PETALING JAYA: The stark reality of organ donations is that there is a severe imbalance between demand and supply.
According to the National Transplant Resource Center (NTRC), only 277 transplants were performed last year despite a staggering waiting list of 9,024 adults – with 416 paediatric patients needing kidney donations alone.Its senior national clinical organ donation manager Dr Hasdy Haron said kidneys were in high demand due to the high number of dialysis patients in Malaysia.
“The demand for transplants rises yearly because new patients are added to the list every month, but the supply remains critically low. There is a huge gap.
“In 2019, we had 136 transplants, followed by 178 in 2020 and 83 in 2021.
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“Organ donations fall into two categories: living transplants that involve kidneys and livers, and cadaveric transplants, which occur after death,” he told The Star.
Dr Hasdy said public awareness of organ donation was reflected in the number of people who have pledged to become donors.
Currently, around 300,000 people in Malaysia are registered as donors, a relatively small number compared with the overall population. He said continuous promotion was important to ensure sustainability.
“Given the sensitive nature of organ donation, which may involve death, awareness efforts must reach all levels of society.
“For instance, when engaging with Muslim communities, we need to collaborate with religious authorities and ensure greater visibility and involvement of prominent figures.
“One of the major issues holding people back from donating their organs is the lack of knowledge about the benefits of transplantation. All organs and tissues are equally important for transplants, but many people may not understand the benefits and requirements, which holds them back,” he added.
According to the National Renal Registry (NRR), there are currently over 50,000 patients on dialysis in Malaysia, with 69.2% of kidney failure patients having diabetes and 21.8% having hypertension.
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In 2022, the NRR indicated that 51,256 Malaysians suffered from end-stage kidney failure and it is estimated that by 2040, this number will double.
In 2021, the annual crude death rate on dialysis was 18.1%. The annual crude death rate among haemodialysis patients was 17.8%, while chronic peritoneal dialysis patients had a rate of 20.6%.“Only 5% of people were aware that they had been diagnosed with chronic kidney disease (CKD), which is extremely low and may indicate missed opportunities to prevent more serious problems or delayed detection,” the National Kidney Foundation (NKF) said.
It also said many people were still hesitant about organ donation – the most prevalent reasons cited by the NTRC were concerns over body mutilation and lack of knowledge about the deceased’s last wishes.
To address concerns of body mutilation, it is important to note that the deceased undergoes surgery similar to that conducted on the living during a transplant.
“The procedure is done in a manner that preserves the anatomy of the deceased with no obvious disfigurement, ensuring the organ remains in good condition for transplant.
“Secondly, the MySejahtera pledge system now allows users to convey their intent to be donors.
“To facilitate a kidney transplant, individuals have two options: they can volunteer as a living-related donor for a family member in need or register as a deceased donor.
“If opting to be a living-related donor, prospective donors must undergo a series of assessments conducted by the transplant nurse coordinator at a nephrology transplant centre.
“These assessments include physical examinations and various screening tests to ensure suitability for surgery.“Typically, the preparation process for a potential kidney donor lasts between three and six months in uncomplicated cases,” the NKF said.
It added that maintaining a healthy kidney required a person to commit to a healthy lifestyle by adopting regular exercise routines, managing and maintaining a healthy body weight, and quitting smoking.
It is also recommended that salt intake be reduced to less than 2.4g/day (equivalent to about one teaspoon) to optimise blood pressure management, a crucial factor in kidney health.
