Overview of organ donation and transplantation
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- Marilynn Warner
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1 BTS Congress, March 2018 Overview of organ donation and transplantation Rachel Johnson Statistics and Clinical Studies NHS Blood and Transplant
2 Organ Donation and Transplantation: the headlines Subject Cardiothoracic organ transplantation New Kidney Offering Scheme Organ Utilisation National Organ Retrieval Service Patient based Liver Offering Scheme Speaker Sally Rushton Lisa Mumford Chris Callaghan Kate Martin John O Grady
3 Organ Donation and Transplantation: the headlines Subject Cardiothoracic organ transplantation New Kidney Offering Scheme Organ Utilisation National Organ Retrieval Service Patient based Liver Offering Scheme Organ Donation Quality in Donation Pancreas and islet session Speaker Sally Rushton Lisa Mumford Chris Callaghan Kate Martin John O Grady Full session at 2pm today Thurs pm
4 Outline Trends in deceased organ donors and transplants Living kidney donation - Non-directed altruistic donors The ODT Hub Useful resources
5 Trends in deceased organ donors and transplants
6 Deceased donors and transplants Highest number of deceased donors in the UK last year resulting in 3710 transplants Figure 2.1 Number of deceased donors and transplants in the UK, 1 April March 2017, and patients on the active transplant list at 31 March 9000 Over the last ten years % decrease in waiting lists Number Donors Transplants Transplant list % increase in transplants (all organs) Year 75% increase in deceased organ donors
7 Number Deceased donors DBD vs DCD donors Age of deceased donors DBD Donors DCD Donors / / / / / / / / / / / / /17
8 Increase in deceased donors this year? 900 DBD donor ages: April-February Taken from the weekly statistics : Number / / / / / / / / / /18 Age April-February <18
9 YTD = end Jan Potential Donor Audit recent trends
10 What about transplant rates this year? Kidney txs DD 8% LD 3% SPK 11% Pancreas 7% P islets 42% Liver txs 5% Heart txs Lung txs 15% Taken from the weekly statistics :
11 Living kidney donation non-directed altruistic donors
12 Number Non-Directed Altruistic Kidney Donors (NDADs) Year
13 Number Non-Directed Altruistic Kidney Donors by donating hospital,
14 NDADs - by donating hospital & receiving centre only donations direct to list included,
15 Donation pathways Direct to Waiting List Short Chain Long Chain AD Exception! If match for high priority patient on waiting list AD AD WL D1 R1 Paired Exchange pairs D1 D2 R1 R2 WL WL
16 Donation pathways Direct to Waiting List Short Chain Long Chain AD Default pathways from Jan 2018 AD AD WL D1 R1 Paired Exchange pairs D1 D2 R1 R2 WL WL
17 No. of donations Non-Directed Altruistic Kidney Donors 140 Long chains Donation type Short chains Into chain Direct to list
18 No. of transplants Non-Directed Altruistic Kidney Donor Transplants 140 Long chains Donation type Short chains Extra transplants Into chain Direct to list By December 2017: 635 Donations 791 Transplants
19 Total Living Kidney Donor Transplants Rise in both paired and altruistic living donor kidney transplants
20 Total Living Kidney Donor Transplants Fall in incompatible living donor kidney transplants
21 The ODT Hub Transforming the organ donation and transplantation pathway MAKING IT SAFER, SIMPLER, SUPPORTIVE
22 So far we have. Safely implemented new heart and routine lung allocation schemes Using new Hub IT platform Automating processes no more white board in Hub Operations (Duty Office)! Implemented Urgent and Super-urgent lung offering schemes Designed and developed a systematic donor assessment process for all referrals
23 We are now working on.. Final testing to implement a new national liver offering scheme Building and testing the new donor referral and assessment process for national roll out in 2018 Automating and simplify processes within Hub Operations
24 Number of calls to and from Hub Ops Jul-14 Oct-14 Jan-15 Apr-15 Jul-15 Oct-15 Jan-16 Apr-16 Jul-16 Oct-16 Jan-17 Apr-17 Jul-17 Oct-17 Jan-18 % of Hub Ops offers 2018/19 plans for ODT Hub Finalising Business Case but we expect to be working on: New kidney offering scheme New HTA-A and B forms (donor information and transplant confirmation) Ensuring capacity for increased workload Number of calls to and from Hub Ops 12,000 20,000 % of organ offers going through Hub Ops 100% 80% 60% 42% 40% 20% 85% 0% Month Number of calls to and from Hub Ops Monthly
25 Useful resources
26 Resources ODT website
27 Resources online tools Transplant tools Relative Chance of Kidney Transplant (adult and paediatric) Calculated Reaction Frequency (crf) Living donor kidney incompatible pairs Matchability calculator crf calculator for living donors in KSS UKELD calculator
28 Resources NHSBT Clinical Trials Unit
29 Resources NHSBT Clinical Trials Unit Why use us? Knowledge of organ donation and transplantation Friendly, helpful and professional team Fully registered (with UK Clinical Research Collaboration) Access to UK Transplant Registry data: Sample size calculations Trial outcomes (cost effective) Contact: Phone: Web: Come and talk to us on our BTS stand!
30 Summary Deceased donors & transplants set to hit record high again this year Non-directed altruistic donors making an increasingly valuable contribution to kidney transplantation The ODT Hub updating organ offering schemes and streamlining processes Useful resources see and come and see NHSBT Clinical Trials Unit today!
31 Acknowledgements Transplant unit and other hospital staff and Specialist Nurses for Organ Donation for provision of data to the UK BTS Congress, March 2018
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