Organ Donation Past, Present and Future

Introduction

Ella Poppitt (Regional Manager)

SOUTH CENTRAL

Dr Malcolm Watters (R-CLOD)11th June 2013

Programme

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10:00 Introduction10:15 Donation in the UK (F105, 2C06) Dr Paul Murphy11:00 Coffee11:15 Donor Identification and Referral (I102, 2C06) Dr Malcolm Watters12:30 Lunch13:15 Donation after brain-stem death (1A01, 1A02, 2C06)

Diagnosis of death Dr Dale GardinerDonor optimisation Dr Gerlinde Mandersloot

1430 Coffee1445 Family approach and consent (F101, I106, 2C06) Dr Angus Vincent1600 Discussion and next steps1630 Close

Attendance at this meeting has been recognised for 5 CPD credits by the Royal College of Anaesthetists

Organ Donation Past, Present and Future

SOUTH CENTRAL

3Organ Donation Past, Present and Future

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Objectives

1. Update on progress since 2008 Organ Donor Taskforce Report and scene set for future challenges.

2. Outline best practice, using regional and local data, and the most recent national guidance around:– The referral and identification of donors– Donation after Brain Death– Family approach and consent

3. Secure commitment to change practice in your hospital around key pinch points in deceased donation pathways

4Organ Donation Past, Present and Future

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Organ Donation Services Team

SCOTLAND

NORTH

NORTH WEST

YORKSHIRE

MIDLANDS

SOUTH WALES

EASTERN

SOUTH EAST

SOUTH CENTRAL

SOUTH WEST

NORTHERN IRELAND

Regional Clinical LeadMalcolm Watters

Regional ManagerElla Poppitt

Team ManagersTrish CollinsAmanda Small

18 Specialist Nurses

2 Admin Staff

13 Trusts (18 Hospitals)Pop of approx 4.5 million2 Transplant Centres

5Organ Donation Past, Present and Future

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Donation in the South Central Team2003-2013

6Organ Donation Past, Present and Future

56.0%

40.9%

46.4%

SOUTH CENTRAL

Eastern

London

Midlands

North W

est

Northern

Northern

Ireland

Scotla

nd

South Central

South East

South Wales

South West

Yorkshire

0

25

50

75

100

125

150 148.4

44.8

87.5

26.6

50.8

81.874.1

46.4

19.77.1 11

30.4

Perc

enta

ge A

chie

vem

ent

50% Target by Donor Team

Organ Donation Past, Present and Future 7

SOUTH CENTRAL

6th

Eastern 13%

London 13%

Midlands 12%

North West 10%Northern

8%

Northern Ireland 3%

Scotland 8%

South Central 8%

South East 8%

South Wales 4%

South West 7%

Yorkshire 7%

Contribution to 50% by Donor Team

50%

8

Tied 5th

Organ Donation Past, Present and Future

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9Organ Donation Past, Present and Future

Organs from South Central Donors: 2003-13 SOUTH CENTRAL

0

20

40

60

80

100

120

140

160

180

200

2003

/04

2004

/05

2005

/06

2006

/07

2007

/08

2008

/09

2009

/10

2010

/11

2011

/12

2012

/13

Kidneys

Pancreases

Livers

Hearts

Lungs

10Organ Donation Past, Present and Future

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126

8

52

818

Kidneys Pancreases Livers

Hearts Lungs

164

24

68

1227

Kidneys Pancreases Livers

Hearts Lungs

2007-2008 Organs Transplanted from South Central Donations

2012-2013 Organs Transplanted from South Central Donations

% o

f p

os

sib

le d

on

ors

0

10

20

30

40

50

60

70

80

90

100

Possibledonors*

Neurologicaldeath testsperformed(DBD only)

Neurologicaldeath

confirmed(DBD only)

Contraindications Familyapproach

Consent/authorisation

Donation

* The annotated figures represent the percentage of remaining patients lost at each stage, not the percentage of all possible donors*

* DCD - Possible donors not confirmed dead by neurological criteria where imminent death anticipated and treatment withdrawn* DBD - Possible donors meeting criteria for neurological testing*

DBD, 59 donated (48% of possible donors)DCD, 32 donated (7% of possible donors, 12% of those not contraindicated)

24%5%

3%7%

22%5%

45%

45%

49%

57%

Where are potential donors in the South Central team lost?

11Organ Donation Past, Present and Future

SOUTH CENTRAL

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2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 Best Practice0

200

400

600

800

1000

1200

1400

1600

1800Target Actual

50%

13.4 ppm

19.1 ppm

Organ Donation Past, Present and Future

BUT if all regions adopted BEST PRACTICE

13

2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 Best Practice0

200

400

600

800

1000

1200

1400

1600

1800Target Actual

26.3ppm

TOP 5 in the WORLD

50%

13.4 ppm

19.1 ppm

Organ Donation Past, Present and Future

BUT if all regions adopted BEST PRACTICE

2008

2011

NHSBT Guidelines

15

ED Strategy

Donor Management Bundles and Guidance

FICM & ICS endorsed: Brain-stem Death Forms

www.odt.nhs.uk

Organ Donation Past, Present and Future

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