Shortage of organs for transplantation

Of all the problems foreseen in the pioneering days of organ transplantation, a shortage of donor organs was not even remotely considered as a barrier to progress. Such has been the success of transplantation over the past two decades that organ shortage is now considered the major limitation. This week sees the publication of an extensive study by the British Transplantation Society's working party on organ donation.1 Chaired by Professor John Fabre, the working party examined a variety of issues influencing rates of organ donation in Britain. Clearly, the fact that fewer young people now die because of road traffic accidents or intracranial haemorrhage is a cause of donor loss that must be welcomed. However, the report highlights the fact that many medical and financial practices still mitigate against the efficient identification and recruitment of organ donors. In particular, the lack of intensive care beds means that many potential donors are not being ventilated, with the decision depending on locally devised prognostic criteria. As a result, waiting lists for renal transplantation continue to rise, putting increasing pressure on dialysis budgets. While it would be inappropriate …