ODT - International Benchmarking AGChC(16)15 ODT - International Benchmarking Board Meeting 2016

Excellent data available in the UK AGChC(16)15 Excellent data available in the UK UK Transplant Registry All donors, transplants and patients listed for transplant Dates back to 1972 Potential Donor Audit Audits all deaths in ICU since 2002 Some other countries have a national PDA (e.g. Italy, Spain, France, Australia), but little has been published The Council of Europe’s Transplant Newsletter has provided valuable data on donation and transplant rates per million of population   Canada has an audit for all deaths in each of the 64 hospitals in Ontario, but not across Canada Hungary, Norway, Poland, Switzerland may also have such a programme in place.

Donor and transplant rates pmp AGChC(16)15 Donor and transplant rates pmp

Deceased donor transplant rates in 2014 AGChC(16)15 Deceased donor transplant rates in 2014 Source: Council of Europe – Transplant Newsletter

AGChC(16)15 Family refusal rates, 2014 Note – limited international data available on family refusal rates Source: Council of Europe – Transplant Newsletter

Organ specific transplant rates AGChC(16)15 Organ specific transplant rates

Deceased and living donor kidney transplant rates, 2014 AGChC(16)15 Kidney transplant rates Deceased and living donor kidney transplant rates, 2014 Source: Council of Europe – Transplant Newsletter *Deceased and living donor transplants

Living donor kidney transplant rates, 2014 AGChC(16)15 Kidney transplant rates Living donor kidney transplant rates, 2014 Source: Council of Europe – Transplant Newsletter

Liver transplant rates AGChC(16)15 Liver transplant rates Source: Council of Europe – Transplant Newsletter

Pancreas transplant rates AGChC(16)15 Pancreas transplant rates Source: Council of Europe – Transplant Newsletter

Heart transplant rates AGChC(16)15 Heart transplant rates Source: Council of Europe – Transplant Newsletter

AGChC(16)15 Lung transplant rates Source: Council of Europe – Transplant Newsletter

AGChC(16)15 Organ utilisation

AGChC(16)15 Donors by age group 2015

AGChC(16)15 Donors by age group 2015

Discard rates for kidneys from deceased donors, 2014 AGChC(16)15 No. kidneys retrieved N= 2986 14754 2432 700 % adult deceased donor kidney transplants from a DCD ~ 11% in Spain ~ 15% in US ~ 37% in UK ~ 26% in Australia 24% overall DCD DBD 19% overall % of retrieved kidneys not transplanted http://optn.transplant.hrsa.gov/converge/latestData/rptData.asp https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/ And http://srtr.transplant.hrsa.gov/annual_reports/2012/pdf/2012_SRTR_ADR_updated_full_intro.pdf http://www.anzdata.org.au/anzod/ANZODReport/2015/2015ANZOD_annrpt_05_organdata_v1.0_20151009.pdf DCD DBD 10% overall DCD DBD Overall Source: ONT – Spain data, OPTN - US data ANZ - Australia data, NHSBT - UK data ¹ 2012 data

Discard rates for kidneys from deceased donors, 2014, by donor age AGChC(16)15 No. kidneys retrieved N= 64 54 159 239 433 391 863 491 1085 300 4 32 24 105 112 194 198 349 44 277 DBD DCD % of retrieved kidneys not transplanted http://optn.transplant.hrsa.gov/converge/latestData/rptData.asp https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/ And http://srtr.transplant.hrsa.gov/annual_reports/2012/pdf/2012_SRTR_ADR_updated_full_intro.pdf Donor age Source: ONT – Spain data, NHSBT - UK data

AGChC(16)15 What donor rate could we reach in the UK if every team achieved the level of the best?

Actual deceased donor rates in 2014 AGChC(16)15 Actual deceased donor rates in 2014

Actual DCD donor rates in 2014 AGChC(16)15 Actual DCD donor rates in 2014

Highest key rates by team in 2014/15 AGChC(16)15 Highest key rates by team in 2014/15 Team range…. Neurological Death Testing (Northern) = 95% (68-95%) Referral DBD (Northern) = 100% (92-100%) Referral DCD (Northern) = 88% (68-88%) Approach DBD (South Wales) = 98% (91-98%) Approach DCD (South West) = 61% (32-61%) Consent/Authorisation DBD (South West) = 80% (55-80%) Consent/Authorisation DCD (South East) = 64% (44-64%) Source: Council of Europe – Transplant Newsletter

Deceased donor rates in 2014 AGChC(16)15 Deceased donor rates in 2014 Source: Council of Europe – Transplant Newsletter

Are more patients waiting in the UK? AGChC(16)15 Are more patients waiting in the UK?

Kidney waiting list vs transplant AGChC(16)15 Kidney waiting list vs transplant Waiting list Active waiting list patients pmp Source: Council of Europe – Transplant Newsletter * Spain data is not available **Patients on waiting list as at 31 December 2014

Pancreas waiting list vs transplant AGChC(16)15 Pancreas waiting list vs transplant Waiting list Active waiting list patients pmp Source: Council of Europe – Transplant Newsletter *Patients on waiting list as at 31 December 2014

Liver waiting list vs transplant AGChC(16)15 Liver waiting list vs transplant Waiting list Active waiting list patients pmp Source: Council of Europe – Transplant Newsletter *Patients on waiting list as at 31 December 2014

Heart waiting list vs transplant AGChC(16)15 Heart waiting list vs transplant Waiting list Active waiting list patients pmp Source: Council of Europe – Transplant Newsletter *Patients on waiting list as at 31 December 2014

Lung waiting list vs transplant AGChC(16)15 Lung waiting list vs transplant Waiting list Active waiting list patients pmp Source: Council of Europe – Transplant Newsletter *Patients on waiting list as at 31 December 2014