Tuesday, October 17, 2017


Hi friends,

Have you heard of HOTA? Of course not. I've probably heard of HOTA except I've conveniently forgotten it. HOTA or the Human Organ Transplant Act came into effect in 1987. It is an opt-out system to allow for kidney, liver, heart and cornea in the event of a brain death. I remember back then I felt really yucky about having my organs removed after death but I was too lazy to do the paperwork for opting out of donating my organs. I have to say it was a good call on the part of the committee to come up with an opt-out system. Thanks to it, lazy people automatically become organ donors.

Having forgotten I am an organ donor, I was rudely reminded of it recently when a mail came for my son. He's turning 21 next year (so fast!) and I guess HOTA was in a hurry to reel in one more potential donor. I felt it is my duty as a mom to educate my son about HOTA. So I read through the booklet that came in the mail and I bravely broached the topic of organ donation with son. Surprisingly he couldn't care less. I think he said 'whatever'. So once he turns 21, he becomes an organ donor. Later when I recalled how I broached the subject with son, I realised I forgot to mention he would be saving lives.

I don't know if hubs is an organ donor. When I asked him, he said he had no idea. Knowing him, he probably didn't do the paperwork either. There is one big disadvantage to opting out but I doubt it's something people think about: you receive lower priority on the waiting list should you require an organ.

Not every death results in organ recovery. It has to be a brain death and it must occur in a hospital. The organs need to be suitable and of course there must be suitable recipients.

I read through the history of HOTA and realised that Muslims were excluded at first for religious reasons. In 2004, non-accidental deaths were included. In 2008, HOTA was amended to include Muslims. In 2009, the age limit of 60 was removed.

Interestingly, HOTA using the opt-out system to consent to organ donation did not lead to an increase in organ transplants. With a low opt-out rate, you would think it's a success story. In fact organ transplant has remained low for the past 10 years. 58 transplants were carried out in 2015 compared to 69 in 2006. I read this article that says presumed consent is the issue as the HOTA database does not differentiate between those who did not opt out and those who chose to be a donor. For doctors who are in a position to harvest organs, it becomes an ethical as well as emotive issue.

Last month there was a story in the papers about a heart donor's parents who met with the organ recipient to listen to her heartbeat. To be honest, I was quite emotional when I read the story. After I learnt more about it, I wondered how with donors/recipients info being confidential the recipient manage to "connect the dots" to track down the donor's parents? I also thought about how I would want things if I were in their position. (touch wood) I think this might surprise you but if anyone in my family donated an organ, (again touch wood) I really, really don't want the recipient to track me down. Similarly, should I donate my organs, I don't want the recipients to show up in front of my family. That's too weird.


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