Over the past five years, the average waiting time for a corneal transplant in Hong Kong has been cut down from 36 months to 15 months, thanks to the efforts of the Hong Kong Eye Bank. As such, they have been awarded the 2017 Outstanding Award by the Hospital Authority.

Waiting time halved, but Hong Kong Eye Bank wants to achieve more

The Hong Kong Eye Bank is a small team consisting of just 16 core members including four coordinators, five technicians and six supporting staff. Yet, the organisation is responsible for a great deal of work; from contacting family members of potential donors to coordinating the transplantation process – a very time sensitive ordeal.

“Time is never on our side,” technician Kenneth Kam-hon Wong mentioned, adding on that there is a limited window of opportunity when dealing with patients who had not pre-registered as organ donors.

Despite these challenges, the organisation has successfully decreased the waiting times for a corneal transplant and now, only 280 people remain in the active waiting list. By contacting 300 families of recently deceased patients, the team were met with an acceptance rate of 35%-40% which totalled to 278 corneal donations.

This figure was a marked improvement over prior statistics, as explained by Catherine Suet-man Wong, the manager of the Hong Kong Eye Bank, “The [voluntary donation] rate has remained around 10% for eight to 10 years and of course we want more.”

While the number of donations has improved, the Hong Kong Eye Bank acknowledges that the corneal donor situation in Hong Kong is still far from ideal. As a result, they are persistently working on improving the situation of those in need of corneal transplants as well as educating the general public on organ donation.

However, Wong insisted that the root of the problem did not lie within the system but rather the need for increased awareness and education amongst the public and professional harvesting services.

Hong Kong’s per capita donation rate is eight times lower than the United States

The recent improvements in corneal donation rates have signalled a big change over the past for Hong Kong. Back in 2015, Hong Kong with a population of 7.3 million people, only 239 corneas were donated annually whereas the number of patients on the waiting list for corneal transplantation was more than double the annual donation supply.

In comparison to the United States, Hong Kong’s corneal donation rate per capita was eight times lower. An often-quoted reason for the low donation rates is Hong Kong’s opt-in systems, which has only 28% of citizens consenting for organ donation and 66% objecting to any form of donation.

These findings were attributed to the traditional Chinese belief of wanting to preserve the body’s integrity following death. Moreover, family members too had to consent to organ transplantation following a patient’s death.


Cultural barriers still exist towards corneal transplantation

This was proven in a collaborative study between the Hong Kong Eye Hospital, University of Hong Kong and Hospital Authority Eye Bank, which identified the factors determining the rates of corneal donation in Hong Kong.

Three major factors were discovered: obtaining consent from family members, the lack of health education and promotional campaigns, and the presence of a cultural barrier against organ donation.

For a large majority of family members who consented to organ donation, their main reason was “the wish to help others” (86% of respondents). Meanwhile, the most common reason for refusal was “traditional Chinese culture to keep the body intact after death” (24.7% of respondents) – which relates to cultural beliefs clashing with medical advances.

Recognizing these hurdles, the team proposed the need for a health promotion and education system which takes into consideration Chinese cultural beliefs. It is hoped that through future initiatives the government will gradually change the community’s perception towards organ donations and increase the rates. MIMS

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Sources:
http://www3.ha.org.hk/ehaslink/issue92/HASLink_1.pdf
http://www.scmp.com/news/hong-kong/health-environment/article/2107539/waiting-time-hong-kong-cornea-transplants-more
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514281/
https://www.organdonation.gov.hk/eng/statistics.html
https://www.ncbi.nlm.nih.gov/pubmed/27861305