Organ transplantation is an age-old topic, with the first renal transplant reported in 1969. However, the rate of organ donation in Hong Kong is low: with only six donors per million population, Hong Kong lags behind many developed countries in this respect. For the past 40 years, Dr Ka-foon Chau, Head of Division of Nephrology at the Department of Medicine, Queen Elizabeth Hospital, Hong Kong, has worked ceaselessly for her lifelong mission of organ transplantation. Dr Chau, also honorary president of Hong Kong Transplant Sports Association and a member of the Committee on Promotion of Organ Donation, gives us a chance to see behind the scenes of organ procurement and the limiting factors in Hong Kong.

Forty years ago, organ donation was not a popular concept. Dr Chau recounts a tearful story that sparked her lifelong mission. While she was still a junior doctor, resources were so limited that patients who were unmarried or without children were denied dialysis. Among those denied treatment, some women committed suicide because they could not work or have children, and were incessantly rebuked by their in-laws. There were also young men who were in chronic pain. Dr Chau covertly helped to give peritoneal dialysis to one of these young men who was only in his twenties. After some time, his abdomen was so scarred she could not find a clear space to insert another needle. She spent the last few hours of his life by his side. Dr Chau remembers that he never had a word of complaint, although he was in so much pain. She thought at that time that a kidney would have eased his suffering.

Dr Chau thus plunged headfirst into organ donation. She joined training workshops and liaised with the Hospital Authority and the Hong Kong Government about the topic. She also led her nephrology team into proactive organ procurement. Nonetheless, while organ donation has evolved to become a more commonly discussed topic, there remains a gap between theoretical understanding and concrete practice. In 2008, Dr Chau inaugurated the Hong Kong Transplant Sports Association, with a vision to improve rehabilitation after transplant surgery, to acknowledge the families of organ donors, and to raise awareness of organ donation in society.

She led the first team of transplant patients from Hong Kong to the biennial World Transplant Games in Bangkok, Thailand. Since then, the popularity of the Games has flourished in Hong Kong and internationally. Competitors from Hong Kong have won medals in the Games, and have participated in a wide variety of regional and international championships. For patients, the Games are a strong incentive to exercise, paving the way to better rehabilitation; for donors and their families, the Games provide acknowledgement for their altruistic contributions with vivid, breathing examples. In 2012, Dr Chau coordinated the Hong Kong Transplant and Dialysis Games. This local addition gives more incentive to rehabilitate, and allows for greater connection between transplant recipients and donor families, whose participation is also welcomed. The Games is a powerful testimony to those involved in organ donation, showing the world the life-giving impact that organ donation can make. Perhaps most importantly, the Games reorients any misconceptions and reasserts that transplant patients can achieve many things.

“If I don’t give up, why should you give up?” After retirement, Dr Chau is still an unfalteringly passionate advocate of organ donation. Despite years of hard work, the organ donation rate in Hong Kong still remains low. Transplant medicine not only necessitates the transplant itself, but a multidisciplinary approach ranging from psychological support for donor families to hospital management for efficient organ procurement and policy making for better delegation of resources. The limited availability of intensive care unit beds, lack of organisation in organ procurement, unsupportive government bodies, and the conservative local culture are still major barriers to organ donation.

There have been times when Dr Chau has felt helpless, and she cheerfully accounts her unyielding passion to the like-minded friends who gave her a pat on the shoulder and cheered her on. This seems to be her outlook of life: we are all here to help each other out.

The recent coronavirus disease 2019 (COVID-19) pandemic casts a lot of uncertainty and challenges on the healthcare system, yet Dr Chau is not staying idle. She is now preparing her first broadcast on RTHK, titled: “The ‘New’ Breakthrough of Transplants”, which will be aired between July and September 2020. Please tune in to her broadcast!

Dr Chau’s enthusiasm in her work inspires us to strive for better care for our patients. “No matter what your calling is—it does not have to be in organ transplant—if it is a good and noble cause, go for it wholeheartedly, and you will be working directly or indirectly for organ transplantation too.” We can all play a role in this movement by signing up ourselves, sharing with family members, or even volunteering at the Transplant Games. There is always something we can do to improve our patients’ care.

Find out more about organ donation and sign up as an organ donor at: https://www.organdonation.gov.hk/eng/home.html

Tune into “The New Breakthrough of Transplants” airing 6 July to September 2020 at RTHK

Details of the World Transplant Games Federation can be found at: https://wtgf.org/