1. Organ Donation Update - GICU

2. Progress at St Georges 2014 – 2015 2013 – 2014 43 Donors 27 donors
DBD 33
DCD 10
136 organs retrieved and transplanted.
2013 – 2014
27 donors
DBD 23
DCD 4
101 organs retrieved and 80 transplants
So far this year we have 38 donors
South East Organ Donation Team. Pager:

3. Dashboard
GICU
Data Source
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Referrals
PDA
100%
n/a 0%
Timely referrals
Planned Approach with SNOD
50%
BSD Testing Rates
N/A
Totals - Potential DBD/DCDs
1 DBD 3 DCD
1DBD 2DCD
0 DCD
1DBD 1DCD
2DBD
1 DCD
All consultant approaches and all declines- December on boxing day

4. Achievements so far, April 2015- December 2015
NICU- 33 Consents, 26 proceeded = 95 organs retrieved
GICU- 3 Consents, 3 proceeded, 12 organs retrieved
CTICU- 7 Consents, 7 Proceeded, 18 organs retrieved
For DBD 100% referral rate overall (96.4%- National)
For DCD 94.1% referral rate overall (82.5%-National)

5. Achievements
NICU 35 consents. 29 proceeded. = 110 organs retrieved.
GICU 14 consents. 11 proceeded = 35 organs retrieved.
CTICU 8 consents. 3 proceeded = 9 organs retrieved.
For DBD 100% referral rate overall
For DCD 94.6% referral rate overall
Over to Marietta 1 uncontrolled death 1 contraindication (found post consent) Overall 29 referrals
Over to Anthea & Joe (1 all centre's declined & 1 PTA)
Over Matt & Leanne ( 2 PTA + 1 ACDecline)

6. Year to date GICU- 3 proceeding donors 12 organs being transplanted
7 Kidneys
2 Livers
2 Lungs
1 Pancreas

7. Non proceeding consents
Factors affecting conversion rates:
All centres decline
PTA
Uncontrolled

8. Why bother? Savings after transplant Over a 100% cost saving
Renal Costs per patient per annum Dialysis £28,967 Cost over 10 years - £ 289, 677
Savings after transplant
Over a 100% cost saving
(X17 kidneys = £ !)
Benefit to the patient
Benefit to the economy
Transplantation costs per patient Assessment & transplant £52, 443 After 1st year £35, 430 Costs per year £7,274 Cost over 10 years - £ 102, 716

9. Challenges GICU Coroner Variations in approach
Clarity on consenting before BSDT
Telephone approaches
Telephone consents

10. Requesting Donation
Families need to understand the patient has died (ie BSD) or that death is inevitable before they are approached to think about donation
Brain Stem Death Tests/withdrawal of treatment and Organ Donation are separate issues
Collaborative approach is key

11. Approaching a Family for Consent for Organ Donation - 3 Key Stages
Huddle!
Planning
Confirming understanding & acceptance of loss
Discussing donation

12. Integral Part of End of Life Care – Nursing Guidance
Wherever possible, assess the dying person’s wishes regarding organ, tissue and body donation.
Whole body donation can only be agreed by individuals themselves & not by anybody else on their behalf after death.
If an individuals wishes regarding organ & tissue donation were not formally recorded before death, consent can be sought from a nominated representative or someone else in a qualifying relationship.
Care before death p.8 points 5-8
Published 2011, due review April 2014

13. You know, We know. Do they know?
South East Organ Donation Team. Pager:

14. Who Should Be Asked?
No Religions oppose donation
No Ethnic Groups opposed to donation
Each family is individual – no assumptions should be made on the basis of ethnicity, culture or religion
Every Family Should Be Given The Choice – even if they are not present and planning to not return to the unit

15. Key Aspects Donation is not a tick box exercise
Donation is a flexible process to meet the needs of families
Telephone approach/consent is common
Families can bring up donation prior to BSDT
Drs decision on when to test & if pre conditions met.

16. Kirstie Tancock Cystic Fibrosis 6 months to live
Double lung transplant 2011 as a 21yr old while in ICU.
Love on the Transplant Waiting List
Chronic rejection 2 years post op.
Received 2nd lung transplant Autumn 2013
South East Organ Donation Team. Pager:

17. Tree of Life memory day.

18. Thank you any questions