Mind the Gap:

Challenges in the Lack of Organs for Transplantation

Professor Anthony Warrens is Dean for Education and Director of the Institute for Health Sciences Education at Barts and The London School of Medicine & Dentistry, Queen Mary University of London. He is Professor of Renal and Transplantation Medicine and an Honorary Consultant Renal Physician at the Royal London Hospital where he has a particular interest in transplantation medicine but continues to participate in the management of a full range of patients with renal disease. He is a Non-Executive Director of Barking, Havering and Redbridge University NHS Trust and sits on both the Advisory Committee for Safety in Blood, Tissues and Organs and the UK Donation Ethics Committee. He is President-Elect of the British Transplantation Society and is a past President of the Section of Transplantation of the Royal Society of Medicine. His research interests include attitudes to organ donation, particularly in different ethnic groups, and biological mechanisms of rejection.

He trained at the Universities of Glasgow (BSc), Oxford (DM) and London (PhD) and undertook a period of post-doctoral training at the Massachusetts General Hospital, Harvard Medical School, Boston, USA.

To fill the yawning gaps in his diary, he is Chair of Council of the London School of Jewish Studies (LSJS) and a trustee of the UJIA as well as being a governor of Immanuel College.

Professor Warrens highlighted the major health problem of the widening gap between the need for and the supply of organs for transplantation. At the moment three people die every day on the UK waiting list because an organ has not become available for them. While alternatives such as animal organs and stem cell technology are the subject of major research, no real alternative is yet available. Nor has it proved possible to find ways of switching off the immune response to a graft and thus avoiding rejection without very powerful immunosuppressive drugs (i.e. to induce ‘immunological tolerance’). As a result, we have started using organs that we would not previously have considered, such as those from other, less well donors, or ABO-blood group incompatible donors – with surprising success. However, most success has come from promoting the use of organs from living donors and from people whose deaths have been defined by circulatory failure rather than the classical brain-stem death criteria. Judaism’s attitude to donation is very positive in principle, as it is to any life-saving procedure. Its sole concern is in defining death and not hastening death. There remains a difference of opinion amongst rabbinic authority as to whether brain stem death is acceptable under Jewish law. Discussions continue.