INTERNATIONAL TRENDS IN ORGAN DONATION

R.J. Johnson¹, C. Counter¹, J.A. Bradley², C.J.E. Watson³, C. Rudge⁴, J. Neuberger^5
1Statistics And Clinical Audit, NHS Blood and Transplant (UK), Bristol/UNITED KINGDOM, ²Transplant Surgery, Addenbrooke's Hospital NHS Trust, Cambridge/UNITED KINGDOM, ³Transplant Surgery, Addenbrooke's Hospitals NHS Trust, Cambridge/UNITED KINGDOM, ⁴, Department of Health, London/UNITED KINGDOM, ⁵, NHS Blood and Transplant, Bristol/UNITED KINGDOM

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Introduction The number of DBD donors in the UK declined gradually from the 1990s, due to a combination of falling death rates from trauma and cerebrovascular accidents, limitations in access to intensive care units (ICU) and changes in neurosurgical practice. In addition not all potential donors were referred from ICUs to transplant coordinators, and more than 40% of relatives of potential organ donors did not give consent. This led to the introduction of two key initiatives in the UK aimed at reversing the trend and providing more organs for the 8000 patients on the transplant list. First, in 2003, a national audit of all deaths in ICUs in the UK was established to identify accurately the real potential for organ donation and determine the reasons for lack of consent for donation. Second, in 2006, the British Government established an Organ Donation Taskforce to identify barriers to all parts of the organ transplant process and to recommend solutions that would increase the number of transplants performed. The recommendations, in the form of a five-year plan, were funded by the government and are now being implemented. Results Over the last 5 years the number of deceased organ donors in the UK has risen, in large part due to an 8-fold increase in DCD donors. The number of DBD donors has also plateaued. Over the ten years 2000-2009, not only have donor patterns changed in relation to DCD and DBD, but the acceptance criteria for organ donors has also changed markedly. In 2000, 14% of deceased organ donors were aged over 60 years compared with 22% in 2009. A decrease in donors resulting from trauma has been seen: 20% of donors in 2000, 12% in 2009. Donor body mass index has increased: 12% of donors had BMI≥30 in 2000 rising to 20% in 2009. There are also changes in living kidney donation with paired and altruistic living kidney donation contributing almost 5% of LD numbers in 2009, and antibody incompatible transplantation programmes extending the boundaries still further. Conclusions Major initiatives have impacted on the number of deceased organ donors in the UK over the last 5 years and coupled with a change in donor acceptance criteria the number of people receiving a DD organ transplant in the UK has increased by 18% since 2005.

Disclosure: All authors have declared no conflicts of interest.