A new start for organ donation

MANILA, Philippines – Should sudden tragedy befall their loved ones – say a fatal accident or a stroke – only one in 10 million Filipinos would donate any of their organs to those who need it to live.

Compare this with a country like Spain, where as many as 350 of 10 million Spaniards in their last throes shared their organs in 2005.

The Philippine government, through the Department of Health (DOH) and private-sector partners, is hoping to improve the country’s numbers in organ donation starting next year, especially with the notable rise in illnesses like chronic kidney disease (CKD), a cousin to hypertension and diabetes that often deteriorates to an end-stage condition requiring kidney transplantation.  

Harvesting the organs of the “brain dead” to give new life to the sickly is the tough new proposition to meet the growing needs of Filipino patients for organ transplant, and to turn around the country’s besmirched reputation in recent years because of alleged organ-trafficking activities.

A tough order, but doable, says international organ transplant surgeon Dr. Maria Vanessa de Villa, a main architect of the newly launched DOH program on organ donation from deceased donors.

She estimates that it might take several years for the program to see optimal results as shown in other countries, an assessment that is drawing some concern among fellow practitioners.       

De Villa said the new program doesn’t have to start from scratch. It already has the experiences of Western countries to take its cue from.

There is also the grim advantage of having a constant donor pool among people dying from instant, unexpected causes in the country. The tens of thousands of people dying from road accidents and strokes per year in the Philippines may suffice, says De Villa, to serve the needs of transplant candidates.

Dr. Albert Chua of the Philippine Society of Nephrology (PSN) estimates that even if only 10 percent of the estimated 8,000 annual deaths from vehicular accidents can be tapped for deceased donation, it is enough to wipe out the waiting list for kidney transplant in two to three years. 

At the heart of the deceased-donor program is the Philippine Network for Organ Sharing (PhilNOS), the main coordinating body for all activities under the program, particularly in dealing with organ-procurement organizations (OPOs).

PhilNOS will work with four OPOs which will do the groundwork of seeking out and processing candidates for organ donation in assigned areas in Metro Manila and later on in the provinces.

“Outside of Metro Manila, we will have ignition points where we could begin, in places like Davao, Naga, Cebu, and Iloilo in the south, and Tarlac and Ilocos in the north. We just need to focus on hospitals in these areas,” De Villa says.  

The DOH is initially allocating P20 million for the program. Not that sizeable, admits Dr. Ernie de Vera of the DOH National Center for Disease Prevention, but projected to rise over the next few years.

An important investment, he says, will be the full computerization of the donor-allocation process to ensure credibility. 

PhilNOS was created by virtue of a DOH directive, AO 2010-0019, issued alongside another AO that further tightened the restrictions on living, non-related organ donors (LNRDs), who are at the center of allegations about organ commercialization in the country.

Restricting LNRDs clears the deck for the deceased donor program to work. De Villa acknowledges that the perennial lack in organ supply has caused LNRDs to proliferate.

“You only resort to LNRDs after you have fully exhausted the potential of deceased donation,” she says.