Title Organ and tissue donation at SASH Presented by: Dr Somi - - PowerPoint PPT Presentation

1 Presented by: Dr Somi Desikan – Clinical Lead Organ Donation Authors: Dr Desikan and Miss Emma Little – Specialist Nurse Organ Donation

Title Organ and tissue donation at SASH

Trust Board – 29 September 2011 Agenda item: 3.1

Contents

Background Organ Donation Task Force (ODTF) SASH Organ Donation Committee (ODC) Activity in last 3 years Future

Deceased Donors pmp 2009

5 10 15 20 25 30 35 40

S p a i n P

• r

t u g a l B e l g i u m A u s t r i a E s t

• n

i a F r a n c e N

• r

w a y I t a l y E i r e C z e c h R F i n l a n d C r

• a

t i a S l

• v

e n i a S l

• v

a k i a U K G e r m a n y L a t v i a L i t h u a n i a D e n m a r k H u n g a r y S w e d e n N e t h e r l a n d s

Background

 Organ donation rate historically low in UK  7800 patients waiting for organ donation  3 deaths daily – > 1000 deaths / annum waiting for

transplant

 Barriers to donation – Uncommon event, but can occur 24/7 – Identification + Referral from donor hospitals – Education and Training – Disincentive to donor hospitals

773 745 777 770 751 764 793 809 899 958 1010 2311 2247 2388 2396 2241 2196 2385 2381 2552 2645 2699 7797 7877 7655 7219 5673 5654 5604 5532 6142 6698 7980 1000 2000 3000 4000 5000 6000 7000 8000 2000- 2001 2001- 2002 2002- 2003 2003- 2004 2004- 2005 2005- 2006 2006- 2007 2007- 2008 2008- 2009 2009- 2010 2010-11 Year Number Donors Transplants Transplant list

Number of deceased donors and transplants in the UK, 1 April 2000 - 31 March 2010, and patients on the active transplant lists at 31 March

Figure 2.1

Organ Donation Task Force ( ODTF)

 Set up in 2006, DOH published ODTF report in 2008  Recommended sweeping changes to improve UK donor rates  1. Identification and Referral  2. Donor co-ordination  3. Organ retrieval  Aim – Increase organ donation by 50% in 5 years – Implementation 14 key recommendations

A UK Model for Donation

NHSBT Department of Health Acute Hospital Trusts More donors

National ODO Effective co-ordination and retrieval Education, training and audit Public engagement Funding Resolution of ethical and legal issues Performance Management Training Public recognition Clinical leads Embedded co-ordinators Donation committees

When is it possible?

Organ donation - Hospital of our size Potential D.B.D 2 - 5 p.a Potential D.C.D – 8 p.a ( Any time of day/night, easy to miss – identification Pt’s on breathing machine’s Most likely in ICU / ED – rarely in theatre / recovery Overall majority pt have a catastrophic brain injury

SASH Organ Donation Committee (ODC)

 Set up in September 2009  Chaired by Trust NED : Mrs Norma Christson  Clinical Lead (CLOD) : Dr Somi.Desikan  Specialist Nurse (SNOD) : Miss Emma Little  Reps from Outreach, Emergency Medicine, Palliative

care, Theatres, Chaplain and PALS

O.D.C Achievements to date

Onsite Resident SN-OD provided by NHS Blood and Transplant SASH Organ Donation Policy Identifying Local Barriers Organs per Donor have increased – through donor oprimisation Local Organ Donation Strategy written Annual study day for all staff – Excellent feedback SASH Represented - Regional Collaborative Programme CLOD - completed National Donation Development Programme 2009/10 Organ donation and transplant awareness- Road shows Links with Harefield Hospital to improve Donor Optimisation Potential Donor Audit in all Critical Care areas CCDG / Morbidity and Mortality – standing items E.D Consultant– represented SASH at DOH Donation Scoping event 2010 Donor Memorial - in progress

Surrey and Sussex Healthcare NHS trust Organ Donation Committee focus 2011.12

 Increase Diagnosis of Diagnosis of Brain Stem death (DBD), including

vigilance of potential cases outside of the usual ICU environment, e.g. Emergency Department / Theatre Recovery.

 Increase DBD and increase Donation after Cardiac Death (DCD) referrals

according to National Minimum Notification Criteria

 Increase Donation after Cardiac death  Increase donation from Emergency Departments  Increase donation consent rates – by optimising the donation pathway  Increase the quality and quantity of donated organs for transplant –

• ptimise donor management strategy

In Numbers

15 Corneal Donors – 30 recipients 1 multi tissue Donor 7 (Includes lung, liver, kidneys and pancreas) 2 - DBD April 2010 to March 2011 15 Corneal Donors – 29 Recipients 7 Multi tissue Donors 15 Includes lung, liver, kidneys and pancreas) 5 – D.B.D April 2009 to March 2010 6 Corneal Donors – 11 recipients 5 (Includes kidneys and liver) 2 (1 DCD / 1 DBD) April 2008 to March 2009 Other Tissue Donations ( E.G Cornea, Heart Valves, Skin) Number of transplants ( lives saved) Number of patients donated organs Year

Financial – Donor Reimbursements made from NHSBT to SASH

Reimbursements received by SASH for organ donations 2008 to 2009 £ 6000.00 2009 to 2010 £ 10275.00 2010 to 2011 £ 10368.00

Doesn’t it cause some problems for critical care capacity?

Trust Executives and Board Trust Executives and Board

Not really on

• ur agenda

Aware of the benefits, but Aware of the benefits, but not a priority target for not a priority target for us? us?

Why it should be a priority for SASH board

Postcodes RH1-6, and CR3-5 surrounding SASH



149,040 individuals have actively expressed their choice to donate via O.D.R – our local population are telling us they want to donate, and we need to respond appropriately by optimising the donation pathway internally 65 patients waiting for transplant locally (NHSBT data)



Kidney 57



Kidney / Pancreas 2



Heart 1



Lungs 2



Liver 3



These patients use our local services, as well as tertiary transplant centres



Complex cases when cared for locally



Nationally 3/patients die everyday on the transplant list. Satellite Renal Dialysis Unit (Crawley hospital) – Social / Financial/ Environmental impact –Satellite Dialysis for 1 patient / annum costs £22,152, produces 4.3 ton CO2, consumes 62,400 L water /annum. Compared to Renal Transplant, £17,000 (yr 1), reduces to £5000 / p.a for medication only - transplant is cost saving, importantly patient outcomes improve physically / socially. Reduction environmental impact Tissue Donation – Ophthalmology Service locally is an end user of corneal grafts

What O.D.C need from SASH Board

• 1. Endorsement and Continue Supporting O.D.C
• 2. Include Organ + Tissue Donation into Trust Strategy
• 3. Assist O.D.C recovering Donor Reimbursements
• 4. Make Donation - part of Mandatory Training – (recent complaint

from patient family)

• 5. Assist recovering O.D Committee funding – unable to access 3

yrs

• 6. Make – Donation a usual not an unusual event

Donation a usual not an unusual event