1. Midlands Organ Donation Services Team
Regional Data Update
Midlands Organ Donation Services Team

2. Actual deceased donors in the UK
Individual Hospital Donation Reports April September 2014 (detailed report and summary) - sent to CEO’s 20th November.
SNOD’s can provide further detail with regards to these reports if required.
Review of National Data April/ September 2014 and Projected April/ March 2014/2015 Data.
No of DBD’s predicting slight increase / /2015.
No of DCD’s predicting decrease / / (-66 DCD)
1 April 2005 to 30 September 2014, data as at 14 October 2014

3. Actual deceased donors- Midlands team
Midlands Team Data April/ September 2014 (46 DBD and 25 DCD). Mirrors the National Picture + 5 DBD’s & - 15 DCD’s.
Non proceeding April – September 2014/2015 (44) 22 PTA
Non proceeding April – September 2013/2014 (29) 11 PTA
Nationally ‘There is a need to address and quantify the impact of Non Proceeding DCD’s’. Ella Popitt will discuss in more detail.
DePPaRT – Death Prediction and Physiology after the Removal of Therapy. Dale to discuss in more detail.
1 April 2005 to 30 September 2014, data as at 14 October 2014
Hospitals are allocated to teams using the current team allocations, not the allocation at the time of donation

4. Actual deceased donors
Midlands 1 of the busiest teams.
In addition to 71 proceeding donors (DCD and DBD) facilitated by the team April – September Team also facilitated an additional 49 non proceeding donors (44 DCD and 5 DBD).
1 April 2014 to 30 September 2014, data as at 14 October 2014

5. Mean no. of organs donated per donor
Outcome 3. Action by NHS Hospitals and staff means that more organs are usable...and surgeons are better supported to transplant organs safely into the most appropriate recipients.
Organs donated per donor.
As a Collaborative aware of a number of initiatives to increase the number of organs retrieved and transplanted per donor.
Organ Ox, Regional Normothermic Perfusion – could increase number of organs Tx by a further 5%.
DCD kidney screening.
QUOD - Quality in Organ Donation (QUOD) Project. Research will lead to better biomarkers of organ function and help clinicians decide which organ will be best for which recip.
Hannah one of the QEH Scouts will be presenting later re a case whereby a potential DBD on a Balloon Pump was managed successfully resulting in a Heart and Lung retrieval and transplant.
1 April 2014 to 30 September 2014, data as at 14 October 2014

6. Midlands donors, organs and transplants
Taking Organ Transplantation into 2020 (UK Strategy).
Strategy clearly states measures for success – likely to take longer than seven years to achieve these measures fully- but they represent world class performance and should be the UK aspiration.
UK’s rates of organ utilization already compares well with other countries. 94% of actual donors result in a least 1 transplant, compared with 86% Spain and 87% US.
1 April 2005 to 30 September 2014, data as at 14 October 2014
Hospitals are allocated to teams using the current team allocations, not the allocation at the time of donation

7. DBD- Neurological death testing rate
Testing Target 81%.
1 April 2014 to 30 September 2014, data as at 14 October 2014

8. DBD- Midlands Neurological death testing rate
Testing rates do vary from Trust to Trust. Data relating to Neurological Death Testing Rates included in Hospital Trust reports and also accompanying Midlands Organ Donation Services Team report (can be reviewed for bench marking)
1 April 2014 to 30 September 2014, data as at 14 October 2014

9. Reasons why neurological tests were not performed (primary reason)
Patient haemodynamically unstable 6
Biochemical/ endocrine abnormality 4
Family declined donation 4
Other
Continuing effects of sedation 3
Clinical reason/ Clinicians decision 2
Cardiac arrest despite resuscitation 1
Inability to test all reflexes 1
SNOD advised that donor was not suitable 1
Treatment withdrawn 1
27 Cases

10. DBD referral rate
Target 95%, therefore exceeding target
1 April 2014 to 30 September 2014, data as at 14 October 2014

11. DCD referral rate
Target 75% and therefore under target.
1 April 2014 to 30 September 2014, data as at 14 October 2014

12. Referrals
Attended
% Attendance
DBD
DCD
Non proceeding DBD/ DCD
Jan
104 66
63% 8 5 13
Feb 97 50
52% 6 9
Mar
102 53
Apr 60
64%
May 76 39
51% 10 4
June
113 83
73% 7
July 64
Aug 96 58
60% 3
Sep
100 68
68% 12
Team on average take referrals a month. Team managers have supported the team since June in taking referrals 1 day week each (undertaken in North West and Yorkshire Team). Will increase to 1 week a month each from Feb 2015.

13. Team Managers Taking Referrals
Impact so far..... Early days.....
Hope to see increase in % of referrals attended...

14. DBD approach rate
Target for DBD approach rate 93.5% and therefore Midlands Team over target.
1 April 2014 to 30 September 2014, data as at 14 October 2014

15. DCD approach rate
Target for DCD approach rate 46.4% and therefore Midlands Team over target.
Approach rate is calculated by Number of eligible DCD donors/ Number of eligible DCD donors whose family was approached. The approach rate does not take into account the number of eligible DCD donors whom are deemed non eligible donors following discussion with transplant centre's prior to approach. It is assumed that some of these patients were assessed for suitability with transplant centre’s and deemed not medically suitable/ not eligible and therefore not approached.
1 April 2014 to 30 September 2014, data as at 14 October 2014

16. DBD SN-OD involved
Target DBD SNOD attendance 85%.
Hopefully TM’s taking referrals will ensure quicker response from on call SNOD to attend potential donor referral and hence be involved in the planning and making of the approach to families re donation. April – September Data DBD Consent Rate SNOD and Clinician 69% vs. Clinician only 67%.
1 April 2014 to 30 September 2014, data as at 14 October 2014

17. DCD SN-OD involved
Target 73%.
April – September Data DCD Consent Rate SNOD and Clinician 50% vs. Clinician only 38%.
1 April 2014 to 30 September 2014, data as at 14 October 2014

18. DBD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

19. DBD SN-OD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

20. DBD no SN-OD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

21. DCD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

22. DCD SN-OD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

23. DCD no SN-OD consent rate
1 April 2014 to 30 September 2014, data as at 14 October 2014

24. Consent Behavioural Change Strategy Workforce Planning
Welsh Opt Out Legislation
ACCORD
Clinical Pathway
Donor Recognition
Consent is our focus for the remainder of the year and continuing for many years to come.
Over the past 5 years considerable gains have been made in maximising Organ Donation in the UK.
One element of the pathway ‘Consent’ is resistant to change.
It has been suggested that public promotion and societal engagement may improve Consent Rates.
There is evidence that the way in which the possibility of donation is presented to a grieving family can have a critical impact – upon the decision they make.
Current professional guidance clearly advocates involving the SNODs in the planning of the family approach
Number of local initiatives and national initiatives underway to increase consent. The collaborative today will discuss some of these initiatives...