Families Resist Hospitals' Attempts To Encourage Organ Donations

By Ran Reznick

The success of various hospitals in Israel in getting agreement from families to harvest organs for transplant from their deceased relatives varies greatly, according to data the Health Ministry's National Center for Transplants gathered over three years.

The statistics, now published for the first time, show that gaps exist even among hospitals of similar size in the same geographic area that admit similar numbers of victims from traumas like traffic accidents, which are potential post-mortem organ donors.

The heads of the Israel Society of Transplant Surgeons met Health Minister Dan Naveh yesterday to apprise him of the severe problems in the field of transplants in Israel and to object to the fact that the National Center for Transplants has failed to significantly increase the number of organ donors in Israel.

Two weeks ago, Haaretz reported a 20 per cent fall in post-mortem transplants last year. By mid-December the organs of only 52 patients had been transplanted, the smallest number in five years.

Hospital administrators, senior transplant surgeons and nurses, and the National Transplant Center data all indicate that the attitudes of hospital administrators and medical personnel, are highly important elements in increasing organ donations.

The work of transplant coordinators in educating hospital personnel to locate potential transplant patients, and successfully raise the issue with families, has a very great influence on families' decisions to donate organs, senior medics say.

They also note the effect of attitudes to transplants among differing ethnic groups, especially the ultra-Orthodox, who rarely donate organs.

About 1,000 patients are on waiting lists for organ transplants, especially for kidneys. About half of all kidney transplant patients in Israel strive to obtain the organ illegally from surgery carried out in Africa, Turkey, Eastern Europe, or South America.

Health Ministry statistics show that Rambam Medical Center in Haifa, with 11 agreements for organ harvest, and Beilinson Hospital in Petah Tikva with 9, have harvested the largest number of organs for transplant in the last three years.

Of the large hospitals, Sheba Medical Center, Tel Hashomer, has registered a major drop in organs harvested for transplants - in 2003 only two families allowed organs to be harvested from deceased relatives. At Ichilov Hospital in Tel Aviv, only three families agreed to donate organs last year.

Registered Nurse Anat Glaser, who was transplant coordinator at Sheba Medical Center until September 2003, says awareness and cooperation on the part of hospital administration are extensive at Sheva, but for inexplicable reasons a large number of families have refused organ harvests in recent years.

Soroka Medical Center in Beer Sheva is one large hospital with a small number of organ harvests relative to its size, and senior Soroka officials admit failures in this area over the past few years.

Hadassah University Hospital in Ein Kerem is another hospital with a small number of organ harvests, especially considering the large number of trauma patients it admits from the Jerusalem area.

Among the smaller hospitals, the most impressive success rate in obtaining permission for organ harvests was at Schneider Children's Medical Center in Petah Tikva. Schneider had the largest number of agreements for organ harvest both in relation to the number of beds (2.2 per cent) and in relation to the number of deaths (4.4 per cent).

At a conference on organ harvesting a month ago in Herzliya, Prof. Pierre Singer, chief of Intensive Care at Beilinson Hospital, said his research showed a considerable number of doctors, including neurologists and ICU specialists, are ignorant when it comes to transplants and determination of brain death - one reason for the gap between the potential for organ donation and their actual harvest for transplant.

"We have to organize differently in hospitals and strengthen the weak points in the functioning of every hospital," Prof. Singer told Haaretz.

Copyright © Haaretz.

This article posted February 4, 2004.