Robert Little of Phillip had his first dialysis treatment aged 12. After two successful kidney transplants he has been waiting three years for a donor to make his third transplant possible.Photo: Melissa Adams

It's been a lifetime of waiting.

Two-time kidney transplant recipient Robert Little was the ACT's youngest patient on dialysis at the age of 12.

The 42 year old sits for hours three evenings a week on a dialysis machine at Canberra Hospital waiting for a donor to make his third transplant possible.

As the tubes and beeping machines fade into the background he thinks about why the federal government's $250 million investment to boost national donation rates has delivered an increase of just 24 deceased donors in the three years he has been on dialysis.

"Money is being spent and the figures show 69 per cent of Australians are willing to be donors yet we are behind the rates of donation in Malta, Croatia and Spain," he said.

In 2008 the Rudd Government set a goal for Australia to become an international leader in the field.

In May the federal government launched a review of the nation's organ donation system, saying multi-million dollar investment in reform had not led to the intended rise in transplant numbers.

The Australian Organ and Tissue Authority created the Donate Life Network in 2009 as part of the reform agenda.

At that time the number of people whose organs were donated when they died was 11.4 per million people.

This figure rose to 16.1 per million last year.

Assistant Health Minister Fiona Nash has raised concerns about the "relatively slow progress over the last six years" and hitting the 2018 target of 25 donors per million population.

As of July there were 1698 people on national organ transplant waiting lists.

Australian Organ and Tissue Authority chief executive Yael Cass has stood by the performance of the national reform program, describing outcomes so far as demonstrating "strong growth."

Throughout six years of spending, 180 Donate Life hospital-based staff and a larger cohort of 929 treating staff in intensive care units and emergency departments have undertaken best-practice Family Donation Conversation workshops.

She said Australia's progress was in line with international counterpart's at a similar stage, however Spain and Croatia launched their decade-long reform programs in 1989 and 1998 respectively.

Hard work at 77 public hospitals across the country had led to a 59 per cent rise in the number of deceased organ donors, a 38 per cent rise in the number of transplant recipients and a 39 per cent increase in the number of organs transplanted, she said.

"Twenty-three per cent of transplant recipients (1204 of 5224) have received a life-saving transplant because of the growth in donation outcomes since 2009," she said.

OTA National medical director Helen Opdam said reform in this field could not happen overnight.

"It may not meet everyone's expectations but I am not sure how things could have been done more quickly than they have been," she said.

"It can't be immediate, it's complicated and there are many elements to it. It's quite clear that what has been achieved in Australia is a good change to date, but yes there is more to be done."

The wait continues for Mr Little.

"God knows I am not about blame but it just seems what was promised is not happening," he said.

"I like to think I'm in the best of a bad lot. When kidneys fail you can be on dialysis but those who are waiting for hearts, lungs or liver don't have that option. They just really need to get them."

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