Why Hongkongers should donate organs and how they can help
Traditions and misconceptions pose obstacles in city with one of the worst donor rates in the world
It is commonly known that the rate for organ donations in Hong Kong is shockingly low. There were only 5.8 donors for every one million residents last year, down slightly from 6.1 in 2013 – placing Hong Kong among the least donor-friendly places in the world.
A poll conducted by the Department of Health last year showed that traditional beliefs – based on a taboo about death in Chinese culture – and other misconceptions about organ donation procedures were reasons for the low donation rate. Most people who said they would refuse to donate organs said they wanted a “dignified” funeral and to be buried as a full corpse, or were worried that a decision to make a donation would be opposed by older family members. The department’s study found some also worried that their appearance might be affected after the donation or that doctors would not try hard enough to save their lives if they were a registered donor. The study also found that men were more reluctant to donate organs than women. Men in their 50s with incomes below HK$20,000 a month who were divorced or lived alone were least likely to donate.
In Hong Kong, almost all vital organ transplants take place at Queen Mary Hospital in Pok Fu Lam, with the exception of cornea transplants, which are usually carried out at the Eye Hospital in Kowloon, and bone and skin transplants, which take place in all hospitals.
- Over 2,000 patients waiting for vital organs
- 225,149 people registered to be organ donors, just 2 per cent of the local population
A corneal transplant can help restore vision in patients who suffer blindness or opacity. But the organ has the shortest time span for donation. It has to be harvested within 12 hours of cardiac death. People who are short- or long-sighted can make a donation.
Recipients of a heart transplant are usually those with serious heart disease and who can no longer respond to medical treatment. But there are many limits to a heart transplant. For one, the deceased donor has to be declared brain dead and with no history of heart disease. The blood group and body size of the donor needs to be compatible with those of the recipient.
A non-smoker is the ideal donor but due to an extreme shortage of the organ, doctors now also consider accepting donors who smoke in order to save lives. But hepatitis carriers cannot be considered for lung donation. Patients who suffer end-stage pulmonary or pulmonary vascular disease require both a heart and a lung transplant.
Kidneys are in greatest demand as most of those on the waiting list need such an organ.They often suffer kidney failure and need dialysis, which is demanding, time-consuming and expensive. Those lucky enough to receive a new kidney need to wait an average 51 months. A donor must have no history of renal disease and have normal renal function. Hepatitis carriers can donate a kidney to a patient who is also a hepatitis carrier.
A patient who suffers terminal liver failure needs a new organ to save his or her life. A donor has to have no history of chronic liver disease and have normal liver function. Traditionally, hepatitis carriers are not suitable for liver donations but doctors will now consider accepting donations from carriers to save lives.
Bone grafts can be removed from deceased or living donors and used in skeletal reconstruction after tumour resection, traumatic bone loss or joint replacement. Bone grafts must be removed from donors within 12 hours of cardiac death, then sterilised through gamma irradiation and stored at -80°C for up to five years or for a longer period through freeze-drying.A donor cannot have serious infections or be a long-term bedridden patient.
Skin grafts can be used to treat severe burns and for reconstructive surgery. A transplant helps to minimise pain, provides a barrier against fluid loss and infection, and promotes the healing of wounds. The donation must be made within 12 hours of cardiac death by a donor aged over 10 and with a body weight exceeding 30kg. The donor must not have serious infections and cannot be a hepatitis carrier.
How to sign up to be an organ donor?
> Register on the Department of Health website
> Fill in a registration form and send it by post or fax
> Carry an organ donation card at all times
The Food and Health Bureau has launched a series of campaigns to promote awareness of organ donation, including setting up a promotion committee in April this year after several high-profile organ donation appeals in the past year.
Local secondary schools have recently been encouraged to use a set of new teaching materials developed by the Hong Kong Organ Transplant Foundation to discuss organ donations in liberal studies classes.
The government is developing a Facebook app through which organ donors will be able to register and spread awareness of the life-saving initiative to friends.
The government plans to conduct a study to find out public views on a presumptive consent scheme or an opt-out system – meaning everyone is considered a donor unless they specifically say they are not.