Progress to date in implementing Organs for Transplant

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Progress to date in implementing Organs for
Transplant

• Elisabeth Buggins CBE DL

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Real progress!

• 7 increase in ODR registrations
• Record 11 rise in deceased donors
• 174 extra transplants
• 12 rise in living donors
• 170 donor coordinators now in post
• 148 Clinical Leads appointed by Trusts with the
  biggest donation potential
• Legal clarity to be published later this year
• Donation Ethics Committee now appointed

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Progress against 50 increase in donation

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Number of deceased donors and transplants in the
UK
1 April 1999 - 31 March 2009 - patients on the
active transplant lists at each year
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Incidence of Brainstem Death on ICU
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Falling incidence of BSD on ICUs

• Therapeutic advances (fewer deaths)
• Decompressive craniectomy for traumatic brain
  injury
• Early coiling in aneurysmal subarachnoid
  haemorrhage
• Craniectomy / thrombolysis for ischaemic stroke
• Futility (different deaths)
• Withdrawal of cardiorespiratory support

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Non-heartbeating Organ Donation in the UK
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Non- heartbeating Organ Donation
More to come?

• 580 missed potential NHB donors per annum
• 177 missed actual donors
• 407 additional transplanted patients

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Transplants from NHB Donors

• OK for kidneys
• Increased delayed graft function
• Problem for livers
• Ischaemic cholangiopathy
• Possible for lungs
• Avoids autonomic storm of brainstem death
• ?? hearts
• Requires cardiac re-vitalisation

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Donation from Depts. Of Emergency Medicine, North
Thames 2004-09
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Progress by country April to September 2009
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ODR Registrants
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Business as Usual

• Maintenance of Donation Champions
• Replacements, salary changes, professional
  queries
• Commissioning relationships with acute hospitals
• Annual reporting, business planning
• Professional Development
• On-going training, guidance review, reference
  database
• Regional networks
• Annual meeting
• Communications
• E-space
• New strategies, national developments etc
• Devolved administrations
• Governance arrangements
• Relationship with DAG

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Major public campaign

• Teaser last week
• Television adverts from 2 November till March
  2010
• Based on extensive research
• Consent rates have already risen slightly from
  60 to 62.

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The Big Wins

• Brainstem death testing (350 missed potential
  donors)
• Minimum notification criteria
• Improved consent rates (from 60- 85 in BSD
  donors would mean extra 172 donors)
• Nationwide NHBD programmes (170 missed potential
  donors)
• Donor optimisation
• Donation from A E