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Transplantworld 2, 2018

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Transplantworld 2, 2018 2018 | Issue 2 Transplant Games The Gift that Unites H Consent Laws – how has Spain led the world in donation H H 40 years of World Transplant Games H H ReFit for Life! Program H H Get ready for 2019! H Inside this edition 02 Board of Trustees World Transplant Games 2019: 03 Guest Editorial 09 Sports Information Presumed Consent is not the Key for Success 10 NewcastleGateshead 2019 in Deceased Donation 12 Count Down to the Games – How Prepared are You? Rosario Marazuela; Beatriz Domínguez-Gil 14 World Transplant Games 2021 04 Message from the President 15 European Transplant & Dialysis Sports 05 Fit for Life! Ambassador Martin Wong Championships 2018 1st Thailand Open Transplant Games 16 Our Story 06 ReFit for Life! A WTGF Initiative Isaac O’Kane and Living Donor Mum Michelle 07 News from Brazil 17 Member Country News 08 News from Hungary 20 Portsmouth, UK 1978 Remembered Acknowledgements Officers and Councillors Editor: Chris Thomas Sub Editor: Colleen Horan-Green Executive: Content/Article Coordinator: Karen Cole Artwork: Inkcap Design, Bath, UK www.inkcapdesign.co.uk Printer: Printech Europe Ltd, Chelmsford, UK Chris Thomas Liz Schick Colin White President Honorary Secretary Treasurer www.printecheurope.com Front cover: The Spirit of the Trustees: Colombian Team – taken at the Latin American Transplant Games, Salta 2018 Anders Billström Zachery Brooks Dr Ka-foon Chau Prof Won-Hyun Cho Olivier Coustere Vicente Granados Paul Harden André Lassooij -Cabezas WTGF Basepoint Business Centre 1 Winnall Valley Road Winchester Gudrun Manuwald- Willie Uys SO23 0LD United Kingdom Seemuller Tel: +44 1962 832560 Email: [email protected] Staff: Website: www.wtgf.org Registered Address: World Transplant Games Federation, Basepoint Business Centre, 1 Winnall Valley Road, Winchester, Hampshire, SO23 0LD, UK Registered Charity No.1179470 Company limited by guarantee Kim Renyard Gary Green Karen Cole No.10323481 Registered in England Executive Manager Sports Manager Office Administrator Page 2 GUEST EDITORIAL Presumed consent is not the key for success in deceased donation Rosario Marazuela and Beatriz Domínguez-Gil discuss issues surrounding presumed consent for organ donation olid organ transplantation is the best systems have moved on to this type of circulatory death.6 and, frequently, the only therapeutic consent. Recent examples are those of When taking a look at countries that S strategy available for patients with Argentina, Colombia, Scotland or The have changed their system towards end-stage organ failure. According to the Netherlands. presumed consent, there is no single Global Observatory on Organ Donation example where such modification has and Transplantation, almost 136,000 Key for success? derived in increased rates of organ solid organ transplants were performed But is really presumed consent the key donation, at least in a sustained manner. worldwide in 2016.1 Although impressive for success? Spain is a world leader On occasions, such change has raised at first sight, this activity barely covers in organ donation and has an opt-out negative reactions because it has been 10% of the transplantation needs of system in place since 1979. However, we seen as an attempt of the government to patients. Shortage of organs is indeed have never considered that this type of control individual’s decisions, particularly the main obstacle that precludes the full consent explains the Spanish success.3 when a strict implementation of the expansion of transplantation therapies. First, it was not until 1989 – ten years opt-out system is applied. On the other As a result of shortage, thousands of after the legislation was issued – that hand, debates about shifting towards a patients die or endure a poor quality of donation rates started to increase in our presumed consent policy may bring the life while waiting for an organ. Desperate country following the implementation of topic of organ shortage to the public patients in need for a transplant may the so-called “Spanish Model on Organ attention, but only temporarily. look for solutions in the form of organ Donation and Transplantation”.4 The On a personal note, in a country trafficking and transplant tourism, presumed consent policy is not strictly where every person in need has access practices that violate fundamental enforced either, so the daily practice more to transplantation, a law that assumes human rights and erode the image of closely resembles an opt-in system.5 the normality of donating organs after ethically sound transplant programmes. Donor coordinators must ensure that no death can only be informed positively, Transplant rates are also extremely opposition to organ donation has been as it brings a clear message to the unequal across countries, ranging from 0 recorded during the life time of potential community. But aware that what can to more than 110 patients transplanted deceased organ donors, through the make a real difference is a system where per