Scottish Donation and Transplant Group written update: April 2024

Deceased organ donation update

Update given by:

• Susan Hannah, Regional Head of Nursing Organ Donation (Scotland Team), NHSBT

Donation performance April 2023 to January 2024

From April 2023 to March 2024, the 12 months validated potential donor audit (PDA) data taken from the donating hospitals has highlighted organ donation improvement in Scotland. The performance target given from NHSBT was 109 donors and actual was 120 donors, which is a 15% increase from 102 donors last year. This is the second highest number of donors in over the last 10 years.

With a total of 120 donors the total number of organs retrieved for transplant was 416 and with twenty retrieved for research. Donor eligibility has seen an overall improvement from 299 to 305. Donation after brain death (DBD) figures have improved 30% from 81 to 105 and donation after circulatory death (DCD) has seen a slight reduction of 8% from 218 to 200, which has resulted in 57 DCD donors and DBD 63 donors.

The referral rate to the Scotland organ donation service has consistently remained high at 98%, which is higher than UK average of 94%. The number of potential donor families approached for organ donation increased by 22% with 228 and 140 authorised (willing to donate) with a 61% combined authorisation rate the same as UK average and 6% lower than last year.

The DBD authorisation rate in Scotland is one of the highest teams in the UK with 74% with a UK average is 68%. However, the DCD authorisation rate is one of the lower teams with 53% and is lower than UK average of 56%. 

A widening gap is noted between Expressed/On the NHS Organ Donor Register (ODR) authorisation rate of 84% and deemed authorisation of 63%. This 21% gap has increased from last year with a 7% difference. The number of Expressed/On the ODR overrides is fourteen which is one more than last year, however unsupported deemed has more than doubled from 13 to 28. There is a similar increase in UK and reduced public confidence in NHS has noted a small statistical impact which correlates with reduced authorisation and consent rates for organ donation.

The Specialist Nurse and Specialist Requestor (SR) combined presence when approaching potential organ donor families is 89% and remains lower in comparison to UK average of 91%. The main reason for this is consultant preference not to approach with Specialist Nurse which is more evident with DCD donors.

There are challenges UK wide with continued reduced neurological death testing rate in DBD donors. The UK average 75% and Scotland rate is higher with 78% and 8% lower than last year with thirty-one cases not tested, in comparison to last year 14 not tested.

Eye only authorisation the Scotland team is in the process of transferring back to the National referral Centre (NRC) due to the complexities of the eye donation pathways, capacity, and resources. We are currently in the process of training National Referral Centre with handover planned in May 2024.

The Donor Recognition Funding (DRF) proposal submitted to all NHS Boards Organ Donation Committees have all responded with option choices and organising new process of centralised funding to improve flexibility and resources for utilising promotional awareness more effectively across Scotland.