Scottish Donation and Transplant Group written update: December 2024

Tissue donation 

Update given by:

• Dr Sharon Zahra, Clinical Lead, Scottish National Blood Transfusion Service (SNBTS)
• Mr Neil Healy, Lead Nurse - Tissues and Cells, SNBTS

Tissue referrals

Recruitment of Tissue Donor Co-ordinators is currently complete with training ongoing of the new team members. 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 first eight months of this financial year there were 232 referrals for consideration of multi-tissue donation. There were a further 51 donors referred for eye only donation.

Tissue donation rates

In the first eight months of this financial year 19 deceased donors donated multi-tissue. Thirteen of these 19 donors donated tissue after organ donation, while the remaining six donors donated tissue-only. These 19 donors donated 16 heart tissue products and 20 tendons.

In the first eight months of this financial year there were also 56 eyes retrieved by SNBTS from 28 eye donors. Potential Donor Audits carried out in a number of hospitals identifies that the potential eye donor numbers are much higher than the actual number of donors progressing successfully to donation. Discussions are required to identify how to resource eye donation in Scotland to ensure that eye donation potential is not lost.

Pancreatic islet programme

The SNBTS Islet Isolation lab continues to provide an excellent life-saving service and continued to provide contingency across the UK while one of the islet labs in England remained in extended down-time until October 2024. In the first eight months of this financial year, until the end of November 2024, 18 suitable pancreata were sent to Tissue, Cells, and Advanced Therapeutics (TCAT), leading to a successful islet cell product in eight cases (44%); of these three (17%) 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

The bone donation rate was slightly lower than the target required for meeting the clinical demand for a number of months in this financial year, mainly due to most patients requiring primary hip replacement having multiple co-morbidities so that they were identified as being unsuitable for bone donation. In light of this, SNBTS is engaging with an additional hospital to establish another bone donation programme to ensure the bone donation rate is such as to meet the clinical demand. SNBTS aims to have six months’ worth of bone stock at any one time.

In the first eight months of this financial year, up to the end of November 2024, 370 femoral heads were donated with 428 being used clinically.

For the Assessment of Individualised Risk (FAIR) III changes

As previously reported the FAIR III changes were implemented for live tissue and cell donors in November 2023. Implementation of the changes for deceased donors remains on hold at the present time while discussions continue with NHSBT as to the changes that are required to the Medical and Social History (MaSH) (questionnaire used for the assessment of all UK organ and tissue donors). The MaSH is controlled and managed by NHSBT on behalf of the UK – discussions have continued but are yet to be finalised.