Scottish Donation and Transplant Group written update: December 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 three months since the last report (August 2023 to October 2023) there were sixty-three referrals for consideration of multi-tissue donation, down twenty compared to the previous three months; and a further eighteen referred for eye-only donation, six less than the previous three months.

In the same period (August 2023 to October 2023) the Scottish National Blood Transfusion Service (SNBTS) also accepted five donated hearts for research and training purposes.

Tissue donation rates

In the last three months (August 2023 to October 2023) twelve deceased donors donated multi-tissue. Eight of these twelve donors donated tissue after organ donation, while the remaining four donors donated tissue-only. These twelve donors donated fourteen heart tissue products and twelve tendons.

In the last three months (August 2023 to October 2023) there were also twenty-two eyes retrieved by SNBTS from eleven eye donors. Work continues in collaboration with NHSBT and colleagues in the NHS Boards 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 first seven months of the current fiscal year (April 2023 to October 2023), eighteen suitable pancreata were sent to Tissue, Cells, and Advanced Therapeutics (TCAT), leading to a successful islet cell product in thirteen cases (72%); of these 7 (39%) 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. SNBTS is currently supporting the islet transplantation programme out with Scotland more than usual as one of the UK islet laboratories is currently in down time.

Live bone donation

Work continues to be progressed to increase the number of hospitals that can support live bone donation during orthopaedic surgery – the bone stock is now in a more stable position as elective orthopaedic surgery is normalising post-pandemic.

In the first seven months of this fiscal year (April 2023 to October 2023), 455 femoral heads have been donated with 291 being used clinically.

Recent and 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 Safety of Blood, Tissues, and Organs (SaBTO) recommendations from the ‘For the Assessment of Individualised Risk (FAIR) III’ went live on 15 November 2023. SNBTS updated the way donors are assessed in line with the updated changes as of the 15 November 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 expected on 6 December 2023.