Wednesday 21 November 2012

Encephalopathy


The reason as to why I have no clear memory of the days and deeds leading to my transplant, a period of at least five days, is encephalopathy. In a nutshell encephalopathy is the occurrence of “confusion, altered level of consciousness and coma as a result of liver failure” - when the liver ceases to function correctly otherwise harmful toxic nitrogenous substances fail to be neutralised, the effect of which, as experienced first hand, causes severe memory loss and confusion. In general encephalopathy is reversible and can be treated. However, in the context of acute liver failure the advent of the condition forewarned of a liver lost. Sitting crossed legged on the hospital bed, surrounded by recently made revision notes for an imminent university exam on the foundations of East Asian history, one of the many faces of the upper echelons of the Royal Free’s liver team asked me to sit-up straight, close my eyes and raise my arms, with clenched fists, in front of my person. I often think about the point at which I opened my eyes and discovered I had utterly failed what should have been one of life’s hitherto easiest assessments. Even though I hadn’t been informed what this result denoted it was painfully evident on the consultant’s face. Verification imbued with pity; a sealed fate. The true curse was that the path irrevocably paved would become, in essence, well tread by many...but not me, at least in a dualist sense of me. To put in perspective, I actually have no recollection of being told that, unless what had become lost was made new, I would be dead within days. Encephalopathy was the precursor to death, my encounter with my end, yet tangible only posthumously... well, at least posthumously in the respect of my organic organ.

This said, however, I do have a couple of memories-come-hazy-flashbacks of my person during the encephalopathy induced confusion. I do recall frantically, and not so subtly, insisting to my little brother that the nurses were patronising me. I believe this logic heralded from a unprecedented want of juice, a want ultimately denied due to some water only or nil-by-mouth regime; exactly which I am unsure. I also maintain that I experienced a spell of clarity as I was literally being put under anaesthetic. This said, such a memory seems perhaps too favourable and I fear perhaps it is the product of dream or medicine-induced hallucination. As it happens, due to the fact that in my encephalopathic state I had become somewhat deviant and unresponsive to request and reason, I am told it was decided I should be anaesthetised whilst the wait for a possible donor continued. I vividly recollect, however, simply knowing that I was have my consciousness medically surrendered. I was suddenly surrounded my medical staff, being put into a slumber I did not understand and I was scared. I don’t intend to preach fear but I cannot feel that which I felt during that heartbeat moment of lucidity. It scarred me, and if again I ever glimpse this fear I know I will break, run, shatter and not have the strength to become whole again. I wanted my parents, so simple, so desperate, I wanted my makers to just make it right.

Thursday 8 November 2012

Organ Donor Facts


There are 7,951 patients on the transplant waiting list: 6,867 need a new kidney, 370 need a liver, 268 need a kidney and a pancreas, 231 need a lung or pair of lungs, and 118 need a heart.

The UK has one of the lowest donor rates in the western world. About 1000 people a year die waiting to receive one.There were 2,640  transplant operations between April 2009 and April this year, involving 1,057 live related donors (relative, friend or stranger). A healthy person can survive donating part of their liver to someone else, as theirs grows back quickly to full size, as does the donated section.

The number of people who have signed the organ donation register has risen from 8 million in 2001 to 17.1 million – about 27% of the population. Traditionally, organs have come from road accident victims and brain haemorrhage patients. Improved road safety and medical intervention mean fewer are dying. Kidney failure costs the NHS in England more than £600m in 2004-5 – about 1% of its total budget. There are close to 2,100 people on dialysis. 


Organ Donation Q & A's                                            [sourcehttp://www.nhs.uk/Livewell/Donation/Pages/Ethicsandworries.aspx]

Can I agree to donate to some people and not to others?

No. Organs and tissue cannot be accepted unless they're freely donated. No conditions can be attached in terms of potential recipients. The only restriction allowed is which organs or tissue are to be donated. 

Could my donated organs and tissue go to a private patient?
Possibly. However, patients entitled to treatment on the NHS are always given priority for donated organs. These include UK citizens, members of Her Majesty's forces serving abroad and patients covered by a reciprocal health agreement with the UK.

Other people will only be offered an organ if there are no suitable patients entitled to treatment under the NHS. Every effort is made to ensure that a donated organ does not go to waste if there is someone who can benefit.

Donated tissue is made available to any hospital in the UK where there's a patient in need.

Could any of my organs or tissue be given to someone in another country?
Yes, possibly. There's an agreement that any organs that cannot be matched to UK patients are offered to people in other European countries. Likewise, UK patients benefit from organs offered by other European countries. This cooperation increases the chance of a suitable recipient being found, ensuring that precious organs do not go to waste. Tissue might also be offered to patients in other countries.

Are there religious objections to organ and tissue donation?
No. None of the major religions in the UK object to organ and tissue donation and transplantation. If you have any doubts, discuss them with your spiritual or religious adviser. In addition, the Organ Donation Directorate of NHS Blood and Transplant, has produced a series of leaflets that focus on the six major religions in the UK.

Does the colour of my skin make a difference?
No. However, organs are matched by blood group and tissue type (for kidney transplants) and the best-matched transplants have the best outcome. Patients from the same ethnic group are more likely to be a close match. A few people with rare tissue types may only be able to receive a well-matched organ from someone of the same ethnic origin, so it's important that people from all ethnic backgrounds donate organs. 

Successful transplants are carried out between people from different ethnic groups wherever the matching criteria are met.

Can I agree to donate some organs or tissue and not others?

Yes. You can specify which organs you would wish to donate. Simply tick the appropriate boxes on the NHS Organ Donor Register form or on the donor card, and let those close to you know what you've decided.

Will organs or tissue that are removed for transplant be used for research purposes?
Organs and tissue that cannot be used for transplant will only be used for medical or scientific research purposes if specific permission has been obtained from your family.

Would a donor's family ever know who the recipient was?

Confidentiality is always maintained, except in the case of living donors who already know each other. If the family wish, they'll be given some brief details, such as the age and sex of the person or persons who have benefited from the donation. Patients who receive organs can obtain similar details about their donors. It's not always possible to provide recipient information to donor families for some types of tissue transplant.

Those involved may want to exchange anonymous letters of thanks or good wishes through the transplant coordinators. In some instances donor families and recipients have arranged to meet.

Can people buy or sell organs?
No, the transplant laws in the UK absolutely prohibit the sale of human organs or tissue.

Can a deceased person donate sperm or eggs for future use?
While it is possible to retrieve sperm or eggs it is illegal to store either or to create an embryo without the prior written consent of the donor.

Can someone with HIV or hepatitis C donate?
Yes. In very rare cases, the organs of donors with HIV or hep C have been used to help others with the same conditions. This procedure would only ever be carried out where both parties have the condition. All donors undergo rigorous checks to guard against infection.