families refusing to give consent for deceased organ donations are concerns over body mutilation, and lack of knowledge as to what the deceased would have wanted.
To address the first point, to successfully conduct a transplant, the deceased would have to undergo surgery similar to that conducted on the living. The organ needs to be in good condition for transplant and, as such, the procedure is done in a manner that preserves the anatomy of the deceased so no obvious disfigurement occurs.
To address the second, the MySejahtera pledge system now allows users to convey their intent to be a donor.
In terms of health benefits to living donors, there’s the potential discovery of one’s predisposition to disease, or of undiagnosed conditions during the process of signing up to be a donor. Treatment and management may then commence early, staving off further complications in the future.
Ultimately, organ donation is an act of altruism that offers a new lease of life for those who need it. Unlike the kidneys, where dialysis may assure a patient’s survival, heart, liver and lung patients will not survive without transplants.
So do make the pledge to be an organ donor via your MySejahtera app.
This article was written by Mohamad Zaimi Abdul Wahab, vice-president of the Malaysia Society of Transplantation and a transplant nephrologist at Hospital Kuala Lumpur.
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