Image: The donor, her son and daughter - supplied by the family.
Australia has become the fifth country in the world to facilitate organ donation after Voluntary Assisted Dying (VAD), after a Victorian woman was able to donate her organs earlier this year.
The 66-year-old from Ballarat was last year diagnosed with Motor Neurone Disease (MND), an incurable and progressive condition, and given the prognosis of less than six months. She raised organ donation with her neurologist, and later with her VAD clinician, after she was granted a practitioner administered VAD permit.
In an act of altruism, the retired nurse was able to donate her lungs, liver, and kidneys, saving the lives of four people on the organ transplant waiting list.
Countless others will benefit into the future through the donation of her eyes and tissues to medical research, with her eye tissue being donated specifically to a MND research program that will contribute to earlier detection of the disease.
With around 1,800 Australians currently waiting for organ transplants, experts say the option to donate organs after VAD could be a game-changer, with the potential for hundreds more transplants each year across the nation.
DonateLife Victoria’s State Medical Director, Dr Rohit D’Costa, says the opportunity to help others through organ donation can bring some comfort to those who choose to access VAD, and their families.
“In usual circumstances, organ donation is rare. Only 1-2% of deaths in hospital occur in a way that donation is possible. Donation after VAD provides an opportunity for people to donate, who would otherwise not have been suitable,” says Dr D’Costa.
“While it is difficult to be certain how many more potential donors this may represent, data suggests 10-15% of those accessing VAD may be able to become organ donors, with many more potentially suitable for eye and tissue donation,” Dr D’Costa says.
The patients most likely to have the option for organ donation are those receiving in-hospital administration of VAD medication by a medical practitioner. The recent Victorian VAD Review Board of Operations report (2022-2023) details many of the relevant numbers. Since VAD was implemented, there have been a total of 140 people who have died via this pathway and many more have had approval to do so.
These people represent a new addition to the potential ‘organ donation pool’ alongside other Victorians dying in Intensive Care Units and Emergency Departments.
Even those who cannot donate organs may be suitable for eye and tissue donation which is a separate process that would not require the patient to die in a hospital setting.
DonateLife Victoria estimates up to 15 patients a year could be suitable and willing to donate. With an average of three organs per donor, we could see up to 45 people receive organ transplants from this new practice in Victoria alone. Many more could also benefit from eye and tissue donation from this group.
“Legislation enabling VAD is now being enacted across Australian states, with personal autonomy an important driver. Being able to support someone’s decision to be an organ donor is well aligned with this principle,” says Dr D’Costa.
Organ donation currently needs to occur in a hospital environment, so the option may not be possible if the patient chooses to administer VAD medication at home.
The woman’s treating VAD clinician, Dr James Hurley, says, “Death with VAD usually occurs in the peace and comfort of the home environment, but we did our utmost to deliver the same in an ICU bed as a planned admission. The process was as peaceful and dignified as one could wish for.”
“I was proud to be part of a larger team that made possible my patient’s wishes – to end her life with dignity, without suffering further decline, to donate her organs, and to provide comfort to her children.”
Victoria was the first state in Australia to pass a VAD law in November 2017, with the law coming into effect in June 2019.
Currently, Victoria is the only state in Australia that has consented a patient for organ donation following VAD. All Australian states that currently allow VAD are exploring options to allow organ donation after VAD. Collaboration between the states regarding VAD and donation principles has been ongoing for several years and will continue.
Interviews
For an interview with Dr Rohit D’Costa, State Medical Director, DonateLife Victoria, please contact:
Liz Sonntag, Media Advisor, DonateLife Victoria
Tel 0488 247 019 | Email esonntag@redcrossblood.org.au
Addendum
▪ Factsheet: Organ donation after Voluntary Assisted Dying (VAD) in Victoria
▪ Factsheet: The Organ Donation Process
