A surgeon in Beaumont Hospital has defended his decision to send three organs to the UK for transplantation last month in the interests of patient safety.
Consultant surgeon Dr David Hickey described the incident as a “travesty” and said he could give no assurances it would not happen again.
The hospital said it sent the organs to the UK “due to a combination of factors”, including a reconfiguration of beds at the hospital’s transplant unit, and because it had carried out twice the number of kidney transplants as is normal over the time period in question.
On January 26th last, four kidneys and one pancreas became available for transplant. Two of the kidneys were used for paediatric transplants in Temple Street Children’s Hospital while the remaining organs were sent to the UK Transplant Service despite long waiting lists in the Republic.
Speaking on RTÉ's Morning Ireland, Dr Hickey said it while it was a "difficult" decision "there are standards and there's a line you can't cross in terms of patient safety".
He said:"My colleagues and I met on the topic and decided that we could not safely bend our standards and we had to send the kidneys abroad.
“We need a significant increase in the number of beds.”
The Irish Kidney Association said recipients could have been found at home but stopped short of criticising the decision and said it was happy that the organs were not wasted.
In a statement issued yesterday the hospital described the situation at the end of January as “highly exceptional” but said it was “not an issue of bed capacity per se”.
The statement said that as a result of building works being undertaken at Beaumont there had been an interim reconfiguration of the beds in the transplantation unit.
“This means that the beds used for patients immediately post operatively are currently in a different location to the main ward to ensure their safety and that has issues for provision of nursing by the highly trained specialist staff.”
There are approximately two renal transplants every four days over the course of a year and patients remain within the transplant unit for between four and seven days following their operation.
“On the day in question seven patients had received transplants in the preceding two days. In addition, a patient with a pancreas transplant had just been transferred from the Intensive Care Unit to the transplant unit and it would have been unsuitable to move this patient from the unit. Such circumstances are extremely unusual,” the statement said.
Management and clinical staff sought unsuccessfully to address the issue when they arose on the day and a situation in which organs might have become unviable for transplant was averted by transferring them to another hospital outside the jurisdiction.
The hospital said that measures were being put in place, including recruitment of additional specialist transplant nurses along with reconfiguration of appropriate beds to ensure, that such a situation does not recur.
“Longer-term plans are also being formulated in the context of the development of the living donor renal transplantation service,” it said.
The renal transplant programme at Beaumont is the most active transplant programme in the State and achieved significant growth during 2009. A total of 172 kidneys were transplanted last year, against 146 in 2008 and the 157 undertaken in the previous record year of 1998. Of the 2009 total, 164 transplants were kidney only, 18 were completed as part of the living donor programme, eight were combined kidney and pancreas and one was pancreas only.
There are 580 patients currently awaiting kidney transplant and 25 awaiting a pancreas. The average waiting time for a kidney is just under three years and the average waiting time for a pancreas/ kidney is nine months.