Kidney, heart and cornea transplants have been performed in Malta for more than two decades and the number of donated organs is increasing every year.

The Department of Health Regulation states that one organ donor can save up to eight lives. The same donor can also save or improve the lives of up to 50 people by donating tissues.

“Kidneys are the most common of all donated organs, with around 20 renal patients undergoing a transplant each year in Malta,” says James Muscat, president of the Transplant Support Group, a voluntary association that helps create awareness through talks and presentations within the educational and health sectors.

“Living kidney donation, both related and unrelated, is becoming increasingly popular in Malta and this sense of altruism is contributing to a new lease of life for patients on the waiting list,” says Mr Muscat, who is a living kidney donor himself.

Being in regular contact with kidney patients, Mr Muscat can appreciate first hand how these people’s lives change after they receive a long-awaited transplant.

“Organ donation saves lives. All it takes is a little love. It is the greatest gift of all. As a living donor I strongly feel that transplantation offers patients a better quality of life.”

The Transplant Support Group, founded in 2000, has been instrumental in boosting organ donation awareness in Malta.

Unfortunately, some people are still somewhat sceptical about organ donation and might be influenced by certain myths

“The vast majority of the population is not only fully aware of the benefits of organ donation but also supports this very noble cause,” Mr Muscat says.

Specialised medical teams perform transplants in Malta, the kidney being the most common organ, although hearts and corneas are also transplanted locally.

“More than 300 kidney patients receive dialysis treatment in Malta. About 20 receive a new kidney each year from generous individuals who are registered as organ donors and others who altruistically donate one of their kidneys during their lifetime. Surplus organs, mainly from Italy and the UK, are occasionally transplanted to Maltese patients. Reciprocally, organs that are not transplanted locally can be sent overseas.”

One or two Maltese patients receive a new heart each year. The cornea, a tissue rather than an organ, can be banked and this offers a better chance for patients on the waiting list.

Muscat says nearly 50,000 people were in possession of a donor card between 2000 and 2017. This system has now been replaced with an official register administered by the authorities. More than 13,000 people are now officially registered as organ donors. The new legislation, introduced in 2016, allows anybody aged over 16 to enrol as an organ donor.

“Nevertheless, if a young person aged under 16 passes away, the parents can still opt to donate their child’s organs. Tests on cadaveric donations are carried out only when the person is certified dead by two independent doctors. In the case of living donors, both patient and donor are medically screened ahead of surgery to maximise the success of the transplanted organ,” he points out.

“Surgeons, consultants, nurses and transplant coordinators are all involved in this process. Certain criteria will decide who the eventual recipient of a donated cadaveric organ will be. Apart from the waiting list, the health condition and medical screening of the potential recipient at the time of the transplant will determine if the patient is ready to receive the organ.”

People have added their names to the register to expressly forbid their organs from being donated. Why does this happen? Are they scared?

“Every individual has the right to decide whether to be a donor or not. The system allows for people to opt out, meaning that they specifically declare that they do not want to donate any organs after their death. Unfortunately, some are still somewhat sceptical about organ donation and might be influenced by certain myths,” Mr Muscat explains.

The Transplant Support Group held extensive consultations with the authorities before the opt-in system was officially introduced in Malta.

“This system is very widely used overseas and has yielded very positive results. We need to keep in mind that Malta is a small country with strong moral views. The opt-out system would be more suited in countries where the waiting list is endless,” Muscat says.

The group’s founder, Alfred Debattista, received the heart of a young Gozitan man. The transplant took place more than 18 years ago.

“Alfred passed away last year but his legacy lives on. His motivation and dedication are still felt in our efforts to promote organ donation. Together with my fellow committee members I strive to help patients and their families. As president of this philanthropic group, my ultimate wish is to see more people receive the greatest gift of all.”

‘My donor offered me a second chance’

Moira Tabone Farrugia is a 29-year-old mother who underwent a cornea transplant in March 2016.

Her long and painful journey started when she was studying in Ireland. Moira started to experience a gritty sensation in her right eye and felt extremely sensitive to light. As soon as she returned to Malta, she headed straight to Mater Dei Hospital in excruciating pain.

“The pain was greater than what I felt when I gave birth to my daughter,” she says.

She had contracted acanthamoeba keratitis, a rare disease in which amoebae invade the cornea of the eye and which may result in permanent visual impairment or blindness.

