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Portugal tops for donors This week, 41 years since the first national kidney transplant took place, it has emerged that Portugal currently has the second highest number of organ donors in the world, behind only to neighbouring Spain, which together place Iberia at the top of the donations list.
In just three years, the number of donating cadavers per one million citizens rose by 61 percent, from 19 in 2006 to 31 last year, according to the Portuguese Transplant Association (SPT). In total, last year organs were extracted from 329 cadavers, providing new organs for nearly 1,000 recipients, a growth of 13.3 percent in comparison to 2008. Only in Spain are the figures higher. There was also a 25 percent rise in the number of living donors in Portugal, in comparison to 2008, having risen to 65 people in 2009, mainly relatives or spouses of the patient, who voluntarily donated an organ. The “privileged relationship” Portugal and Spain share regarding transplant organs has, in recent years, been praised by national experts. Maria João Aguiar, coordinator of the National Units for the Collection of Transplantable Organs, Tissues and Cells, attributed the bilateral success to the collaboration between the Portuguese Authority for Blood and Transplant Services (ASST) and its Spanish counterpart, the National Transplants Organisation (ONT). During the first nine months of 2008 Portugal sent 30 nationally-extracted surplus organs to Spain, which for the most diverse clinical reasons, mainly incompatibilities, could not be transplanted to any individual on waiting lists in Portugal. From those, 27 people – 21 Spanish and six Portuguese nationals who were on the Spanish waiting list for a new lung – received a life-changing and in some cases life-saving transplant. Lung transplants are one of few areas where Spain exceeds Portugal. Since 1997 only 33 lung transplants have taken place in this country. In some cases Portuguese patients waiting for a lung transplant are regestered on the Spanish waiting list. In 2008 three livers were sent “urgently” from Spain to Portugal, one of which was used in a transplant in Lisbon, the other two being used in interventions in Oporto. Fernando Macário, president of the SPT, said this week that within Portugal’s National Health Service (SNS), the transplant sector was one to be proud of even though, in his opinion, the recent 60% percent growth in donors has not been accompanied by the respective growth in medical resources. Mr. Macário attributes the steady growth in donations to improved donor/compatible-recipient coordination between hospitals, and better communication with other entities involved in the process. At present, almost all Portuguese hospitals that have Intensive Care units are now equipped to collect organs. “Clearly it would be good if there were more [doctors and resources]”, he stressed, adding that the way forward for the sector entails making it a “more attractive area, with better work conditions, career prospects and different pay”. Domingos Machado, who is in charge of Lisbon’s Hospital de Santa Cruz Transplant Department said it is necessary to “maintain the quality of post-transplant patient service”, following their progress with the necessary assiduity and rigour. Portugal operates on an opt-out system, meaning all nationals are considered potential donors with the exception of those who express their opposition by enrolling on the National Non-Donor Register (RENNDA). Kidneys are the most frequently transplanted organ in Portugal. Last year 595 kidney transplants were carried out, 13 percent more than in 2008, which helped reduce the waiting list by seven percent. Despite being the least frequent intervention in Portugal, the number of lung transplants carried out also increased by 175 percent, from four in 2008 to 11 in 2009. It is hoped that a new centre dedicated to transplants at Coimbra’s University Hospital will help support the growing number of procedures. There are an estimated 10,000 people in Portugal currently undergoing regular dialysis, of which 2,000 are on the waiting list for a new kidney. Another objective Portugal hopes to achieve is to raise the number of living donors. At present living donors provide ten percent of transplanted organs in this country, though in other countries that number can reach 40 percent. Jorge Varela, who received a new kidney in December last year after three years and nine months on the waiting list, praised staff at the Coimbra University Hospital, where he underwent his transplant, describing them as “exceptional”. He told The Portugal News that the support he received throughout his ordeal, both financial and personal, was “excellent”. “It seemed like being in a dream”, Mr. Varela said of being diagnosed with serious kidney failure at the age of 26; “At first you don’t know what to expect. You get on with things but after a while reality sinks in and you feel so restricted and limited”. Mr. Varela decided to see a doctor after experiencing flu-like symptoms and high fevers. He was immediately rushed to Faro Hospital where his condition was diagnosed. “In many cases there is no specific reason for kidney failure. From what I gathered it can be one or many things put together”, he explains. Until receiving the phone call saying a new kidney had been found, Mr. Varela sat through four hours of dialysis, every other day. During the first year of treatment he was forced to travel for nearly one hour to a clinic in Faro, until a specialised clinic opened in his home city of Portimão. A taxi service to and from dialysis was provided and paid for by the SNS, which also paid for a taxi to transport Mr. Varela to Coimbra on the day of his transplant. “I got a phone call at 2am on December 20th saying I needed to go immediately to Coimbra as a kidney had been found. I asked the person on the phone if it was really true, I thought maybe it was a prank phone call”, he recalls. At 15h30 that afternoon Mr. Varela was taken into the operating theatre. He is responding well to his new kidney and respective treatment, and lives a “relatively normal life”. Along with the ARS (Southern Regional Health Administration Board) the SNS continues to pay for his medication and transport to regular check-ups in Coimbra. “Obviously, at least for the first year I have to be very careful with what I eat and drink. I quit smoking, drink lots of water and don’t drink alcohol. And I don’t eat dark meats anymore”, he tells of his recovery. While on the waiting list for a transplant one of the hardest things Mr. Varela says he had to face – and continues to face – was the discrimination within the job market. “When I was on dialysis it was impossible to find a job. Once employers found out I needed specific times for dialysis, even if it was in evenings [outside work hours] they were reluctant to employ me”. He believes a swelling left by dialysis treatment on one of his arms could also be a deterrent for future employers, particularly within the customer services sector, where “appearance counts a lot”. Nevertheless, Mr. Varela remains optimistic about the future. Throughout his dialysis he attended an electrician’s course and now hopes to sit his exams in November. He currently has a check-up every three weeks in Coimbra. These check-ups will eventually be diminished to once every three months, should he keep responding well to treatment. Like most other transplant patients Jorge Varela knows nothing of the person (cadaver) from whom he received his kidney. It is a legal requirement in Portugal to protect the identity of donating cadavers. Recipients are selected based on criteria such as age, blood compatibility, and how long the patient has been on the waiting list. Speaking of receiving his new organ, Mr. Varela explained “it’s like being born again”. “Some things you give much more value to, other things that you used to think were important become futile. Some people wait years for a transplant and never get that call. I think it’s a question of luck”. A petition has been launched to instate July 20th as National Transplant Day, to officially mark the annual anniversary of Portugal’s first kidney transplant. Carrie-Marie Bratley
Edition: 1071 |
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