In addition to these changes, organ donation surgery became restricted to six zones whereas before the ODTF recommendations, all 26 transplant units in the country contributed to cadaveric organ donation. Also, the national sharing of organs (which had been voluntary, in so far as we aimed to serve our own community primarily and additional organs were shared only in certain cases) became enforced. This essentially was because there was a postcode imbalance, and some kidney failure patients waited six years for their transplant whereas in the northeast, patients generally waited only for 18 months.
The reasons for this imbalance were complex and were partly influenced by certain ethnic minority populations who didn’t support cadaveric donation while simultaneously making up a significant percentage of the number of patients who needed a transplant.
Additionally, different transplant unit structures had varying degrees of enthusiasm for donation. The work force obviously recognized these problems and tried to unify the approach and also ensure equality of access.
On a personal level, I was reluctant to throw my lot in with these national developments because our transplant population had a good deal! Indeed, with the national sharing mechanism, our local transplant rates initially fell, resulting in an increased waiting time.
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