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Discuss about the Organ Donation Rates And Transplantation In Australia.

Deficit Of Kidneys For Transplantation In Australia

Kidneys are specialized bean shaped organs that are located on either sides of the backbone or the spine. They form part of the urinary system that is responsible for excretion of waste products from the body. Kidneys are actually some of the unsung heroes in the human body due to the many functions they carry out. Some of the important roles that are accomplished by the kidneys include but not limited to: They are responsible for extracting excess fluids so as to make urine. Kidneys also control blood pressure .They are also responsible for filtering waste products from the body as well as control of the fluids that are found in the body. Kidneys also assist in the production of red blood cells as well controlling the levels of different salts in the body such as the potassium, calcium and finally phosphorous. Kidneys also regulate the synthesis of vitamin D.

There are circumstances under which the kidneys might fail to carry out their designated functions. The scenarios that can lead such occurrences include sudden loss of excessive blood especially during surgery, an accident of certain infection. An immediate alteration in the functioning of the kidneys is known as acute kidney injury and it is often temporal and rarely would there be lasting damages to the kidneys. The functions of the kidneys deteriorate with time or years .It is due to this fact that it is referred to as chronic kidney disease which is also abbreviated as CKD. This is seen as a silent disease since there are no visible signs and symptoms. Some people even end up losing more than 90% of the kidney functions before they experience any signs and symptoms.

There are several signs and symptoms pertinent to kidney failure. The most notable ones however include alteration in the sexual functions, loss of weight, nausea, itchiness is also a common occurrence. Sleeplessness, irritability, impaired memory and concentration, fatigue and the retention of excess fluids that lead to difficulties in breathing and swelling are the common signs and symptoms of the kidney failure. Whenever a patient does not feel good enough to lead a normal lifestyle due to excess fluids and swelling, there is a procedure called dialysis that is initiated. According to research, there are 2000 people in Australia that are subjected to dialysis or kidney transplants in a single year. Studies further established that there are 21000 people in Australia that are subjected to dialysis or living with transplants (Sypek et al., 2018, p. 102).Majority of the causes of kidney infections or failure include diabetes, High blood pressure, nephritis and the polycystic kidney disease.

Ethical issues

There are different treatment options of the kidney. The type of treatment option utilized depends on the stage of the affected kidney. The end stage is the most notable one and it is characterized by the inability to get rid of excess of fluids and other waste products. This is very serious and the best treatment option include replacement of the kidney. Other patients would however opt against either dialysis or transplant then settle on supportive care. Under this option, the patient is supposed to be subjected to different medications and diet so that the symptoms can be well managed. Kidney transplantation involves the transfer of a kidney from either a living or deceased donor into the body of the patient. Dialysis on the other hand has several options and they include home dialysis or the center based hemodialysis. Home dialysis can either be peritoneal dialysis or home hemodialysis. The most effective mode of treatment for kidney failure remains to be the kidney transplant. This is only effective however, if the patient is suitable for the option. When compared to other modes of treatment, kidney transplantation increases the life expectancy and the quality of life of the patient.

It is a very critical condition whenever one of the organs in the body fail to perform their designated functions. It is the role of the nurses to ensure that the patient is kept a live for quite some time. This may call for the replacement of the organs (Lawton, McDonald, Snelling, Hughes, & Cass, 2017, p. 345). According to statistics, there are over 2000 people in Australia who are on the waiting lists to receive kidney transplants, heart, liver, lungs and other vital organs in the body. The core reasons as to why most of the patients are on the waiting lists is due to the fact that the organs needed for transplants are not enough (Sypek et al., 2018, p. 102). When compared to other developed countries, Australia stills lags behind when it comes to organ donation (Alexander, Clayton, & Chadban, 2017, p. 891). Some of the issues that lead to a deficit in kidneys include ethical issues that surround donation and unwillingness of donors due to lack of proper incentives.

The main reason as to why the three countries have an established rates of kidney transplants is that they established different reform models that favor the exercise .The key reforms include an appropriate legal as well as ethical framework that guides kidney transplantation (Nivison-Smith et al., 2016, p. 286). There are also good established national coordinating bodies in the said countries. Besides, these countries also offer specialized training to healthcare specialists on how to manage deceased donation and hold donation conversations (Ghinea et al., 2018, p. 5). There is also media engagement as well as the national community awareness and education about kidney transplants.


