Scottish Donation and Transplant Group written update: August 2023

Tissue donation

Update given by:

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

Tissue referrals 

The Tissue Donor Co-ordinators continue to engage with tissue donating hospitals to maintain awareness about tissue donation, providing training and feedback on a regular basis. 

During the six months since the last report (February 2023 to July 2023) there were 163 referrals for consideration of multi-tissue donation, up nineteen compared to the previous six months; and a further thirty-four referred for eye-only donation, seven more than the previous six months.

Of the 163 referrals (February 2023 to July 2023), 113 donors (69%) were deferred, most due to medical unsuitability for multi-tissue donation, but some due to family decline, family being unavailable or no available bloods.

Tissue donation rates

In the last six months (February 2023 to July 2023) nineteen deceased donors donated multi-tissue. Fifteen of these nineteen donors donated tissue after organ donation, while the remaining four donors donated tissue-only. These nineteen donors donated twenty-three heart tissue products and twenty-six tendons. 

In the last six months (February 2023 to July 2023) there were also fifty-four eyes retrieved by Scottish National Blood Transfusion Service (SNBTS) from twenty-seven eye donors. There is currently ongoing work in collaboration with NHSBT to continue to progress ways of increasing the eye-donation rate in Scotland.

Pancreatic islet programme 

The SNBTS islet isolation lab continues to provide an excellent life-saving service. In the last fiscal year (April 2022 to March 2023), twenty suitable pancreata were sent to Tissue, Cells, and Advanced Therapeutics (TCAT), leading to a successful islet cell product in ten cases (50%); of these 8 (40%) were successfully transplanted. 

In the first four months of the current fiscal year (April 2023 to July 2023) ten suitable pancreata were sent to TCAT, leading to a successful islet cell product in six cases (60%); of these four (40%) were successfully transplanted. 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.

Live bone donation

Work continues to be progressed to increase the number of hospitals that can support live bone donation during orthopaedic surgery – orthopaedic surgery currently remains reduced in most hospitals.

In the last fiscal year (2022/23) 538 femoral heads were donated and 527 were used clinically.

In the first three months of this fiscal year (April 2023 to June 2023), 196 femoral heads have been donated with 132 being used clinically. 

Anticipated changes to donor assessments

The updates to the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) guidelines required to implement the Advisory Committee on the Safety of Blood, Tissues, and Organs (SaBTO) recommendations from the ‘For the Assessment of Individualised Risk (FAIR) III’ report is awaited. Once they are issued the changes will be implemented a few months later due to the significant training that will be required to ensure the changes are implemented safely.