‘Gift of life’: Bill ‘could expand organ donation, ease dialysis burden’

Barbados could soon open the door to deceased organ donation for the first time, under new legislation introduced in Parliament on Wednesday that health advocates said would ease pressure on overstretched dialysis services and expand life-saving transplant options for as many as 30 000 people at risk of kidney failure.

The Human Tissue Transplant Bill, presented in the Senate on Wednesday, would legalise deceased organ donation through a regulated framework for the removal and transplantation of human tissue.

Currently, Barbados is only able to perform living donor kidney transplants.

The new law would allow for transplantation following death, potentially expanding life-saving options for patients with end-stage renal failure and reducing heavy reliance on dialysis.

President of the Barbados Kidney Association, Sadie-Ann Sisnett, described the bill as significant, especially for people who are either on dialysis or who are expected to need dialysis.

“We have 400 persons right now currently, between SILS [Dialysis Barbados] and QEH on dialysis; you have 20 to 30 000 people living in Barbados, 13 or so per cent of our population that will need to be on dialysis in the near future. So you have stage one to stage five of kidney disease. About 20 to 30 000 persons are at stage four going to stage five, which means they will need dialysis,” Sisnett told Barbados TODAY.

The QEH lacks the capacity to manage the number of people needing dialysis, she said.

“A person that should be dialysed three times a week can only be dialysed… twice a week because literally of the amount of persons that need dialysis and the resources that we currently have. Yes, we’re outsourced to the SILS but it’s still more fast-paced than we can keep up with.”

Sisnett described the legislation as “critical” to getting more people off dialysis. 

“It’s critical to getting those persons off of dialysis. We have a living donor transplant program right now. We probably transplant about two to three a year at the absolute most, we would like to increase that to ten. Those persons are removed from dialysis, they’re persons again who are on dialysis because of lifestyle, so whether it’s hypertension, diabetes, diet, that kind of thing. 

“If we can bring that number down, if that can be reversed at the early stages, which is why testing is so important, if you can catch that kidney disease, that kidney function before it gets to a stage where it cannot be reversed, then you stop someone from having to go on dialysis.”

Renal transplant surgeon at the Queen Elizabeth Hospital, Dr Margaret O’Shea, expressed how overwhelmed with joy she felt to finally see this bill being brought to Parliament. 

“I’m overjoyed, tearful almost for the benefit that this bill is going to have to patients who are in need of organs, for the benefit of people who want to have something good happen after death, you know, as tragic as it may be, those of us who want to give of our organs if something happened to us suddenly, to help somebody else. It’s a joy that’s gonna happen from donation and also the joy from receiving — a gift of life.”

She also suggested this legislation would improve care for dialysis patients.

Founder and president of Kidney Caribbean, Allan Haynes, a dialysis patient for nine years, said if this bill becomes law, it would have a life-changing impact.

He told the story of his sister, whose kidney transplant lasted 45 years: “She just passed away recently, but she has a child and 3 grandchildren now after that, OK, so it can make a total difference to your life.”

The legislation could be life-changing, he added, particularly for younger dialysis patients.

Vice-president of the Barbados Kidney Association, Adrian Boyce, described the bill as a “watershed” moment and believes it represents a historic milestone for Barbados.

“It sets a precedent for the history of Barbados, having the Human Transplant Bill passed after all this time. Indeed, it will not only take us to the next level internationally in terms of optics, but it also saves lives at the end of the day, not only for kidney patients, but also those persons who will need other transplants, whether the liver or any other organ, once there is the specialist and the surgeon available to do the actual operation. We’re definitely in the right direction.”

Sisnett also explained what this means for people with renal failure who are on dialysis and whose lives are constantly disrupted or on hold.

Many of these dialysis patients are of working age and have had to stop working or significantly reduce employment.

“Having deceased donation means then that these persons can find the donor, find someone who matches, and they can actually go back to their lives. They’re persons who are the sole breadwinner of their family. How can you have a family, support a family on welfare, and live a meaningful life?

“You can go back to work… If you talk to persons, that’s what they really want to do to be able to support themselves and get back to living normally.”

These people who are unable to work contribute to declining national productivity, she said. 

According to the kidney care campaigner, a transplant is also about restoring people’s quality of life:

“To be able to get persons off of dialysis and back into being a productive member of society, being able to, again, make money, have children, take care of their household, just do what they normally do, and they did before dialysis. That is an incredible, incredible thing.”

Sisnett used herself as an example of the impact receiving a kidney transplant has had on her life:

“I got married, it was nine years before my husband and I could have a child because I only could do it after my transplant. So again we have a fertility issue. Our birth rate is going down, and we have persons of that childbearing age on dialysis and more about to be on dialysis.

“So there are so many instances in society; it’s not just a health issue problem, it is a productivity problem. It is a cross-sectoral issue that we need to get our minds around in terms of what this bill could mean for not just families and people; that is important for our entire society.”

 

(LG)