Ireland has had its worst year for organ donations in nearly 25 years although patients here may now benefit from a groundbreaking new donor retention scheme in the UK.
According to Mark Murphy, chief executive of the Irish Kidney Association (IKA), Ireland's ability to introduce an effective donor system is failing in comparison with Britain, despite strong public commitment towards donating here.
In an average year there are between 80 and 90 donations of organs. When final figures are posted, a drop-off of around one third is expected for 2010. "We have had a bad year," Murphy said.
There were also about 25 living donors without whom, said Murphy, "we would have had our worst year ever in modern times".
These included 28-year-old Dublin woman Kate Mooney, who donated a kidney to her brother Cathal (31).
Last year there were about 105 deceased kidney transplants compared to 154 in 2009.
"The problem is in deceased donations and we don't know why," said Murphy. "People will speculate about the drop-off in road traffic accidents but the reality is the vast majority of donations do not come from road accidents.
"I think it's a problem in the hospitals and I think Chris Rudge would agree with me."
Rudge is the UK's newly empowered organ tsar who is overseeing a dramatic new addition to the retention system which will see organs taken from accident and emergency departments in British hospitals as well as intensive care wards, which is the normal source.
In the UK, about 30% of organs last year were sourced from cardiac deaths as opposed to the more common brain-stem deaths. Ireland only sources organs from brain-stem deaths.
Murphy blamed the drop-off in donors on a lack of a "proper skill mix" in hospitals that could improve communication with families to secure donations. "Managing them properly is key to getting extra organ donors in the country," said Murphy.
"We are a good nation for donating organs if we are asked and asked properly. The system has failed, not the public.
"Where we could get the same benefit is if we adopted the same system as the UK. We are on the verge of having our own Chris Rudge. We have identified the need for the role of the tsar of transplants in Ireland.
The new A&E approach in Britain – to be launched this year – is likely to benefit Irish patients on waiting lists due to our agreement on organ sharing where appropriate.
Those waiting for livers and, to a lesser degree, hearts and lungs could receive assistance from the UK.