 HISTORY OF ORGAN DONATION
The history of organ donation and transplantation are inseparably entwined. Before 1960 kidney failure had a dreadful prognosis and dialysis was very crude and often dangerous. Many patients died within months of the development of kidney failure. There was no treatment for liver failure or advanced heart failure. In 1960 an act of charity between two twin brothers allowed the UK’s first successful kidney transplant to be carried out (from one brother to the other) in Edinburgh by Sir Michael Woodruff. Following this a small number of living-donor transplants were performed between siblings. By 1965, technology had moved on and it became possible to transplant kidneys taken from people who had died under cover of new immunosuppressive drugs (which were used to prevent the rejection of transplanted organs), some of which were developed in Scotland. Over the coming years the use of organs from deceased donors became much more common and living kidney donation became a rarity. The establishment of a robust definition of brainstem death; where the heart continues beating but the brain has died and can no longer control vital functions including breathing, improved the quality of organs and the outcomes of transplantation. As a result, kidney transplantation became accessible to patients all over Scotland. The accumulating expertise in transplantation in Scotland combined with the creation of a UK-wide organisation for matching organs provided the opportunity to extend services. In 1992, the Scottish Liver Transplant Unit was established by Professor Sir David Carter and the first liver transplant was carried out by Professor James Garden in November of that year. Since then more than 720 patients have benefitted from a liver transplant in Scotland. The Scottish National Heart Transplant Programme was then established in Glasgow and in 2000, the Scottish Pancreas Transplantation Programme undertook its first transplant - over 100 of which have now been performed in Edinburgh to date. Medical care of patients with organ failure continued to improve and it became possible to keep more and more patients alive while they waited for transplants. Partly because of this, the waiting lists for transplantation lengthened and the shortage of organs for transplantation began to cause real concern. Living-donor kidney transplantation came back into regular use and around a quarter of all kidney transplants now performed in Scotland are from living donors. Scotland was awarded the first NHS-funded living-donor liver transplant programme and the first such transplant was carried out successfully in January 2008 from a woman to her husband at the Royal Infirmary of Edinburgh. In Scotland, many patients continue to wait for transplants and a proportion die waiting. Scotland has the lowest rate of organ donation per million population in the United Kingdom. Continued: Organ donation and transplantation is one of the strongest examples of partnerships in health between the community and the NHS. Without the generosity of the public in discussing organ donation and their families in confirming their loved one’s wish to donate, transplantation simply could not happen as it does today. In Scotland each year some 180 patients receive a new kidney, 60 a new liver, 12 a heart and 25 a pancreas and kidney. The future development of transplantation in Scotland depends on the support of the Scottish public in backing organ donation. Stephen J Wigmore
Professor of Transplantation Surgery Scotland in 1948 How the NHS came into being in Scotland is a story that isn't widely known. It had its own strong and distinctively Scottish roots well before 1948. Looking back at 1948 largely through the black and white filters of film and photos seems to capture a grim era of austerity when basic items like food were still subject to the rationing imposed in war time. But daily life in Scotland also had its fun, excitement and even colour. - Glamour had returned to Edinburgh with its new Festival.
- Oor Wullie on his upturned bucket offered weekly cheer along with the Broons.
- Hibs had won the League, Rangers the Cup and East Fife the League Cup. Henry Cotton had just won his third British Open at Muirfield.
- And Cathie Gibson from Motherwell was about to head off to the London Olympics where she became the only British swimming medallist.
- Millions went to the pictures . . . to see a stunning Moira Shearer dance ballet in the Red Shoes. And the prospect of Whisky Galore then being filmed in the Western Isles during a summer of flash floods.
What made Scotland different? The NHS didn’t suddenly appear from nothing on July 5 1948. It also did not create a single new nurse, doctor or bed. Health Minister Aneurin (also known as Nye) Bevan merely nationalised the existing system across the UK. The revolutionary change was to make all services freely available to everyone. Half of Scotland’s landmass was already covered by a state-funded health system serving the whole community and directly run from Edinburgh. The Highlands and Islands Medical Service had been set up 35 years earlier. In addition, the war years had seen a state-funded hospital building programme in Scotland on a scale unknown in Europe. This was incorporated into the new NHS. Scotland also had its own distinctive medical tradition – centred on its medical schools rather than private practice. And a detailed plan for the future of health with the Cathcart report. Through the writings of AJ Cronin, the creator of Dr Finlay, it also shaped public opinion in favour of a National Health Service by exposing the injustices of existing provision. |
