Hong Kong has one of the lowest organ donation rates in the world and within the Asian region – at a rate of 5.8 donors for every million citizens, according to a Legislative Council study in 2015. Despite positive efforts undertaken by both government and non-governmental organisations, the organ donation register in Hong Kong only accounts for 3% of the city’s total population. Recent efforts have observed a steady hike in the number; nonetheless, there are still 3,000 patients in Hong Kong awaiting vital organ donations.

As such, suggestion has been put forward to ‘simplify’ the organ donor registration procedures in Hong Kong. But, will this alternative work?

Factors affecting organ donation rates

In order to answer the question, there first needs to be a thorough understanding about the factors affecting the organ donation rates in Hong Kong. For that, a team of researchers from Queen Elizabeth Hospital’s Department of Medicine and the Hospital Authority’s (HA) Transplant Coordinating Service collaborated to study the factors affecting the deceased organ donation rate in the Chinese community.

The study found that, in 2014, among the 121 possible organ donors, only 11 patients became actual organ donors lending an overall conversion rate of just 10%. From these 121 possible organ donors, close to half were excluded due to medical contraindications. Meanwhile, the remaining half of the candidates were excluded due to reasons such as failure to identify and inform organ donation coordinators, failure of donor maintenance, brain death diagnosis not being established and refusal for donation by relatives.

However, what appeared to be more jarring than the 90% ‘exclusion’ rates of identified organ donors are the rate of ‘identified’ organ donors. Among the 3,659 patient deaths in 2014, only 121 were identified as possible organ donors – with a majority originating from non-intensive care units. This amounts to a mere 3% of patient deaths eligible for organ donation.

Highlighting the deficiencies faced by the organ donor system – both before and after death – the study concluded that sweeping improvements to all stages of the donation process have to be improved, in order to boost the organ donation rate.

The call for action

One such suggestion, put forth by the Hong Kong Transplant Sports Association (HKTSA), is by allowing Hongkongers to register as organ donor when applying for identity cards or driving licenses. By making organ donation campaigns more pervasive and incorporating it into official documents, the advocacy group believes that this move could drive up the low organ donation rates in the city.

One of the proposed measures – to boost organ donation rates – is to include organ donation registration as part of identity cards and driving licenses application. Photo credit: Hong Kong Free Press
One of the proposed measures – to boost organ donation rates – is to include organ donation registration as part of identity cards and driving licenses application. Photo credit: Hong Kong Free Press

Speaking on the current system, Dr Ka-foon Chau, honorary president of the HKTSA, mentioned that current organ donation procedures are “too complicated”, further urging the government to relax the barriers of entry.

“Many willing donors end up not being able to make donations due to a lot of reasons, such as the objections of their family,” expressed Chau.

“There should be easier ways to ask people to register; for example, [during] the application for Hong Kong identity cards or driving licenses.”

Chau went on to add that many who have registered via the online organ donor register are mainly those in the younger demographic.

Government’s next course of action

In response to the call for action, the Food and Health Bureau (FHB) is currently considering an opt-out scheme for organ donation as a mode to increase the transplantation rate.

A spokesperson of the Bureau echoed that they are waiting for the results of a Census and Statistics Department’s household survey (that involved the public’s view) pertaining to the new opt-out system – which will most likely be available early next year – before considering any major changes. MIMS

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