Not enough organ donors, laments foundation

The health ministry says that Malaysia has the highest number of patients per capita requiring dialysis, with half of those needing kidney transplants. (Bernama pic)

PETALING JAYA: An organ foundation has raised concerns regarding the low number of pledged organ donors despite the rising number of patients.

According to the health ministry, Malaysia has the highest number of patients per capita requiring dialysis, with half of them needing kidney transplants. However, Malaysia also has the lowest number of pledged organ donors in the world.

Speaking to FMT, Dr Fadhlina Zakaria of the National Kidney Foundation Malaysia (NKF) said more than 20,000 patients are on the waiting list for organ transplants, about 90% of whom for kidney transplants, while the rest require other organs such as liver, hearts and lungs.

Fadhlina said the number of patients in the final stage (stage five) of chronic kidney disease has been increasing in the past few years, while the number of kidney transplants remained low.

She said that fewer than 300,000 people are organ pledgers.

“A dialysis patient spends 12 to 15 years waiting for a kidney transplant. This is for people less than 60 years old; after 60 they are no longer on the waiting list,” she said.

The long wait leaves patients exposed to further complications, such as cardiovascular diseases. Many patients died of heart attack and stroke, as these are the top causes of death,” she said.

Fadhlina said the lack of knowledge on organ donation is the main issue that prevents people from pledging.

“Poor understanding of the risks and benefits of this programme make patients and caregivers not keen to venture on this option.”

Malaysia currently adopts a soft “opt-in” system for organ donations. Explicit consent from the organ donors or next of kin must be obtained before a deceased’s organs could be removed, she said.

“Donors must register their choice to become an organ donor, and those who do not register are presumed to be a non-donor. However, due to lack of understanding, many organs were not able to be harvested as the next of kin withdrew the consent.”

On the issue of black market organ trade, she said it would be difficult to tackle as many patients are desperate to live a normal life, which makes them resort to this option.

“As long as there is demand, there will be people to take advantage of these desperate patients.”

Fadhlina added that efforts to initiate or enhance deceased donor transplants were essential to minimise the burden on living donors.

“Educational programs are useful in addressing the barriers, misconceptions and mistrust that currently impede the development of sufficient deceased donor transplantations.

“NKF has a regular programme to encourage organ donation mainly targeting the pre-dialysis and dialysis patients to take up living transplant as the best option for treatment.

“NKF also does a road tour to universities and colleges to encourage youth to become pledgers regularly,” she said.

She also said that recovered Covid-19 patients could also become pledged donors.