Adding Life to Living

Organ donation: A second chance at life

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By Henrylito D. Tacio

“Organ donation is an act of legacy and salvation of one another. By pledging your organs, you say, ‘I will do it during life, and I will do it beyond life.’”

The statement came from Dr. Antonio Paraiso, program manager for Philippine Network for Organ Sharing (PhilNOS). He said those when the country was attempting to break the Guinness World Record (GWR) on having the most number of people to enlist as organ donor registrants some years back.

Dr. Franklin Guillano, a Davao-based nephrologist, said organ donation is now rebranded as lifeline. “Being a lifeline is giving everybody a chance to help other people (in need of organ transplantation), even after they die,” he said.

Dr. Guillano advocated for organ donation from cadaver or from those declared brain-dead. “We don’t bring our organs to heaven. If we become organ donors we extend other people’s lives,” he was quoted as saying.  

Davao firefighter Louie S. Puracan knows that. More than a decade ago, he went to a hospital for his regular medical checkup.  The doctor became cautious when he noticed the creatine level of the 41-year-old patient was increasing.

The doctor talked with him as he wanted to find out if what he was assuming was right.  Puracan disclosed during the conversation that arthritis started to knock him out when he was 30. To get rid of the agony, he resorted to taking pain relievers. 

Hearing the revelation, the doctor told him that most pain relievers can cause kidney disease.  He advised the patient to undergo a glomerular filtration rate (GFR) to measure the level of his kidney function and determine the stage of kidney disease at the National Kidney and Transplant Institute (NKTI) in Quezon City. 

“The result caused me sleepless nights,” he recalled. “My kidney function rate was 60% and it was irreversible. Upon hearing that diagnosis, my world seemed to collapse. The only thing doctors could do was to delay the progression.”

In 2016, when the result of his GFR test was placed at 21%, his doctor recommended preemptive transplant. “She didn’t want me to undergo dialysis as it would entail more expenses on my part,” Puracan said. “She advised me to look for a possible kidney donor as soon as possible.”

By this time, Louie was getting weak and felt catching his breath. Family members and relatives knew the situation and so a clan meeting was held in his home town in Bansalan, Davao del Sur. Four cousins and his adopted sister volunteered to be his donor.

In January 2017, the doctor started doing the laboratory work for cross-matching. Here, blood from the donor and recipient are mixed. If the recipient’s cells attack and kill the donor cells, the crossmatch is considered positive. This means the recipient has antibodies “against” the donor’s cells. If the crossmatch is negative, the pair is considered compatible.

His adopted sister, Blessyn, then 30 years old and married with three children, was a perfect match for Puracan.  He had his transplant operation on May 16, 2017, which was successful.

“I feel better now,” he admits. “I’m back to my work but mindful of my diet. I’m so happy that the Lord extended my life leading me to the right people, my nephrologist and the transplant team. And to my sister, who shared her life with me by giving one of her kidneys.”

Blessyn’s generosity saved the life of her brother. It is inspiring but, sadly, not typical. Records from the Department of Health show at least one Filipino dies each hour from kidney failure, which is considered the ninth leading cause of death in the country. Some 10,000 Filipinos need kidney transplants from donors every year.

And the situation is likely to get worse. As people live longer, organ diseases and health problems like diabetes – one of the main causes of kidney failure – are expected to rise, creating even greater demand for organ donations.

Organ donation is defined as “the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.”

“Organ donation saves lives and it is very important that every person has the power to save a life by becoming an organ, tissue or eye donor,” says Dr. Teodoro Herbosa, former undersecretary of health. “It is a noble gift because you can give someone a second chance at life.”

In Davao City, Dr. Ma. Theresa Bad-ang is pushing for public awareness on organ donation to help patients that need those organs to have a second chance at life. People who need to know this are the health professionals themselves.

“Organ donation should be known first thoroughly by doctors and nurses in the hospital before the public so that it will succeed,” Dr. Bad-ang, nephrologist and head of the Southern Philippines Medical Center-Human Advocate and Retrieval Effort, was quoted as saying by Philippine News Agency (PNA).

She said organ donation will only happen if a family member of a “brain-dead” patient will give consent. Otherwise, no such donation will take place.

“We cannot do organ donation if the patient is not dead,” Dr. Bad-ang pointed out. “The public should know that when you are brain-dead, you are legally dead, and you can donate your organs as long as your family will agree to it.”

The passage of Republic Act No. 7170, otherwise known as the Organ Donation Act of 1991, as amended by Republic Act No. 7885, organ and tissue from donors who have been declared brain-dead has been allowed. 

The World Health Organization (WHO) says “the procurement of organs for transplantation involves the removal of organs from the bodies of deceased persons.” Among the human transplantable organs are kidneys, liver, lungs, heart, intestines, and pancreas. This is in addition to human tissues such as eye tissues, bones, skin, and blood vessels.

Unfortunately, organ donation from brain-dead patients remains dismally low in the country, according to the Department of Health (DOH).

Confusion about brain-dead patients among the families of potential donors, doctors and hospital administrators is one hindrance of donation of organs. To grieving loved ones, the person looks alive. “People think there might be a miracle, so they hold on,” one doctor contends.

If most Filipinos are not aware of organ and tissue donation, the more they never hear of NKTI’s Human Organ Preservation Effort, in which a person signs an organ donation card. It is the “equivalent of a legal consent document” allowing an individual to donate any of his body organs or organs shortly after his death.

“But signing a donation card isn’t enough,” stressed Dr. Enrique Ona, former health secretary. “Potential donors have to tell their families of their wishes.”

Doing so takes much of the pressure off both the family and the hospital’s transplant coordinator at a very difficult time.

In addition, unless a donor’s family agrees with their loved one’s wishes, surgeons will not perform the process. “Even if the brain-dead patient had signed a donation card before, we still ask the consent of the nearest of kin before harvesting the organs,” Dr. Ona said. – ###

Photo: Louie S. Puracan, who was given a second life thanks to the kidney donation of his sister.

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