Organ and Tissue Donation

3rd August 2023

Mr GREG PIPER (Lake Macquarie) (17:48): Last week was DonateLife Week. Today I acknowledge and thank all of the donors and the families of donors who have made the generous decision to donate tissue and organs, selflessly giving another person the gift of a better and, hopefully, healthy life. I also acknowledge the dedicated and skilled clinicians and specialist staff working in the field of organ donation and transplantation. Discussions with families about organ donation often happen at a time when families are coming to terms with the unexpected and sudden loss of a loved one. During these times, grieving families may be forced to make many difficult end-of-life decisions. Conversations with families about organ donation at these times are no doubt extremely hard. It takes a special kind person to approach these discussions with the compassion and professionalism needed during such times.

Right now there are approximately 1,800 Australians waiting for a lifesaving organ transplant and thousands more whose lives could be transformed through organ or tissue donation. During the first 10 years of the implementation of the national organ donation program in Australia there was a 122 per cent increase in deceased organ donation rates. Unfortunately, since the emergence of COVID, the number of organ donors and people who have received a transplant has decreased by 15 per cent. There are many reasons for this. In 2022 the lives of 1,224 Australian were changed when they received an organ transplant thanks to the generosity of 454 deceased donors and their families. I am proud to say that currently Lake Macquarie sits in the top five local government areas for registered organ donors. In Lake Macquarie 57 per cent of residents are registered. Across New South Wales, the figure is 42 per cent. We know, though, that 80 per cent of Australians aged 16 and over support organ and tissue donations. It is clear we have work to do to encourage supporters of organ donation to become registered donors.

But registration alone is not enough because a next of kin can override a donor's registration when the time comes for donation decisions to be made. Conversely, when a person is not registered, families can consent to organ donation on behalf of their loved ones—but that is rarer. According to theAustralian Donation and Transplantation Activity Report 2022, in that year 1,300 requests were made to families for donations, with 701, or 54 per cent, saying yes. This consent rate was higher when families knew their family member was a registered donor. We need to normalise and encourage conversations about organ donation so that our families understand our wishes should the time come for difficult decisions to be made.

Parliament may also need to consider whether a registered donor's family should have the right to override a donor's decision made during their life. This is a complex and difficult issue. Increasing donation registrations and consent rates is vitally important because organ donation is a bit of a numbers game. While many Australians register to be donors, the vast majority will not have the opportunity. Organ donation and transplantation is a complex process. Many factors need to align to make donation a success. While 80,000 people die in Australia each year, around only 2 per cent can be considered for organ donation. In 2022 this was only 1,400 people. Every opportunity for organ donation is a precious opportunity to save a life and often multiple lives. When a family consents to organ donation, it is important that we ensure those precious organs are successfully transplanted into their recipients where possible.

In New South Wales practices and laws could be improved to maximise the viability of tissue and organs for transplantation. One issue that needs to be addressed is the current restrictions around the use of ante-mortem interventions in New South Wales. Ante-mortem interventions are procedures carried out before a patient dies that do not have a medical benefit to a patient but can determine, maintain or improve the viability of tissue to be donated. Ante-mortem interventions can include the administering of medications, the undertaking of blood tests and medical imaging or the maintaining of life support.

Certain medications have shown to improve the function of donated organs when transplanted into a recipient. Despite causing no harm to a patient, the use of ante-mortem interventions is limited in New South Wales because of certain restrictions around medical consent. This needs to be addressed. In 2020 Victoria brought in legislative reform to address this issue; New South Wales needs to do the same. We must treat organ and tissue donations like the precious gifts they are. Yes, we most certainly need more people registering as organ donors, but ensuring that the organs of registered donors are in the best possible condition for transplantation honours a person's generous decision to donate and will no doubt help to save more lives in New South Wales.

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