International Pathology Day celebrates 50 years of matching organ donors with recipients
To mark International Pathology Day on 13 November, RCPI Faculty of Pathology held a special event at No 6 Kildare Street.
In her opening address, faculty dean Prof Mary Keogan introduced the event as a 50th anniversary celebration of the state’s first immunogenetics and histopathology lab, allowing for organ donors to be tested and matched with compatible recipients.
In a session focusing on the life-changing impact of organ transplantation, Dr Colm Henry (Chief Medical Officer HSE) described the recent Human Tissue Act as a “seminal event in healthcare history.” The legislation enshrines donors’ wishes by allowing their families to become advocates.
Dr Henry also discussed renal transplantation in relation to research showing a 265% expansion in in-centre dialysis – a treatment said to be associated with a low quality of life. “We’d like to get to a stage where somebody in end-stage renal failure can go for a planned transplantation rather than dialysis,” he said, referencing the creation of a new nephrologist role in Beaumont Hospital to help reconcile the demands on dialysis treatments.
Dr Brian O‘Brien, director of Organ Donation & Transplant Ireland, presented on the state’s first ever kidney transplant, performed on young musician Edward Tobin in 1963. In a period before a histocompatibility and immunogenetics service, Dr O’Brien speculated that Mr Tobin was treated with whole-body irradiation and steroids, leading to survival of six weeks. Dr O’Brien made a comparison with recent achievements in xenotransplantation: “If we are now getting survival of pig hearts from six-to-eight weeks, we could eventually move into a world where we don’t have to seek organs from dying humans.”
Sharing experiences with donors’ families in Intensive Care Units (ICUs), Dr Catherine Motherway, former head of University Hospital Limerick’s ICU, encouraged improvement of Ireland’s donation rate. Ms Martina Goggins, founder of the donor foundation Strange Boat, described her experience when her son Éamonn was in ICU, and how the tact and communication of hospital staff helped fulfil his wish to donate his organs. “When the question of organ donation was raised, we had no hesitation as, thankfully, I had a conversation with Éamonn about what his views would be. If organ donation was raised too soon, we might have thought that all life-saving attempts weren’t being pursued,” she said.
Clinical experts talked about improvements to transplantation. Microbiologist Dr Breda Lynch discussed changing attitudes towards donors with blood-borne viruses in Mater Misericordiae University Hospital. Dr James O’Rourke (anaesthetist, Beaumont Hospital) talked about how regional perfusion treatments can increase the number of organ donors. Faculty dean Prof Keogan (immunologist, Beaumont Hospital) shared how the National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation (NHISSOT) was improving donor-recipient matching, and enhancing post-transplantation monitoring.
A second session in the day focused specifically on renal transplantation. Mr Tiberius Perreira (cofounder of Patients for Patient Safety Ireland) shared his experience as a transplant recipient, and Mr Usman Horoon (transplant surgeon, Beaumont Hospital) presented on advances in renal transplantation and expanding the donor pool. Donor evaluation was discussed by chemical pathologist Dr Colleen Flannery (University Hospital Waterford) and histopathologist Prof Brendan Doyle (Beaumont Hospital). Nephrologists Dr Carol Traynor (Beaumont Hospital) and Dr Aisling Courtney (Belfast City Hospital) talked about expanding living-donor transplant rates.
In a final session – focusing on cardiothoracic, liver and pancreas transplantation - Prof Tom Gallagher (transplant surgeon, St Vincent’s University Hospital) provided an overview on liver transplantation in Ireland. Histopathologist Dr Niamh Nolan (St Vincent’s University Hospital) shared how the donor profile in Ireland is changing, with increased signs of chronic liver disease and alcohol consumption found in donors. Focusing on heart and lung transplantation, cardiothoracic surgeon Ms Aisling Kinsella revisited the first heart transplant performed in Mater Misericordiae University Hospital in 1985, which gave the recipient 1-3 years life expectancy. (Life expectancy is hoped to be 14 years currently, with better organ preservation and immunosuppression), and Prof Aurelie Fabre (histopathologist, St Vincent’s University Hospital) presented on the pathology of heart and lung transplantation.