million population in Spain.2 Advanced Directive Registries and other the right professionals are in charge of Although many factors can potentially means. An interview is always held with deceased donation, where they receive explain this variable activity across relatives of potential organ donors to appropriate guidance and training and jurisdictions, the type of consent assess if donation was consistent with are subject to a continuous evaluation system for posthumous donation has the individual´s wishes and values. In the of results, one wonders if it is worth to traditionally gathered a lot of attention. end, relatives have always the final veto devote so much time, work and attention Some countries have put in place the so and organ recovery does not take place if to such a secondary aspect as the type called opt-in or explicit consent system, this is not acceptable to the family. The of consent is. One can only conclude that whereby persons will only be considered high rates of deceased donation in Spain presumed consent is a big distraction deceased organ donors if they have are attributed to a model conceived to from aspects that are essential to ensure specifically expressed their willingness ensure the systematic identification of a broader access of patients to organs to donate their organs or if their legal opportunities to organ donation and their from the deceased.7 representatives authorize organ recovery. transition to actual donation. Deceased In countries with an opt-out or presumed donation activities have continued to Rosario Marazuela, MD, PhD; consent policy, all persons are considered increase in Spain as a result of novel Beatriz Domínguez-Gil, MD, PhD deceased organ donors unless they have strategies to further progress towards Organización Nacional de Trasplantes, expressed the opposite during their life self-sufficiency in transplantation, Madrid, Spain time. Because, theoretically, presumed as intensive care to facilitate organ consent sets down a more favorable donation, the transplantation of organs scenario to organ donation, several legal from aged donors, and donation after See page 5 for references 2018 Issue 2 | Page 3 MESSAGE FROM THE PRESIDENT Opt-in or opt-out? The controversy continues WTGF President Chris Thomas takes a look at the choices goverments have to make for their donation systems s there any cause more unifying than organ donation? Is there a photo Imore inspiring than the cover photo of this journal taken in Argentina as the Colombian team readied themselves for WTGF President Chris Thomas in Salta this year the 5k road race? I feel extremely privileged to visit behaviour in competition. I remarked it and every instance. Talking to the doctors places like Salta, Argentina for the 9th was a shame that this isolated incident in Argentina, they are very pleased with Latin American Games and, earlier in undermined the overall message of the immediate response to Justina’s Law the year, Sardinia, Italy, for the European goodwill and the spirit of the games. which was introduced in July making Transplant and Dialysis Championships. The observation alarmed me. ‘You everyone a donor. They were inspired to It is interesting that at a time when need to remember that 15 of the act after a 12-year-old girl died waiting some countries are becoming more 23 countries represented here have for a heart transplant. insular, and globalism is in retreat, organ opt-out donation systems where the However in 2015 DonateLife California donation and transplantation manages to recipients receive their organs from the in a review found a wide disparity within ‘unite the world’. At the World Transplant government.’ European Presumed Consent countries Games people attend from all walks of The clear inference was the role of the donation rates, from a high of Spain’s life and from all cultural and religious donor, and potentially their family, was 33.5 nDPM (donors per million head backgrounds. For a week, our differences, secondary to the government managing of population normalised) to a low of sometimes even prejudices, are cast a system to retrieve organs from those Greece’s 5.7, with a simple average of aside as we come together in celebration. citizens who had not opted-out. Of 12.5 nDPM. This was insignificantly The ultimate display of the generosity of course, in all opt-out countries, families different from the Explicit Consent mankind is on display. are still asked to confirm the donation average of 12.1 nDPM. The Games are a wonderful but this observation shed a different Beatriz gives us some important opportunity to say thank you to the perspective on the merits of opt-out clues for countries wishing to increase donors and their families who opted to systems. donation. Perhaps 70 per cent of the save others through such a wonderful The controversy continues in many solution lies within the hospital setting legacy. ‘Don’t take your organs to heaven, countries about what legal system – opt- where it is essential to have professional heaven knows we need them’.
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