Studies have established that the rate of kidney donation in Australia ranges between eight and ten donors out of a million of the Australian population. This facts and figures are very worrying as compared to other developed nations like Spain, Croatia and finally Portugal (Allen & Pleass, 2017, p. 287). According to studies, there were only 202 organ donors in Australia in the year 2006.It was established during the same year, there were over 2000 people on the waiting lists. Out of the 2000 on the waiting lists, about 100 would die annually while they are still waiting for the kidney transplantation (Peng et al., 2016, p. 11). Those who are always lucky enough to go past the transplantation often experience a dramatic turn round in the quality of life. Studies have found out that the average survival for five years after kidney transplantation is 97%.This statistics are quite satisfactory.

Studies have tried to dig deep and establish the reasons as to why there shortage of kidneys for transplantation. One of the leading reasons is absence of suitable donors (Kausman et al., 2016, p. 936). Studies have established that most of the organs for transplantation are from dead donors especially those who died through accidents whereby their brains are declared dead but the heart and other organs are still functional since the heart is still pumping blood to these organs (Peng et al., 2016, p. 9). Most of the deaths however are due to cardia arrest where the heart can no longer pump blood to organs such as kidneys rendering them dead and unsuitable for donation (Tong et al., 2016, p.6). Another reason behind the deficit in the kidneys for transplantation is the fact that the donors do not have any immediate benefit when donating the kidneys apart from the desire and willingness to assist.

There are several issues that surround donation of the kidneys. These ethical issues negatively affect the transplant process. One of the ethical issues is proving consent. Consent is the wish of the deceased on what they would prefer to be done to them when they are dead. In this context, it involves as to whether the deceased wished to donate their kidneys while they are dead. According to studies, it is usually difficult to prove if indeed the deceased wished to donate their organs. Even if by any chance the deceased wished to donate, there is usually a hurdle to prove that consent (Feiler, 2017, p. 354). A mere expression of a desire is not enough to warrant donation of the organs. According to the Law in Australia, it is the relatives who should consent the donation on behalf of the donor. However, rarely would the relatives do since they are not sure if the deceased wished so.

There are those situations whereby the deceased actually did consent to donate his or her kidneys. However, relatives opt against the exercise since they perceive the procedure as being ghoulish and squeamish (Mancini et al., 2015, p. 391). Majority of the doctors are always to reluctant to press the relatives on. According to studies, difficulties in obtaining consent has inhibited about a third of suitable donors who died to donate their kidneys. This research was conducted by the Donor Advocacy Group, Australians Donate.

The Australian government has taken a step to solve the consent debacle by setting up what is known the National Organ Donor Register. This initiative was set up two years ago. It works by motivating willing donors to enter details on the type of organs they would wish to donate or not (Hughes, 2002, p. 331). Once the willing donor has entered his or her details in the register, there is usually a special card that is sent to them so that they carry it along with them in the wallet. This register is legal proof and it therefore makes it easier for the relatives to know the deceased wishes.

All in all, kidney donation is a very lucrative venture for both the doctors and the families. It is for this reason that a scheme known as National Organ Donation Collaborative was established a year ago so that the whole process is as smooth as posiible.22 participating hospitals have so far implemented the initiative so as to speed up the consent process and identify potential donors (Darrow, Sarpatwari, Avorn, & Kesselheim, 2015, p. 281). The initiative has seen a 36% increment in the number of willing donors.

Conclusion

The kidneys are one of the essential organs in the human body. There are normally two functional kidneys that are located behind the spine. Kidneys have numerous roles in the body. They are responsible for regulating blood pressure, excretion of waste products, production of red blood cells and the control of vitamin D. However, there are certain conditions that alter or affect the normal functioning of the human kidneys. They include diabetes and high blood pressure. Kidney failure is the condition that describes impairment in the kidney functions. The condition is chronic or silent since symptoms take time to be realized. There are three major treatment options for kidney failure and they include dialysis, home based care and finally transplantation. Home based care includes the use of medications while transplantation is the transfer of a kidney from a donor into the body of the patient. According to studies, transplantation is the best mode of managing kidney failure if at all it is successful. Studies have found out that there 97% chances of improving the quality of life for a period of five years after the transplant. Despite transplantation being the best mode of treatment in kidney failure, there is a deficit of kidneys in Australia as compared to other developed countries like Spain, Croatia and Portugal. In 2006 for example, research found out that there were only 202 kidneys for transplantation as compared to over 20000 people who were on the waiting list. Several reasons have attributed to the deficit of the kidneys for transplantation. One of the key reasons is that the organs are few since most of them are from dead donors. Most donors however die due to cardiac arrest and this means the kidneys are also dead by the time of the transplant. Another reason is the ethical issues that surround donation .Finally, there are no benefits to the donors and they only do so with the aim of assisting. Australia should take a bold step and emulate countries like Croatia, Spain and Portugal since these countries are a step ahead on matters concerning organ donation.

