On a recent visit to Australia in March 2011, I visited the New South Wales (NSW) Organ and Tissue Donation Service and the Australian Red Cross Blood service. This was to gain a clearer insight into the deceased organ donation programme in Australia and to learn how things operate there. The meetings were set up by Dr. Jeremy Chapman, Transplant surgeon in Sydney. It was an invaluable visit with a number of take-home lessons.

At the NSW Organ and Tissue Donation Service, I met with Ms. Ellie McCann, State Nurse Manager, who took me through the organizational structure and the functioning of the service. The countrywide initiative is funded by the Australian Government. She also spoke about the importance of community education as well as educating medical students since an attitudinal change is required at all levels. The OK campaign, which focuses on the importance of family being OK with organ donation and giving consent, is now being run extensively. In fact I came across the advertisement on my flight to Australia in the Qantas inflight magazine and I mentioned this to Ellie.

I also met Ms. Carrie who is the Organ Donor Coordinator and part of the DonateLife team at the NSW Service. It was interesting to learn that she helps and guides the hospital-based organ and tissue donation medical specialists and nurses through the entire donation process. She also talks to the forensic pathologist, coroner and the retrieval teams. I found out that the treating doctor made the request for organ donation along with the nurse, but only after a series of discussions with the family regarding the bad prognosis and end-of- life care. Carrie mentioned that now many families raise the organ donation option themselves once the diagnosis of brain death has been made. There is also a Donor Family Support coordinator who offers donor families ongoing bereavement support through the Next Step Program. It was heartening to note that there were 309 donors in 2010 as a result of which the lives of 931 Australians were saved. There were 846 and 799 recipients in 2008 and 2009, respectively. The total of 309 organ donations in 2010 equates to a national organ donor rate of 13.8 per million.

I also met with Jenni Wright, Senior Analyst – Information Systems and Narelle Watson, Senior Scientist, Serology Laboratory & Tissue Typing, who are with the Australian Red Cross Blood Service. Narelle showed me the tissue typing laboratory and explained the process of tissue typing for recipients across the eight states in Australia. Jenni made a presentation on the organ allocation process of the National Organ Matching Service (NOMS). It was extremely informative and I hope that the system can be emulated in India in the future. We do have an online recipient waiting list registry in Tamil Nadu, but we will need to develop more comprehensive algorithms (like the Australian NOMS) as we go along.

                                                     - Dr. Sumana Navin