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Stressed health system impacting Australian eye donations

New Australian Government data of organ and tissue donation shows eye donations are up 12% year-on-year, but a leading eye bank director says stress on the health system is contributing to lower rates compared to pre-pandemic levels.

The latest ‘Australian Donation and Transplantation Activity Report’ shows in 2021 there were 1,472 deceased eye donors, up by 154 compared to 2020. As a result, there were 2,413 corneal transplants, which was 6% more than 2020 when 2,277 were performed.

While the numbers are trending up, they still lag behind 2019 rates when 1,505 eye tissue donations were reported. However, 2021 is comparable to 2019 in terms of corneal transplants undertaken (2,413 vs 2,414).

Since 2009 – when there were only 922 eye donors – more than 26,000 Australians have received a corneal transplant.

Lions Eye Donation Service (LEDS) director Dr Graeme Pollock, who founded the Melbourne-based organisation in 1991, said the organ and tissue donation sector would not recover until the health system was in better shape.

Dr Graeme Pollock.

“And during recovery it will be a case of the donation agencies (organ, tissue and eye) having to re-build and repair some of the referral pathways – there is some hard work ahead,” he said.

“The donation rates are intimately associated with the degree of stress that our hospital/health systems have endured during the pandemic. It’s a complicated interplay of many factors.”

According to Pollock, these include:

  1. A stressed health system places stress on referral systems for donation, and results in fewer referrals coming through as potential donation.
  2. The potential donor pool is somewhat decreased due to the current high incidence of COVID (which is a contra-indication to donation).
  3. Although difficult to completely evaluate, it does appear the additional stresses placed on families during COVID (less access to visitors at hospitals etc) means that the consent rate for donation has been slightly decreased.

“This stress, less donation, has been felt across all sectors of donation – organ, tissue and eye,” Pollock added.

“For our particular eye bank – Lions Eye Donation Service – we have seen lower donor rates in 2022 than we saw in 2020 and 2021. It’s the result of health systems stress and community fatigue.”

Last year, Insight reported how COVID-19 lockdowns and elective surgery shutdowns negatively impacted eye donation rates across Australia. In some cases, donation rates halved, with only 30-50% of usual corneal surgeries being performed depending on their urgency.

In addition, lockdowns put pressure on donor referral systems out of hospitals, which rely on staff having donation front-of-mind. COVID-19 restrictions made bereavement more challenging for families, with donation sometimes considered too complicated to consider at such difficult time.

The latest 2021 report also had a state-by-state breakdown of eye donations.

Queensland had the highest rate with 479, followed by New South Wales (383), Victoria (300), South Australia (147), Western Australia (135), Tasmania (16), and ACT (12).

Of the nation’s 1,472 decease eye donors, 1,154 people donated their eyes only, 127 were eye and tissue donors, 97 were organ, tissue and eye donors, and 94 were organ and eye donors.

The full 2021 report can be accessed here.

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