References

Alexander, S. I., Clayton, P. A., & Chadban, S. J. (2017). Organ Transplantation in Australia.

Transplantation, 101(5), 891-892. doi:10.1097/tp.0000000000001621

Allen, R. D., & Pleass, H. C. (2017). Improving organ donation rates and transplantation in Australia. The Medical Journal of Australia, 207(7), 287-288. doi:10.5694/mja17.00590

Darrow, J. J., Sarpatwari, A., Avorn, J., & Kesselheim, A. S. (2015). Practical, Legal, andEthical Issues in Expanded Access to Investigational Drugs. New England Journal of Medicine, 372(3), 279-286. doi:10.1056/nejmhle1409465

Feiler, K. (2017). Replacement Parts: The Ethics of Procuring and Replacing Organs in Humans. The National Catholic Bioethics Quarterly, 17(2), 353-354. doi:10.5840/ncbq201717232

Ghinea, R., Nesher, E., Aizner, S., Gurevich, M., Mehjibovsky, V., Tennak, V., & Mor, E. (2018). Successful Kidney Re-Transplantation of a Transplanted Kidney 9 Years after the First Transplant. Transplantation, 102, S548. doi:10.1097/01.tp.0000543404.06687.f3

Hughes, J. (2002). Transplantation Ethics: R M Veatch. Georgetown University Press, 2000, pound46.75, pp 427. ISBN 0-87840-811-8. Journal of Medical Ethics, 28(5), 330-b-331. doi:10.1136/jme.28.5.330-b

Kausman, J. Y., Walker, A. M., Cantwell, L. S., Quinlan, C., Sypek, M. P., & Ierino, F. L. (2016). Application of an epitope-based allocation system in pediatric kidney transplantation. Pediatric Transplantation, 20(7), 931-938. doi:10.1111/petr.12815

Lawton, P. D., McDonald, S. P., Snelling, P. L., Hughes, J., & Cass, A. (2017). Organ Transplantation in Australia. Transplantation, 101(11), e345-e346. doi:10.1097/tp.0000000000001911

Mancini, M. E., Diekema, D. S., Hoadley, T. A., Kadlec, K. D., Leveille, M. H.,

McGowan, J. E., … Sinz, E. H. (2015). Part 3: Ethical Issues. Circulation, 132(18 suppl 2), S383-S396. doi:10.1161/cir.0000000000000254

Nivison-Smith, I., Bardy, P., Dodds, A. J., Ma, D. D., Aarons, D., Tran, S., … Szer, J. (2016). A Review of Hematopoietic Cell Transplantation in Australia and New Zealand, 2005 to 2013. Biology of Blood and Marrow Transplantation, 22(2), 284-291. doi:10.1016/j.bbmt.2015.09.009

Peng, X. (., Kelly, P. J., Mulley, W. R., Pleass, H., Pilmore, H., & Webster, A. C. (2016). Donor Characteristics of Pancreas Transplantation in Australia and New Zealand. Transplantation Direct, 2(9), e99. doi:10.1097/txd.0000000000000610

Peng, X. (., Kelly, P. J., Mulley, W. R., Pleass, H., Pilmore, H., & Webster, A. C. (2016). Donor Characteristics of Pancreas Transplantation in Australia and New Zealand. Transplantation Direct, 2(9), e99. doi:10.1097/txd.0000000000000610

Sypek, M. P., Clayton, P. A., Lim, W., Hughes, P., Kanellis, J., Wright, J., …

McDonald, S. P. (2018). Factors Associated with Time to Deceased Donor Renal Transplant Waitlisting or Living Donor Transplantation in Australia. Transplantation, 102, S576. doi:10.1097/01.tp.0000543451.96384.99

Tong, A., Budde, K., Gill, J., Josephson, M. A., Marson, L., Pruett, T. L., … Chapman, J. R. (2016). Standardized Outcomes in Nephrology-Transplantation. Transplantation Direct, 2(6), e79. doi:10.1097/txd.0000000000000593

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