The Australian experience in organ donation--2003

The Australian performance in deceased donor organ donation continues to languish near the bottom of the International ladder. This is despite a national expenditure on health 10% more than the average OECD country (dollars per capita) and the presence of active transplantation programs (heart, kidney, liver, lung and pancreas) with excellent success rates. The deceased donor rate has fallen from 14 donors pmp in 1989 to 9 at the present time and appears to be still falling. Living donors now outnumber deceased donors as a source of kidney transplants. Causes of the low deceased donor rate appear to include variable management of severe brain injury, shortage of ICU beds, lack of ICU priority to potential donors when beds are restricted, and a low family consent rate (50%) despite 83% of the public being willing to donate. Programs aimed at addressing these issues are planned and include additional funding for beds, improved identification of donors and a standard pathway for managing severe brain injury.