The transplantable organ shortage in Singapore: has implementation of presumed consent to organ donation made a difference?
Annals of the Academy of Medicine, Singapore
;
: 346-348, 2009.
Article
in English
| WPRIM
| ID: wpr-340641
ABSTRACT
The success of solid organ transplantation in the treatment of end-stage organ failure has fuelled a growing demand for transplantable organs worldwide that has far outstripped the supply from brain dead heart-beating donors. In Singapore, this has resulted in long waiting lists of patients for transplantable organs, especially kidneys. The Human Organ Transplant Act, introduced in 1987, is an opt-out scheme that presumes consent to removal of certain organs for transplantation upon death. Despite this legislation, the number of deceased organ donors in Singapore, at 7 to 9 per million population per year, remains low compared to many other developed countries. In this paper, we reviewed the clinical challenges and ethical dilemmas encountered in managing and identifying potential donors in the neurological intensive care unit (ICU) of a major general hospital in Singapore. The large variance in donor actualisation rates among local restructured hospitals, at 0% to 56.6% (median 8.8%), suggests that considerable room still exists for improvement. To address this, local hospitals need to review their processes and adopt changes and best practices that will ensure earlier identification of potential donors, avoid undue delays in diagnosing brain death, and provide optimal care of multi-organ donors to reduce donor loss from medical failures.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Referral and Consultation
/
Singapore
/
Tissue and Organ Procurement
/
Brain Death
/
Waiting Lists
/
Terminally Ill
/
Presumed Consent
/
Donor Selection
/
Ethics
/
Intensive Care Units
Type of study:
Practice guideline
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2009
Type:
Article
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