Scottish Donation and Transplant Group written update: April 2024

Tissue donation update

Update given by:

• Dr Sharon Zahra, Clinical Lead
• Mr Neil Healy, Lead Nurse - Tissues and Cells, SNBTS

Tissue referrals 

The Tissue Donor Co-ordinators team has had a significant turnover with one staff member retiring and a further three going for promotion elsewhere within NHS Scotland; recruitment for replacement staff is currently underway. Despite this the team continue to engage with tissue donating hospitals to maintain awareness about tissue donation, providing training and feedback on a regular basis. 

During the last fiscal year there were 337 referrals for consideration of multi-tissue donation, fifty-six more than the previous fiscal year, and just thirteen fewer than pre-pandemic in 2019/20. There were a further eighty-one donors referred for eye only donation.

In the last fiscal year Scottish National Blood Transfusion Service (SNBTS) also accepted fifteen donated hearts for research and training purposes.

Tissue donation rates

In the last fiscal year 37 deceased donors donated multi-tissue. Twenty-nine of these thirty-seven donors donated tissue after organ donation, while the remaining eight donors donated tissue-only. These thirty-seven donors donated forty-seven heart tissue products and forty-six tendons. 

In the last fiscal year there were also ninety-three eyes retrieved by SNBTS from forty-seven eye donors. Discussions are currently ongoing to identify how best to resource eye donation in Scotland.

Pancreatic Islet programme 

The SNBTS Islet Isolation lab continues to provide an excellent life-saving service. In the last fiscal year 34 suitable pancreata were sent to Tissues, Cells and Advanced Therapeutics (TCAT), leading to a successful islet cell product in twenty-three cases (67%); of these 16 (70%) were successfully transplanted. This is the highest islet transplant rate yet to date.

The difference in number between successful islet products and number that were transplanted is multifactorial, including the cells not surviving an overnight hold or because the intended recipient became acutely unwell. SNBTS continues to support the UK islet transplantation programme out with Scotland more than usual as one of the UK islet laboratories remains in down time.

Live bone donation

The bone stock level has been turned around and is currently in a stable position.

In the last fiscal year, 748 femoral heads were donated with 481 being used clinically. 

For the Assessment of Individualised Risk (FAIR) III changes

The updates to the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) guidelines required to implement the Safety of Blood, Tissues and Organs (SaBTO) recommendations from the FAIR III went live on 15 November 2023. SNBTS updated the way donors are assessed in line with the updated changes at the time for all live tissue and cell donors. 

Implementation of the changes for deceased donors are currently awaiting feedback from NHSBT as this will require the Medical and Social History (MaSH) (questionnaire used for the assessment of all UK organ and tissue donors) to be updated by both organisations, with the form being controlled and managed by NHSBT on behalf of the UK – an update on the likely timelines of updating the MaSH form is anticipated.