1. Organ Donation Past, Present and Future Donation after Brain-Stem Death DBD Dr Farrel Igielman Dr Dale Gardiner Dr Gerlinde Mandersloot 4 th June 2013 1

2. 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 2 Organ Donation Past, Present and Future

3. Regional Data Dr Farrel Igielman Clinical Lead Organ Donation Queens and King George Hospitals 3 LONDON

4. Organ Donation Past, Present and Future Donation after Brain Death (DBD) Mechanically ventilated patient where death has been confirmed using neurological criteria. Kidneys Liver Pancreas Lungs Heart Small Intestine 93 donors (2012-2013) 14.8% increase (from 5 years ago) LONDON

5. Organ Donation Past, Present and Future 5 Donation in London 2003-2013 145.8% 14.8% 44.8%

6. LONDON Organ Donation Past, Present and Future 6 Donation in London 2003-2013

7. Organ Donation Past, Present and Future pancreas liver lungs kidneys heart intestine DCDDBD best transplant outcome favours

8. -------- National rate 87 82 76 74 86 78 73 76 74 76 74 ND tested (%) 0 20 40 60 80 100 Team EasternLondon Midlands North West Northern Ireland Scotland South Central South East South Wales South West Yorkshire DBD- Neurological death testing rate 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future 8 3 rd LONDON

9. ND tested (%) 0 20 40 60 80 100 Number of neurological death suspected patients 0102030405060 1 10 11 12 13 14 15 16 17 18 19 2 20 21 2223 24 2526 27 28 29330 4 5 6 7 8 9 HospitalNational rate95% Lower CL 95% Upper CL99.8% Lower CL99.8% Upper CL DBD- London Neurological death testing rate Organ Donation Past, Present and Future 9 1 April 2012 to 31 March 2013, data as at 4 April 2013

10. Mean no. of organs donated per donor 1 April 2012 to 31 March 2013, data as at 4 April 2013 Tied 9’th Northern (1 st ) : Every 10 donors save 4 more lives than we do 10 Organ Donation Past, Present and Future LONDON