Lin Chia-yiun (
Chia-yiun was born with blocked bile ducts, whose function is to carry bile out of the liver.
Although Chia-yiun had surgery to repair the dysfunction a month after her birth, her liver tissue has been seriously damaged by the build-up of bile caused by the block.
One month after the operation, Chang Gung Memorial Hospital's (CGMH) Kaohsiung branch diagnosed cirrhosis of the liver and informed Chia-yun's parents that her only prospects of survival rested on a liver transplant.
Although only a small piece removed from an adult liver would be required to save a baby, the Lins failed to find a suitable donor from among Chia-yiun's third degree relatives (those extending to her aunts and uncles, though not by marriage).
According to Lin Sien-jung (
Under the Organ Donation Regulation, however, the aunt, a relative by marriage, is not qualified to donate organs to Chia-yiun.
"We pleaded with the Department of Health to let the hospital proceed with the transplant by making an exception of Chia-yiun. But the department not only rejected our plea but chided the hospital for urging the patients' family to do such a thing," said Lin.
Growing worse
Chia-yi's condition has been deteriorating since February this year as the varices -- blood vessels enlarged by the excessive amounts of blood passing through them because of her condition -- in her esophagus, a serious complication of cirrhosis that causes the little girl to cough up and excrete blood.
"Life is priceless. I do not know where the government has placed the right to life by setting up such stringent rules for live organ donations when there are precious few brain-death donations each year," said Lin.
Brain death is the irreversible loss of all functions of the brain. It is the legal definition of death in Taiwan and in many other countries.
Hundreds wait, few are lucky
Together with Chia-yiun, over a hundred patients await liver transplants at CGM hospital in Kaohsiung. But their chances are slim. Last year produced only three deceased donors.
"If the government can promote a lottery so successfully that the whole nation goes crazy about it, I wonder why it can't put the same effort into promoting organ donations," the father added.
While at least 6,000 people nationwide await organ transplants, less than a hundred donors -- both living and deceased -- have given organs in each of the past four years, according to the Organ Procurement Association (OPA,
"The situation has gone from bad to worse. From the second half of last year to April of this year, there were less than 10 organ donors in Taiwan and our hospital only received one," Cheng Long-bing (鄭隆彬), head of the CKMH organ transplant committee, and the president of OPA, told the Taipei Times.
Taiwan has 65 prospective donees for every single organ donation, compared to a US ratio of three to one.
Less head injuries
Cheng said that 80 percent of the patients waiting for liver transplants at CKMH a month ago had since passed away.
Cheng said that a contributory factor to the shortage of donated organs in recent years had been the traffic regulations of 1997 that made the wearing of safety helmets compulsory for drivers of motorcycles and scooters.
"Since then, the incidence of head injuries has decreased by 40 to 50 percent," Cheng said.
But doctors say that one of the most important reason for the small number of willing organ donors is local social mores.
As the Chinese saying goes, "We dare not damage our body for it is given to us by our parents," people prefer to keep the remains of the dead intact out of respect.
Moreover, doctors say, even when a person has been declared brain-dead his or her family almost invariably refuses to allow life-support machinery to be turned off, preferring to wait another 10 to 20 days, for the brain cells and nerve cells to die, by which time the organs have been rendered unusable because of lack of oxygen.
Stringent provisions
Some legislators, doctors, and patients suffering from organ failure have blamed the stringent provisions of the Organ Donation Regulation (
This prevents spouses from donating organs to each other unless they have been married for more than three years or have produced offspring, and bans donations between relatives by marriage. Donors must be over 20 years of age and should be of at least the fifth-degree of kinship (cousins) to the recipient.
Cheng, however, says that lifting the regulations will not solve the problem of the shortage of organ donors.
Shiue Ruei-ping (
"In cases of living organ donation, people's attention is often focused on the suffering of the donee rather than on that of the donor. When striving to save a dying man, we often overlook the fact that we are actually putting another person's life at risk," said Shiue.
He added that the stringency of the regulations was aimed at guarding against the buying and selling of human organs.
Moreover, as Cheng stresses, "The fundamental problem of the shortage of donated organs is not caused by the stringency of the regulations but by the extremely low rate of deceased donors in Taiwan."
In order to increase rates of organ donation, the DOH, which established the OPA, is working towards promoting cadaver organ donation by asking people to indicate whether they consent to organ donation after death when registering for national health insurance.
The department is also preparing to establish an organ transplant registration center that would function similarly to the United Network for Organ Sharing (UNOS) in the US.
The UNOS maintains a centralized national organ transplant waiting list and assures that all patients have a fair chance of receiving the organ they need.
"With Taiwan's advancements in organ transplant surgery, it is time for us to work on a more effective way to integrate data from major hospitals and to match organ donors with donees," said Shiue.
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