HEALTH

An acute lack of donors

PATRICIA HLUCHY February 20 1984
HEALTH

An acute lack of donors

PATRICIA HLUCHY February 20 1984

An acute lack of donors

HEALTH

Two Ontario babies who desperately needed new livers to replace their diseased ones highlighted Canada’s severe shortage of human organs for transplants during the past two weeks. Eric Middleton, an eightmonth-old infant from Amherstburg, near Windsor, Ont., was the first to receive the sought-after transplant. Eric had only a week to live when an unidentified New Jersey couple learned of his plight through the media and on Feb. 3 donated the liver of their brain-dead child. Because no suitable livers were available through the normal channels of the North American organ retrieval network, Douglas and Mary Middleton, Eric’s parents, had resorted to a twomonth telephone, mail and media blitz in which hockey star Wayne Gretzky and U.S. Ambassador Paul Robinson, among others, took up the appeal. Last week Eric, who suffered from biliary atresia, a rare, congenital disease in which the liver’s bile ducts are blocked, was in critical but stable condition, recovering from the 10-hour transplant operation at the University of Minnesota Health and Science Center in Minneapolis.

Later last week Lindsay Eberhardt was still waiting for her chance. Doctors gave the 21-month-old Toronto child three months to live because of biliary atresia. Like the Middletons, Lindsay’s parents, James and Christine, were planning to launch their own public appeal to hospitals and physicians throughout North America. At the same time, Ontario Lt.-Gov. John Aird took up their cause and gave an emotional press conference. Said James Eberhardt, a 22-year-old laborer: “People are not donating because they really are not aware of the need. From here on, it is downhill for Lindsay. She needs a liver and she needs it right away.” Physicians and organ retrieval technicians say that improved transplant techniques and the advent of antirejection drugs have dramatically increased survival rates of organ recipients and made the demand for organ transplants much greater. Dr. Michael Robinette, chairman of the Metro Organ Retrieval and Exchange Program (MORE) in To-

ronto, said that the success rate after one year for kidney transplants has increased to 80 per cent from 60 in the past three years. But of the roughly 2,500 Canadians eligible for kidney transplants fewer than 500 will have the operation this year because of the shortage of available organs. And as medical science makes further advances, there will be a greater demand for other body organs as well. Canadian physicians concede that health professionals must take action to increase the supply because the current system does not appear to be adequate. Every province has, or will soon introduce, an organ donor card, which will accompany each driver’s licence and, when signed, authorize doctors to donate any card-holder’s organs in the event of a fatal accident. Still, a Gallup poll taken a year ago indicates that only 21 per cent of Canadians had signed such a card. What is more, doctors can only take such organs as kidneys, livers, hearts, lungs and pancreases from patients—usually accident victims or people who have suffered cerebral hemorrhages—who are brain-dead but whose organs are still working. And even when a signed donor card exists, physicians must still obtain consent from the next of kin for organ donation. Because it is an emotional time, permission is often denied. Said Marty Smith, transplant co-ordinator for the organ donor program of the British Columbia ministry of health in Vancouver: “Often when the family is making the decision about whether to donate, it is at the single worst period of their lives.”

Anne Lake, a Toronto organ retrieval technician, and others say that the medical personnel who attend braindead patients in hospital intensive care units also have to become more aware of the desperate need for organs. MORE, the second-largest organ retrieval agency in the North American donor system and a provincewide service linked to eight other Canadian agencies, will not approach a bereaved family to discuss organ donation until the attending physician has already introduced the topic. But Dr. Frank Leblanc, a neurosurgeon at Foothills Hospital in Calgary, said that in Alberta physicians will not suggest organ donation to the family. Instead, they notify the hospital’s organ retrieval team or pastor to let them make the suggestion themselves.

Many doctors say that the publicity surrounding Eric Middleton and

Lindsay Eberhardt’s search for livers has increased the public’s awareness of the need for more donors. Although some doctors are concerned that there will be a public backlash against such emotional and highly public campaigns, for now the response is favorable. Said Robinette about the impact on MORE: “We are busy right now. It really has a ripple effect.”

PATRICIA HLUCHY

with

Jackie Carlos

inToronto.