Scottish Donation and Transplant Group written update: March 2023

Scotland organ donation update

Update given by:

• Susan Hannah, Regional Manager – Scotland, NHS Blood and Transplant (NHSBT)

Donation performance April 2022 to January 2023

From April 2022 to January 2023 the ten months validated potential donor audit (PDA) data taken from the donating hospitals has highlighted organ donation improvement in Scotland.

The referral rate to the organ donation service has consistently remained high between 97% to 100% and this is higher than UK average of 94%.

The number of potential donor families approached for organ donation was 156 with 105 authorised (willing to donate) with a 67% combined authorisation rate and is 9% less than target of 76% with UK average of 61%.

The Donation after Brain Death (DBD) authorisation rate in Scotland remains one of the highest of all teams in the UK with 83% and UK average is 68%. However, the Donation after Circulatory Death (DCD) authorisation rate is one of the lower teams with 57% and is the UK average.

The combined authorisation rate of DBD and DCD remains low with 67% and similar UK wide with 62%. A widening gap is noted between DBD and DCD authorisation rates with NHS Organ Donor Register (ODR) opt-In difference of 12% (DBD 92% and DCD 80%) and Deemed 34% difference (DBD 92% and DCD 58%). Most common reasons cited for DCD family declines is ‘wanting immediate withdrawal of treatment’ and ‘their loved one did not want to be a donor.’

The highest trend of proceeding donor numbers was in the months of July, August, and December 2022 this correlates with improved eligibility of potential organ donors currently at 33%. Whilst continued recovery with organ donor numbers UK wide this has not returned to pre-pandemic numbers.

The Specialist Nurse and Specialist Requestor combined presence when approaching potential organ donor families is 89% and whilst continued improvement for Scotland, it remains lower in comparison to UK average of 92%.

The number of ODR opt-in overrides is twelve which is five more than last year, and deemed unsupported is eleven which is four more than last year. The most common reason cited is ‘their loved one would not have wanted organ donation.’

The UK wide number of DBD donors has declined by 17% with a drop in death by neurological criteria (DNC) testing rate from 87% to 76% pre covid. In Scotland, the DNC testing rate is higher than last year with 86% (3.5%) and it is noted our number of DBD donors trending down with a current gap of only three donors’ difference between DBD (50) and DCD (47).

With a current total of ninety-seven donors this is a 17% increase in last year donor numbers and the number of organs taken for transplant was 305 which is a 27% increase from last year.