Hawaii has one of the highest rates of kidney disease in the United States.

Currently there are 430 patients on a transplant waiting list in the islands. End-stage renal (kidney) disease put about 93 percent of them on that list, which costs Hawaii’s health care system approximately $10 million annually.

Although actual transplants are expensive, the annual cost of medical care for kidney transplant recipients is 10 percent of the cost of medical care for kidney patients on the waiting list. Many of those on the list are undergoing dialysis in hopes of living long enough to receive a life-saving transplant.

So what if Hawaii became the first state to make organ donation an automatic process that people could choose not to take part in, rather than waiting for people to opt in?

Transplants are expensive, but even more costly is keeping people alive who are on transplant waiting lists. Flickr.com

The current process includes registering on a website (legacyoflifehawaii.org) or noting organ donation status on a driver’s license or state identification card. Each of those options requires active participation in the program, and all too often, people do not go to the trouble of registering as an organ donor.

But if it was automatic, then those who felt strongly against it could opt out of the program — for any reason.

This could significantly increase the number of organ donations in the islands, and potentially decrease the waiting time for local residents needing a new kidney or new liver. Transplants are done locally, and that could add to the much-needed family support for those who both give and receive organ donations.

It’s not a new idea. This has been done in other developed countries for over a decade. Twenty-four European countries have “presumed consent” for organ donation, including Austria, Belgium, the Czech Republic, Finland, France, Greece, Hungary, Israel, Italy, Luxembourg, Norway, Poland, Slovenia, Spain, Sweden and Turkey. In some countries up to 90 percent of residents are participating.

In contrast, in countries such as the United States only 15 percent of people are organ donors, as the default status is not to be a donor.

Kidneys are not the only organs desperately needed in Hawaii. Other organs can be transplanted locally. The local branch of Legacy of Life notes that other organs that are accepted are the heart, pancreas, liver, lungs, and kidneys for life-saving organ transplants. Tissues can also be donated, such as corneas, bones, tendons, and skin for life enhancing procedures to replace damaged or diseased tissues.

It’s often after a traumatic injury that organ donation takes place. However, without local awareness of how the process works, many potential organs are not procured for those in need.

Other states have tried to enact legislation to make organ donation the presumed option for someone upon death, but have met with significant opposition. Connecticut state Sen. Ted Kennedy Jr., a health care attorney and cancer survivor, said he was inspired to draft the bill after Connecticut Senate President Martin Looney received a kidney transplant. But the proposal did not make it out of committee.

Given our ethnic challenges in finding organs that match with our population, it would seem that having Hawaii be the first state to pass legislation mandating an opt-out approach to organ donation would make sense.

When I moved here, I signed up to be an organ donor right away. I’ve asked my brothers if they are as well, and they both nodded their heads in agreement.

Even if it never comes to pass, as a health care provider, it’s my duty to be a part of a program that could end dialysis as we know it, revolutionize the way medicine is practiced locally, and provide this life-saving option for those who might be alive on this planet longer than I will.

I don’t plan on dying anytime soon, but if for some reason that happens, I would want my final legacy to be made helping someone else, just as I would accept an organ donation if I needed one.

Meanwhile, it would be nice to increase the survival chances for those on the transplant waiting list by presuming everyone is willing to help unless they specifically say otherwise.

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