UK: High-risk (deceased) organ donors used for one in four transplants

[Clark]

http://www.dailymail.co.uk/news/article-2854875/Quarter-organ-transplants-high-risk-donors-says-leading-surgeon.html

High-risk organ donors used for one in four transplants: Hundreds of patients receive body parts from drug addicts, cancer sufferers and the elderly
Hundreds of patients are being given potentially lethal organs from addicts
Surgeons even pressured to give livers from donors dying from liver failure
Bryon Jaques warned NHS drive to increase donations was flawed
Two patients died after being given kidneys from a homeless alcoholic
By SOPHIE BORLAND

Hundreds of patients are being given potentially deadly organs from drug addicts, cancer sufferers and the elderly.

At least a quarter of all transplants that took place last year involved ‘high-risk’ organs that could be damaged or infected.

One surgeon was even put under pressure by officials to give livers to patients from donors dying from liver failure.

Bryon Jaques, who worked for Newcastle upon Tyne Hospitals before emigrating to Australia, warned the NHS drive to increase donations was flawed.

Earlier this month, it emerged that two patients had died after being given kidneys from a homeless alcoholic infected with a rare parasitic worm.

The relatives of Darren Hughes, 42, and grandfather Robert Stuart, 67, say they were never told about the lifestyle of the donor by doctors at University of Wales Hospital in Cardiff.

The figures obtained from NHS Blood and Transplant, the authority which oversees donations, show that last year, 333 patients were given high-risk organs.

This represented a quarter of the 1,320 transplanted and included donors who were former addicts, cancer sufferers or those aged over 71.

The 333 figure was almost certainly an underestimate because it does not include donations from smokers, the obese or the very sexually active who may have HIV or other infections.

The numbers of ‘marginal’ organs has almost doubled in three years – there were just 181 in 2011/11.

A planning document published by the transplant authority last year stated: ‘As the number of marginal donors increases, surgeons are working increasingly at the extremes of what is acceptable.’

Experts say organs are declining in quality with more now coming from the elderly or those damaged by lifestyle.

Mr Jaques, who is a transplant surgeon and liver specialist, said: ‘We were regularly offered donors that I considered to be very high risk. We were offered organs of patients who were dying of widespread sepsis (blood infection).

‘I was offered organs from patients with a history of recent and significant high grade cancer, which has a high risk of transmission.

‘We were offered livers from patients who were actually dying of liver failure. The vast majority of transplants that do take place in the UK are successful and that’s due to the dedication and hard work of the whole transplant community.

‘But this drive to increase organ donation is fundamentally flawed. The idea is that every patient dying in hospital should be a potential donor but there are too many ‘ands’ or ‘buts’ about a lot of patients who are dying in hospitals.’

Although his transplant unit refused high-risk organs, they may well have been accepted by other hospitals, Mr Jaques added. He said hospitals were under pressure from the transplant authority to accept as many organs as possible.

Those that frequently turned them down were ‘named and shamed’ in monthly league tables and threatened with closure.

The figures from the investigation – obtained by BBC Radio 5’s 5 Live Investigates – relate only to donors who died and do not include living kidney donors who can survive with just one.

One unnamed trust rejected 72 per cent of kidneys compared with another that turned down 28 per cent.

The NHS is trying to increase the numbers of willing organ donors because so many patients are dying waiting for transplants. Last year – 2013/2014 – there were 4,655 transplants, an increase of 10 per cent on the year before.

Professor James Neuberger, a medical director for the transplant authority, said: ‘Hundreds of people each year benefit from transplants from organs or donors that could be considered higher risk.

‘Risks are considered against a background where many people die without a transplant and where transplant outcomes are improving. It’s the responsibility of transplant surgeons and the transplant team to discuss the risks associated with a transplant with their patients and to gain consent for procedures.’

DISABLED FATHER-OF-SIX AND GRANDFATHER PAID WITH THEIR LIVES
Darren Hughes and Robert Stuart died after being given kidneys from a homeless alcoholic.

Disabled father of six Mr Hughes, 42, and 67-year-old grandfather Mr Stuart were not told about the lifestyle of their donor at a Welsh NHS hospital. They died within weeks of receiving the kidneys in November last year.

The organs belonged to a 39-year-old alcoholic with cirrhosis and had been rejected by hospitals in England and Scotland before they were accepted by the University of Wales Hospital in Cardiff.

The man had died of meningitis from an unknown cause and the mystery behind his death had stopped surgeons in Leeds, Newcastle, Sheffield, Birmingham and Edinburgh from accepting his kidneys. It later emerged that the meningitis had been caused by the halicephalobus worm – which lives in soil and is found in horses – infecting his kidneys and brain.

Mr Hughes’s father Ian told an inquest into the two men’s deaths at Cardiff Coroner’s Court earlier this month that the families were under the impression the donor had died in a car accident.

Both families say the men would have been happy to stay on dialysis for the rest of their lives if suitable kidneys had not been found.