Organ transplant. Picture: SUNDAY TIMES
Organ transplant. Picture: SUNDAY TIMES

Nurses are the key to increasing South Africa’s low number of organ transplants.

Link to study: Nurses’ knowledge about and attitudes toward organ donation in state and private hospitals in Johannesburg, South Africa

David Thomson editorial:  Organ donation in South Africa – a call to action 

Academics at Wits University uncovered overwhelming support for transplants among hundreds of nurses they questioned‚ but found that the lack of a structured protocol for referring potential donors meant they were uncertain of how to go about it.

"Internationally‚ similar changes in legislation and guidelines have resulted in a significant increase in donor referrals‚" said Harriet Etheredge‚ an expert in medical ethics and organ transplants.

Etheredge and her Wits Donald Gordon Medical Centre colleagues Kim Crymble and June Fabian said a suitable protocol should emphasise teamwork and clarify the role of doctors‚ "as nurses need to be aware of how they might navigate relationships … in the event that doctors themselves are unwilling to refer a potential donor".

SA’s organ donation rate is less than three per million people‚ compared with almost 40 in Spain and 14 in Brazil‚ transplant surgeon David Thomson says in an editorial in the November edition of the South African Journal of Critical Care.

"There is no mandated requirement for discussion of a potential donor with a transplant team‚ nor is there any system in place to audit the standard of our end-of-life care discussions to ensure that all families are given the opportunity to support organ donation‚" said Thomson.

He added that so far this year 82% of families asked to give permission for organ donations at his hospital‚ Groote Schuur in Cape Town‚ had refused. In Spain‚ the refusal rate was only 16%.

The Wits study‚ in the same journal‚ questioned 273 nurses at seven Johannesburg hospitals and found that two-thirds were willing to donate their organs after death. But only a third felt positive about referring patients as potential donors.

Four in five of the nurses said that if a protocol supporting referral was introduced‚ they would follow it.

"Our findings add to other South African studies which dispel perceptions that low referral rates are a function of personal opinions or beliefs that do not favour organ donation‚" said Etheredge.

The researchers also called for education about organ donation to be included in nurses’ training.

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