Drawing the Ace of Hearts

In Australia, we have an Organ Donation Register and an Organ Donation List for each person willing or needing to participate in the donor process.

The Organ Donation Register lists all people who have generously decided to donate their organs should they die. Organs capable of donation include the heart, lungs, liver, tissue, bone marrow, eyes and skin. The organs will only be used if suitable for transplant. For instance, a car accident victim may be a poor donor of a heart due to the trauma experienced by the organ.

Putting a note on your drivers licence is not enough to get you on the register. You need to go on line to the Donate Life website and populate the fields. It's pretty easy. There's plenty of useful information there as well.

For obvious reasons, I can only tell you about the Organ Donation List for hearts. It lists all people seeking a heart transplant. There is a separate list for each State and New Zealand. The people on the list are sublisted as urgent, priority or routine.

An urgent recipient is one who is expected to die within 14 days if a donor is not found. The Eastern States and NZ have an organ sharing arrangement whereby an urgent recipient will get first entitlement to any matching heart in any jurisdiction (not just their own).

A heart is a match if it correlates in blood type, tissue type, size and to a lesser extent age and weight. Sex and political persuasion are both irrelevant.

A priority recipient will get first entitlement to a matching heart in the home jurisdiction, irrespective of how long or short he or she has been waiting.  A priority recipient is one who has a special reason to get a heart quickly. I am on the Queensland priority list because I am surgically joined to the hip to the Impaler. The average wait time for a priority recipient in Queensland seems to be around four months. I've been on the list for about three.

A routine recipient will get a matching heart coming up in his or her jurisdiction if it is not first snaffled by an urgent or priority dude. If the particular jurisdiction cannot use the heart it will be offered to other jurisdictions for their own priority and routine lists.

Here at the Prince Charles we get hearts from everywhere including Adelaide, Auckland, Sydney and Melbourne. Sadly, Western Australia is a stand alone State because you cannot get a heart to or from the place in time.

There is no real benefit in being higher or lower in the list in terms of wait time. It's all about matching like with like.

For the record, my blood type is O Negative. My wife thinks that's quite appropriate because it reflects my life philosophy. So if you know a short fattish bloke (or lady) with the right blood type, please do the honourable thing and kill them. Make sure they are brain dead with a beating heart. No heart trauma please. You can test your victim's heart size on the basis that the heart is about the size of the clenched fist.

Being a maths geek at heart (pun intended) I've used my time on Desolation Row to calculate the approximate probability of my getting a heart on any given day. Take three decks of cards and remove all of the twos, threes fours. Then mark one card. Say one of the Aces of Hearts, for symmetry's sake. Then shuffle the three decks together. Every day, I get to draw one card. Only one. If it's the marked Ace of Hearts, I get the transplant that day. It's got to be the marked card, not any of the other two Aces of Hearts in the deck. If it's not the marked card, no transplant today. The used cards always get returned to the deck before the next draw. Every day I draw from the same full deck.

On average one lucky recipient in Queensland (whether urgent, priority or routine) will get a heart every month. In January, we got five! But none in February or March. Importantly, the deck has no memory. Even if there has been a heart on three consecutive days the odds for the fourth day remain the same - one in 120.

So my job is to keep alive and well and stay sitting at the card table. One day my card will come up. Your job is to get on the Register and tell your friends and family to do likewise.

Even if the deceased is on the Donation Register, the family can kibosh the potential donation. So tell your family your wishes.

Some countries have an Opt Out System. There is no Organ Donation Register, only an Opt Out Register. Everyone is deemed to be a donor on death unless he or she has signed up for the Opt Out Register. There is no family kibosh allowed.

This is a good system. It would increase organ donations that can be used successfully for transplant in Australia by twenty or thirty percent.

In Australia we have excellent doctors and hospitals and boast some of the best success rates for transplants in the world. Well done us! However, we have one of the poorer donation rates in the developed world. This means many people die waiting. People like me.

We all need to do something to support law reform for an Opt Out System. I'm going to write to the Federal and State Health Ministers. When I get better, I'm going to do a little lobbying. I hope you'll join me.

Until next time,