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Human Organ Preservation Effort (H.O.P.E.)

The Human Organ Preservation Effort is a non-profit organization in the Philippines under the umbrella of the National Kidney & Transplant Institute, dedicated to the legal procurement of donor organs for transplantation to patients afflicted with various types of end-stage organ disease. The effort concentrates mostly on donors who have been declared brain dead with otherwise normal organs.

There are two types of donors, the living-related donor and the cadaver donor. The living-related donor (LRD) is a blood relative of the patient who willingly donates one of his or her organs without any corresponding danger to the donor's life or any alteration in his usual physical activities. Organs that can be donated through the LRD route are one kidney, bone marrow and part of the liver if the recipient is a child.

The cadaver donor (CAD) is someone who is unrelated to the patient who nsuffered injury by trauma or disease to the brain, destroying the upper brain functions (which house a person's personality and stock of knowledge, and for all intents and purposes, his very being) leaving the brain stem or vegetative functions (which involuntarily control a person's breathing, heart, and other life-sustaining functions) intact.

Before a patient becomes a cadaver donor he or she has to be certified as brain dead. In the past, death was defined as stoppage of the heart. Presently, the old definition still holds true, however in some cases a person is considered dead even if he or she is still breathing with the heart beating. These brain dead cases are usually caused by trauma to the brain (via gunshot, blunt injury, vehicular injury, etc.). In the Philippines, certification of brain death requires the certification of a neurologist or neurosurgeon supported by imaging studies (Xrays, CT Scan or MRI) and electroencephalography (EEG). Since the donor is considered dead, organs that can be harvested include both kidneys, bone marrow, long bones, corneas, the whole liver, pancreas, lungs and heart.

However, before a cadaver donor's organs are harvested, there must be a signed consent of the nearest-of-kin or via a last will and testament. In the former, especially in cases of sudden trauma, it is the difficult job of HOPE's transplant coordinators to discuss the option of organ donation with the relatives in this time of grief. Only with a signed consent can a patient be harvested for organ donation. In several countries abroad, especially in Singapore, Spain and now Denmark, the system is that unless the donor has previously signified his REFUSAL to donate, his organs can be harvested. In the Philippines, the reverse is true, only if the donor has agreed beforehand or if the relatives have agreed to consent can his organs be harvested.

Because of the Philippines' deep family ties, religious devotion and superstitious/traditional beliefs, the number of cadaver harvests is dismally low. To help relatives make the decision to donate, the Organ Donor Card project was started. Although not the equivalent of a legal consent document at the present time, it can help the relatives realize that the donor has consented beforehand and that his wishes be respected.

Cadaver Organ Donation in the Philippines is still in its infancy even though it was started way back in 1983 because of budgetary constraints. However this does not daunt the people of HOPE to do the best they can.

 

 

 

Copyright © 1999, Human Organ Preservation Effort, Philippines
All Rights Reserved

Incept Date: January 10, 1997      Updated:August 26, 1999