LONG WAITLIST FOR REPRIEVE
According to statistics from the NTRC, more than 10,000 people are on the waitlist for organ donations.
As of February this year, kidney transplant patients make up the largest group, with 10,197 individuals – adults and children – on the list. This is followed by those requiring heart transplants (21), liver transplants (11), heart and lung transplants (eight), and three patients awaiting a lung transplant.
In 2015, there were more than 19,000 patients on the waiting list for a kidney, according to a report by the New Straits Times then.
The number of people on the organ transplant waiting list may have declined as compared to a decade ago, but this can be attributed to how the criteria to be added to the list have become more rigorous in recent years.
President of the Malaysian Society of Transplantation Zaimi Abdul Wahab said that while the waitlist for donations from deceased donors was once open to anyone aged between 18 and 60, they are now subjected to stricter selection.
“Previously, patients who had been on dialysis for 20 years would automatically move to the top of the transplant waiting list,” he said.
“However, after analysing patient survival rates, we found our outcomes were less favourable compared to other countries. This led us to revise the system, as many of these long-term dialysis patients were older.”
Zaimi said that a change in the allocation system for patients had resulted in a reduction in the number of people on the waiting list. But he stressed that this does not necessarily mean that there are fewer patients waiting for a kidney.
He said that currently all patients on dialysis – numbering about 50,000 – would be placed on the national renal registry.
Adults aged between 18 and 60 are eligible for a kidney transplant, with an Estimated Post Transplant Survival (EPTS) score used to determine how long one was likely to benefit from a transplant.
The score takes into account factors such as age and diabetes and the length of time a patient has been on dialysis. Candidates with a low EPTS, a score closer to zero, would likely have the longest time to benefit from a transplanted kidney.
“Their EPTS score will be calculated and those with EPTS less than 40 per cent only are considered to be eligible to receive a kidney from a deceased donor,” said Zaimi, adding that those below 18 are placed on a paediatric waiting list.
Those not on the waiting list can still get a kidney from a living donor.
The stricter criteria for the waiting list would mean more people needing to get donated kidneys from those who are alive, but there are no publicly available statistics on the size of this group, or how many succeed in getting such donations.
The shorter waiting list compared to the past also means that the waiting time for a deceased-donor kidney transplant in Malaysia has gone down.
The average wait used to be as long as 20 years. It is now about 10 to 15 years, said Zaimi, but he again stressed that looking at the larger picture, this is far from ideal.
“Even now we have over 10,000 people on the list for a kidney, but only 80 kidneys (available) a year. Many on the list would have passed on because there weren’t enough organs for donation,” he said.
Data from the International Registry in Organ Donation and Transplantation indicates that Malaysia has experienced variability in deceased donors, with a recent upward trend culminating in 43 donors in 2023.
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