public awareness and urge people to discuss donation with their families.

Representatives from the New England Organ Bank, with which Bermuda is affiliated, will be talking to community groups about organ donation procedures and the importance of informing relatives of the decision to become a donor.

While improved preservation and surgical procedures mean transplants are becoming increasingly more successful and demand for organs is greater than ever, there has been just a small increase in organ and tissue donation in the United States in the last five years.

King Edward VII Memorial Hospital Intensive Care Unit coordinator Mrs. Glenda Daniels has urged people to discuss the subject with their next of kin.

She said the concept of introducing donor cards or recording donor information with driver's licences in Bermuda had been shelved several years ago. Even if a patient carries a card consenting to donate, he must be declared brain dead and his relatives must sign a letter of consent before organs can be removed.

"We've simply been asking people to talk to their next of kin,'' Mrs. Daniels said.

KEMH follows strict protocol guidelines as set out by the New England Organ Bank which, in the event of a possible donor, flies a team to Bermuda to offer counselling to the donor's family and to remove liver, heart, lungs, kidneys or pancreas.

Broaching the subject with a patients' family is tough, Mrs. Daniels says.

"Quite often family members bring it up themselves. Otherwise we try not to push it. It's either yes or no. If they are approached too early it turns them off.'' A series of tests to prove the patient brain dead must be carried out before relatives can be consulted. A patient in a coma or in an unconscious state is not eligible to donate organs.

Relatives must consent unanimously before organs can be removed. At that point KEMH contacts the New England Organ Bank which flies in a consultant to assess the patient, followed by teams specialising in the removal of different organs. The organ is immediately matched to a recipient and flown to the hospital where it is needed.

Before surgery, team members talk to the donor's family at length to explain the procedure. A follow-up programme means relatives are informed whether the organs have been used and the success of the transplant.

In the US, hospitals must by law approach the family of every deceased patient for organ and tissue donations.

Donation coordinator at the New England Organ Bank, Ms Sharon Matthews says ongoing public education is vital to the success of organ donation.

At present, more than 38,000 people are waiting for transplants in the US. In Bermuda, an average of three donations are made each year. While organs are donated to the New England bank, corneas remain on the Island for eye surgery.

"People are pretty good about it in Bermuda,'' said Mrs. Daniels. "We talk to relatives about it and often they agree.''