Putting Australia under the microscope in the global organ donation landscape

“If we’re going to look at the world scene — issues right around the world for everybody — no-one’s exempt from not having enough donors,” Zaidee’s Rainbow Foundation founder Allan Turner said.

Currently, more than 150,000 organ transplants are performed globally each year, according to the Global Observatory on Donation and Transplantation.

However, this figure represents less than 10 per cent of the global transplant demand.

The COVID-19 pandemic has further highlighted these disparities, causing an 18 per cent decline in transplants worldwide.

Australia has improved its rank to 14th globally in deceased organ donation rates, with a rate of 19.43 per million population.

This figure is significantly lower than the leaders, Spain (49.38 PMP) and the United States (48.04 PMP).

What makes these countries excel in organ donation compared to Australia?

The answer lies in their cultural perceptions and organised systems.

In Spain, a cultural shift has normalised organ donation over the past three decades.

“Now, in Spain, if you die, and you’re in a position to be a donor, it’s just a straight yes,” Mr Turner said.

In contrast, the US’ success is driven by its Organ Procurement Organisations, which are structured as businesses focused on the retrieval of organs.

“There are about 14 to 17 of them where they go and retrieve organs, and they fall under these really strict health guidelines,” Mr Turner said.

This systematic approach has proven effective in increasing donation rates, but it also highlights broader issues.

According to a 2022 World Health Organization report, common barriers to successful organ donation persist globally.

These include low organisational and political commitments, inadequate legislation and deficiencies in deceased donor identification.

In many regions, including Australia, cultural resistance to donation and a lack of awareness exacerbate the problem.

“Australia is always 20 years behind when it comes to what the world-leading countries are doing in all sorts of areas,” Mr Turner said.

“When we talk about the worldwide discussion, opt-out is just a normal conversation in most countries around the world.

“Each country has different positives and negatives in the system, but we’re stuck in the middle.”

However, in terms of technology, we are ahead.

One significant innovation in the Australian organ donation landscape is the development of the ‘heart in a box’ technology by Professor Peter MacDonald and his team at the Victor Chang Cardiac Research Institute.

This breakthrough enables the transplantation of donor hearts that have stopped beating after death, representing a monumental shift in how hearts are sourced and preserved.

This technological advancement allows for better matching of hearts to recipients and potentially increases the number of heart transplants by an additional 1000 annually worldwide.

Most importantly, it extends the amount of time a donor transplant heart can spend in transit from four to 14 hours.

Yet current statistics reveal that barriers such as community awareness, organisational commitment and ethical practices still impede progress.

Zaidee’s Rainbow Foundation has been dedicated to bridging these gaps for the past 20 years.

By promoting awareness and encouraging public discussions, it hopes to cultivate a culture of acceptance regarding organ donation in Australia.

Mr Turner said the foundation had greatly influenced the conversation.

“We can never provide the data of what we’ve achieved, but when you’ve got two million pairs of rainbow shoelaces out there ... it’s immense,” he said.

“Zaidee’s has changed the perception that it’s okay for a family to talk to their children about organ and tissue donation, no matter what age.

“We’re really proud of what we’ve achieved over the 20 years, and in areas we never thought we would get into with our crazy campaigns ... no-one else has done it, no-one.

“We’ve changed the culture nationally from starting the conversation.”

The battle is far from over, but the foundation’s advocacy provides a vital lifeline in the ongoing quest to reshape the global narrative on organ donation.

To learn more about Zaidee’s Rainbow Foundation and organ and tissue donation in Australia, visit zaidee.org