Transplantation and organ donation

Question 1

When was the first successful kidney, heart and liver transplants done?

Answer 1

kidney - 1962
heart - 1967
liver - 1968

Question 2

What organs can be transplanted?

Answer 2

lungs, liver, pancreas, bone marrow, bone, cartilage, tendons, veins, skin, fascia, kidneys, small intestine, heart, corneas

Question 3

What does DCD organ donation mean?

Answer 3

donation after circulatory death - increasingly common

Question 4

What is the outcome following transplantation?

Answer 4

highly effective and treatment choice for many conditions

e.g. 
kidney (deceased donor)- 96% 1 yr and 89% 5 yr
liver - 92% 1 yr and 77% 5 yr
heart 84% 1 yr and 67% 5 yr 
lung - 81% 1 yr and 52% 5 yr

Question 5

What are the advantages and disadvantages of living donors?

Answer 5

Adv

• transplantation becomes elective and can be scheduled
• outcomes are better

Cons:

• mortality rate- (1 in 3 / 5000 for kidney, 1 in 200 for liver)
• morbidity in 10-15% of patient
• added social and financial costs to donor
• opportunity to commercialisation and organ trafficking

Question 6

How many new donors are there from 1 million new people on the organ donation register?

Answer 6

only 8

Question 7

What recommendations have been suggested to increase organ donor numbers?

Answer 7

clarified roles in acute hosp trusts and department of health
monitoring and reporting
review of donor coordination and organ retrieval
training
public promotion and donor recognition

Question 8

What is the role of the specialist nurse and clinical lead for organ donation?

Answer 8

bridge between donation and transplantation

• maintaining a visible and accesible presence for involvement in donor activity
• hospital engagement and involving comms depart
• education across all grades of clinical staff
• community work across different ages and communities
• continuing to work with transplant colleague to ensure best outcome

Question 9

How can public behaviour be changed in terms of organ donation?

Answer 9

people donate . when and if they can and it becomes a normal and expected part of end of life care

• conversation and debate
• educating families
• local and targeted
• normalising donation
• understanding the impact of other interventions

Question 10

What are the TOT20 measures?

Answer 10

consent/authorisation for organ donation - aim for rate >80%

deceased organ donation - aim for 26 deceased donor per million population

organ utilisation - aim for transplant 5% more of organs offered from consented actual donors

patients transplanted - aim for a deceased donor rate of 74 per million population

Question 11

What are DBD organ donors?

Answer 11

donation after brainstem death - still more common than DCD

Question 12

What is the median wait to transplant for adult kidney?

Answer 12

AB - 1 yr
A - 2 yrs
B and O - 3yrs
there has been a 27% fall over 7 yrs

Question 13

What are the current initiatives to increase activity of organ donation?

Answer 13

1) focus on missed opportunities - reports of individual missed referrals, family consents, organ transplants
2) review of length of donation process
3) organ utilisation strategy

Question 14

Why are organ donation consent rates higher in wales?

Answer 14

opt out system now