First recognised in 1973, the disease is a rare, vision-threatening parasitic infection seen most often in contact lens wearers and which is difficult to both diagnose and treat.

In fact, Moira was initially misdiagnosed as suffering from herpes, as the symptoms are similar, until ophthalmic surgeon Franco Mercieca, whom she calls “the god of gods”, examined her in January 2016 and diagnosed her with the disease, telling her she needed a corneal transplant as soon as possible.

But being heavily pregnant with her daughter, who was due in January, she had to wait.

“After giving birth and all went well, I went to hospital where I stayed for two weeks in preparation for my transplant. This was a difficult time for me. The pain in my eye was unbearable and I hardly ever slept. I had a paralysed pupil, practically no iris left and a very thin cornea.”

Finally she went through the emergency transplant in March.

“The good thing about corneal transplants is that a cornea coming from a donor does not have to match, like a kidney or a heart, so the process is easier and less complicated from that aspect.”

After the transplant, Moira’s eye started rejecting the new cornea. She experienced double vision for a while, which is normal until one’s eyesight adjusts, and also recently went through trabeculectomy, a surgical operation that lowers the intraocular pressure inside the eye.

Although vision from her right eye is still relatively poor, Moira hasn’t lost all hope. She’s off to London shortly for a check-up on a machine that is not available locally and might need a second corneal transplant.

“All of this has become part of my life. I never thought I was so strong. I’ve learnt how to cope with it. I’ve also learnt how to drive. It takes time to overcome such an ordeal. Sometimes I feel anxious and psychologically distraught.

“But then I think of my donor, who has given me a second chance, who has given me life again. A person’s organs will wither away after death, so why not help someone by donating them instead of letting them go to waste? No other gift can compare to selflessly donating an organ.”

All you need to know about organ donation

Who can register as an organ donor?

To register as an organ donor, you need to be 16 or over.

Is there an age limit?

No, there is no age limit

If I have a medical condition, can I donate my organs?

Yes, you can still be a donor if you have a medical condition. Healthcare professionals will decide whether your organs are suitable for a transplant based on your past medical history when the situation of organ donation arises.

With the new legislation, will my relatives be allowed to overturn my decision?

No, the relatives will not be able to overturn your wish. Nonetheless, it is extremely important to discuss your decision with your loved ones, during your life.

What is the National Human Organ and Tissues Donation Register?

The register is a confidential national database that holds the details of people who want or do not want to donate their organs after their death.

If I register, does it mean that I will be asked to donate organs when I’m still alive?

No, not at all. However, if you ever decide to become a living donor, this is also possible.

After I register my wish to donate my organs, can I change my mind?

Yes, you can change your wish to donate your organs by filling in another form or by completing an electronic form available on www.organdonation.gov.mt. Your wish will be updated immediately.

Will being a declared organ donor (to donate after my death) influence the care I receive in hospital?

Organ donation is not even considered until all possible efforts to save a person’s life have been exhausted and brain death is declared.

Can I choose which organs to donate?

Yes, if desired, a donor can specify which organs are to be donated. The registration form provides for this.

Who will process the personal information collected?

The information is only processed by healthcare professionals involved in the coordination of organ donation and transplantation. Personal data is not maintained after death. The controller is the Directorate for Healthcare Standards.

An application form, available at www.organdonation.gov.mt, makes it possible for donors to decide if they would like to donate all organs or if they wish to be more selective.

For more information, call helpline 2595 3324 or send an e-mail to organdonation@health.gov.mt.

Events being held during Organ Donation Week

As part of Organ Donation Week, the Lifecycle (Malta) Foundation, in collaboration with the Transplant Support Group, is holding a talk about organ donation and organ transplants today at 8pm at the Hilltop Gardens, Naxxar.

James Muscat, president of the Transplant Support Group and a living kidney donor, will conduct the talk and share his experiences together with kidney recipient Amy Camilleri.

Through Organ Donation Week, which is being held until Sunday, Lifecycle aims to get people talking about organ donation with their families and encourage more registrations of organ donations during the campaign.

Organ donation forms are available from Chic Physique Gym Studio and Sanya Spa at Hilltop Gardens, or can be downloaded from www.organdonation.gov.mt.

The talk on organ donation is open to the public. Entrance is free. More information is available from www.lifecyclechallenge.com or www.transplantsupport.org.mt.