Deceased organ donation in STH. A2 - Organ donation... · Clare Jones, Helen Brown, Jamie Smith,...

Deceased organ donation in STH.

Andrew Davidson, James Wigfull, CLODs. Clare Jones, Helen Brown, Jamie Smith, SNODs.

Donation Committee, Shirley Harrison, Annette Laban, Chairs.

751 765 793 809 899 959 1010 10881212

1320 1298

2242 21972386 2384

2559 2655 27062916

3118

35093368

0

500

1000

1500

2000

2500

3000

3500

4000

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15

Donors Transplants

Deceased donors &

transplants

Predicted based on activity to 1 Mar

Source: Transplant activity in the UK, 2013-2014, NHS Blood and Transplant

Transplants7,8

3,505

Organs transplanted7,8

3,969

UK population1

~63,000,000UK deaths2

~570,000Deaths in hospitals3

~ 283,000Potential donors4,5

8,157Eligible donors4,6

5,490

Donation requests4

3,247

Consented donors7

1,999

Actual donors7

1,320

1 Mid 2012 estimates: www.ons.gov.uk2 2012 data: England & Wales www.ons.gov.uk; Scotland www.gro-scotland.gov.uk; Northern Ireland www.nisra.gov.uk3 2012 data: England & Wales www.ons.gov.uk; Scotland www.isdscotland.org; Northern Ireland www.nisra.gov.uk4 2013/2014 data: NHSBT, Potential Donor Audit 5 Potential donor - patients for whom death was confirmed following neurological tests or patients who had treatment withdrawn and death was anticipated within four

hours6 Eligible donor - Potential donor with no absolute medical contraindications to solid organ donation7 2013/2014 deceased donor data: NHSBT, UK Transplant Registry 8 Using organs from actual donors in the UK

UK Potential deceased organ donor population, 1 April 2013 – 31 March 2014

Declared brain stem dead

Approach to family

Evaluation as potential donor

Transferred to theatre on ventilator and organ

retrieval process commenced

Heart beating donor-donation after brain

stem death-DBD

Controlled non-heart beating donation-

donation after cardiac death-DCD

Ongoing care not in best interests

Approach to family

Evaluation as potential donor

Treatment withdrawal

Death Transferred to theatre

May, 2015

0

2000

4000

6000

8000

10000

Deceased Donors and the Transplant Waiting List

Total DeceasedDonors

Transplant waitinglist

X (with living donors)

STH deceased donors 2014/2015

Neurological death testing

Referral to Specialist Nurse-Organ Donation

Family approach

Approach involving a SNOD

Consent for donation.

Overall key rates.

Comparative donation data.

0 0 0 4 4 3 2 4 5

2 0 4

13 12

4 6 6

8

0 0

3

7 6

5 1

6 3

3 2

8

16

13

17

6

9 15

10 10

18

35 44 52

20

26

33

0

10

20

30

40

50

60

70

80

90

2012/2013 2013/2014 2014/2015 2012/2013 2013/2014 2014/2015 2012/2013 2013/2014 2014/2015

Hull Leeds Sheffield

Nu

mb

er

or

org

ans

tran

spla

nte

d

Level 1 Hospital data by year

Organ Donation by Level 1 Hospitals in Yorkshire

Small Bowel

Kidney

Liver

Pancreas

Lung

Heart

Nationally

• Deemed consent-Wales

• UK Organ Donor Register opt out

• Central IT/mobile coordination of donation

• Incentives to donate-Israel

• Neonatal donation and brainstem testing

• Coronial refusal

• Organ preservation-DCD hearts

• Governors and Muslim Chaplin on

Donation committee

• Donation memorial/Communications

• Consent pilot Yorkshire/North West

• Yorkshire CLOD team review

• Cardiac Intensive Care Unit

• Theatre/ICU access, ED workload

• Tissue donation

Local