Donation after Brain-Stem Death DBD Dr Vijay Gupta – North Tees Dr Dale Gardiner Dr Gerlinde Mandersloot 3rd July 2013 Suggest a local CLOD to present data

Session Objectives Present regional data for DBD Understand that DBD gives better organs than DCD Increase rate of neurological confirmation of death by increasing confidence in the Diagnosis of Death Increase quality of DBD organs adoption of extended care bundle and compliance with the six early interventions in donor optimisation collaboration in Scout pilot Session Chair or CLOD presenting regional data Organ Donation Past, Present and Future

Dr Vijay Gupta North Tees and Hartlepool, CLOD NORTHERN Regional Data Dr Vijay Gupta North Tees and Hartlepool, CLOD

Donation after Brain Death (DBD) Mechanically ventilated patient where death has been confirmed using neurological criteria. NORTHERN 54 donors (2012-2013) 12.5% increase (from 5 years ago) Explain what DBD is Organs that can be donated The number of DBD donors in region (2012-2013 = last year) and the rise over the last 5 years region has seen. Lungs Heart Small Intestine Kidneys Liver Pancreas

Donation in the Northern Team 2003-2013 50.8% 12.5% 173.3% You have seen this slide before Organ Donation Past, Present and Future 5

Donation in the Northern Team 2003-2013 When we just look at DBD over the last decade we will see how little difference we have made. And we are one of the good regions, many regions have seen their DBD numbers go down. Organ Donation Past, Present and Future 6

kidneys intestine lungs pancreas liver heart best transplant outcome favours DCD DBD kidneys intestine lungs Slide to show why for certain organs DBD is best Hearts and small intestine currently only from DBD Pancreas and liver better outcomes with DBD compared to DCD Only lungs and kidneys equivalent pancreas liver heart

Northern Neurological death testing rate -------- National rate 87 82 76 74 86 78 73 ND tested (%) 20 40 60 80 100 Team Eastern London Midlands North West Northern Ireland Scotland South Central East Wales Yorkshire 2nd We are 2nd. Comment… 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

Northern Neurological death testing rate 1 South Tyneside NHS Foundation Trust 2 City Hospitals Sunderland NHS Foundation Trust 3 North Cumbria University Hospitals NHS Trust 4 Gateshead Health NHS Foundation Trust 5 The Newcastle Upon Tyne Hospitals NHS Foundation Trust 6 Northumbria Healthcare NHS Foundation Trust 7 South Tees Hospitals NHS Foundation Trust 8 North Tees and Hartlepool NHS Foundation Trust 9 County Durham and Darlington NHS Foundation Trust Good but not perfect 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

1st Mean no. of organs donated per DBD donor NORTHERN Mean no. of organs donated per DBD donor Northern (1st) : Every 10 donors save 1-6 more lives than others 1st Donor optimization is important in DBD. And we can congratulate ourselves on being the bes for organs donated per DBD donor.t. We are 1st but if we everyone else could optimize like Northern does: for every 10 donors we save 1 (Eastern) to 6 (South Wales) more lives than they do. [I know this headline comment is a stretch of the truth but will grab the attention for Gerlinde’s talk] Optimization and retrieval surgeon acceptance is of course a two way process and this thanks may be to our surgeons in the audience as much as to those on the donation side. 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future