INTRODUCTION: The purpose of this communication is to examine the positive effect of the Transplant Games on organ donation, the link between public opinion and organ donation being the impact and intensity of positive media response and dissemination of information. At their inception in 1978 in Portsmouth, England the purpose of the Games was and is to disseminate as widely as possible the excellent rehabilitation which a successful organ transplant confers on its recipient.

In the 18 years since the Transplant Games were first held, the number of competitors has escalated from 100 to over 1,500 and the participants at the World Games exceed 3,000. Every competitor is the recipient of a life supporting organ graft and sometimes a combination of allografts, all competitors are on immunosuppressive therapy. The World Games take place every 2 years with some 43 countries taking part. In addition all these countries hold national events in which up to 1,500 persons of all ages (4-70) compete. Categorisation into age groups - adult, veteran, super veteran and children ensures equable competition. Since 1993 the World Winter Games held thus far in the French Alps have drawn 200 enthusiastic competitors.

The international 5-6 day games number some 50 events including track and field (with a 13 kilometre mini marathon) swimming, racquet sports, golf and cycling. Standards are high. The 100 metres sprint is won in 11.1 seconds, the 1,500 metres in 4 minutes 31 seconds and the 100 metres free style swimming in 61.8 seconds.

Safety is monitored by rules which ensure enforcement of specific medical parametres indicating the calibre of graft function. Evidence of previous performance is sought and each competitor has a health clearance document signed by their own transplant specialist and checked by both the local organising committee physician as well as by the medical adviser to the Transplant Games Federation.

MATERIAL AND METHODS: Data on the extent and monetary value of the Television, Radio and Newsprint (the later measured as $ per column inch) was monitered and collated by Stanniforth P.R., Manchester. Figures for both Donor Registration and numberof actual donorsfrom whom organs were removed and used for transplantation were obtained from the UK Transplant Service in Bristol. The Hungarian Transplant Agency in Budapest provided the 1991 figures for Hungary. The British Transplant Games were held in Portsmouth in 1994 which is the site of the Wessex Regional Transplant Unit (a region with a population of 2.5 million) and in Sheffield in July 1995. In August 1995 of the same year the World Games were held in Manchester some 50 miles away. Both these centres are in the North West Region. In June 1996 the local Portsmouth newspaper initiated a 2 months long campaign extolling the virtues and benefits of organ transplantation to its readers and urged them to forward their names to the National Donor Registry in Bristol, their postmark identifying the source of the registrant.

RESULTS: Kidney transplants in the Wessex region during July, August and September 1994 increased by 42% compared to the same 3 months in 1993. Nationally over that period the increasewas 6%. During the months of maximal regional and national publicity (June, July, August and September 1995) associated with the Transplant Games in Sheffield and Manchester registration of donors rose from 384,000 to 1,100,000 (157%) over the 4 months preceding the games and was 56% higher for the 4 months following the games.

During the period of and immediately before and after the Games organ donation in the North West region increased by 60% (55 vs 74 donors) compared to the same period in 1994. Nationally the increase was only 3.8%. For the whole of 1995 donation was increased by 35% comparedto 1994. Nationally the corresponding figure was 4%.

In Hungary the increase in organ donation in 1991 was 34% compared to 1990 the main increase being around the period of the publicity created by the World Transplant Games in Budapest in August 1991. As a result of the 2 months local newspaper campaign in Portsmouth there was a 67% rise in donors registered with the Portsmouth post code. The rise of registered donors not bearing the Portsmouth post code was 7%.

DISCUSSION: Unarguably organ donation is an individual choice irrespective of whether the decision is for oneself or for donation pertaining to a close relative. Laws may facilitate the decision but cannot either enforce or determine the choice. Good organisation and efficient logistics e.g. the Spanish example, provides an effective conduit for such choice by allowing its translation into the harvesting of organs and effective transplatation. Individual choice is influenced by a variety of factors of which paramount are public opinion and positive media pressure.

The beneficial physical and psychological efects on the competitors taking part in the Transplant Games have not been objectively studied although it can be easily observed by both officials and spectators. Positive physical health and fitness as well as fun have been provided. The foreging of national and international friendships take place. There is reassurance of long term survival in the presence of active peers. The pride derived as a result of winning a coveted gold medal is almost palpable when shared with the families who have previously seen the competitor in precarious health. The data we have documented on the effect of the Transplant Games on organ donation would indicate that it clearly influences public opinion,that the influence translates to increased organ donation and that the media is the conduit of that influence. However, the influence is predominantly regional and of relatively short duration. In order to sell our "product" - organ donation -the influence on public opinion must be national, sustained and expertly directed by media specialists. We have shown that the Transplant Games is a powerful and effective tool in such an endeavour.

 

Last modified: 11 May 2000