Organ donation

What is Organ Donation?

Organ donation is the act of giving an organ to save or improve the life of someone who needs a transplant. You are able to donate some organs while you are alive, for example; a kidney, or part of your liver. However, most organ and tissue donations will come from people who have died.

Every year, thousands of people have their lives saved or dramatically improved through the gift of organ donation from donors and their families, who think of others at a time of tragic loss. Over 6000 people are waiting for a transplant in the UK, some sadly die while waiting.

Anyone can register a decision to donate their organs and tissue when they die, regardless of their age or medical conditions on the organ donor register which is managed by NHS Blood and Transplant:

https://www.organdonation.nhs.uk/register-your-decision/donate

Critical Care and Organ Donation

Around 600,000 people die every year in the UK, but only around 1% (6,000) die in circumstances where they can donate their organs. Donors can usually only be people who have died in a hospital intensive care unit (ICU). Organs need to be in a suitable condition and transplanted into the person needing a transplant (recipient) very soon after someone has died.

When a person suffers from a life-threatening illness and is admitted to the Intensive Care Unit (ICU), every effort will be made by the ICU team to save their life, above all else, by providing the appropriate therapies. There are many factors that affect the survival of critically ill patients, but, on average in the UK, about 20-30% of patients admitted to ICU sadly die.

If, despite their best efforts, it becomes clear to the ICU team that death is inevitable, the ICU team are obliged to consider the possibility of organ donation in line with best medical practice and national guidance. As end-of-life discussions take place with a patient’s loved ones, a Specialist Nurse in Organ Donation (SNOD) will be notified by the ICU team that the death of the patient is likely. The Specialist Nurse in Organ Donation will undertake an assessment of whether organ donation is possible, and approach the family to discuss their feelings around organ donation. They are experts in this area and are available 24/7 to discuss patients and support relatives/carers. They ensure all patients, including donors, are treated with the greatest care and respect. Faith and beliefs are always respected.

In the United Kingdom, strict criteria help doctors to accurately diagnose death. Organs are never removed until a patient’s death has been confirmed.

Consent for Organ Donation

What is consent? Consent is permission given for something to happen.

The law around consent for organ donation changed in 2020 from an opt-in scheme to an opt-out scheme, known as Max and Keira’s (deemed consent) law. Adults in England are considered legally to be consenting organ donors unless they have opted out or are in the following excluded groups:

• children under 18
• people who lack mental capacity for a significant period before their death
• people who have not lived in England for at least 12 months before their death

People in the excluded groups may still donate organs after discussion and consent from the next of kin.

Those who do not wish to donate their organs are able to record their opt-out decision on the NHS Organ Donation Register. They are able to do this through NHS Blood and Transplant’s website or helpline.

More about Max and Keira’s law

Max received a lifesaving heart transplant in August 2017 aged nine. He was on the waiting list for eight months after being diagnosed with a heart failure condition called ‘dilated cardiomyopathy’. Max’s gift of life came from a young girl, Keira Ball, who tragically died in a road accident, aged nine. Her parents made the selfless decision to help others through their own tragedy. 

Max met several children whose wait for a transplant was sadly too long. Throughout his own wait for a new heart, Max decided to share his story and support a campaign in favour of an opt-out system for organ donation. In 2018 the government announced that the law around organ donation would be changing and would be commonly referred to as Max’s Law, in recognition of all the campaigning Max and his family have done. Max announced he wanted Keira’s name to be added.

Keira’s donation was the inspiration behind the new law. 

Meet Max in this touching video clip:  https://youtu.be/w1RZQPyaLck 

More of Max’s amazing story can be found at:  

https://www.organdonation.nhs.uk/helping-you-to-decide/real-life-stories/people-who-have-benefitted-from-receiving-a-transplant/max-heart-transplant-recipient-and-campaigner/

The decision is still yours to make. Share it with loved ones, Leave them Certain. 

Safeguards

Safeguards are in place and Specialist Nurses will always discuss donation with families so an individual’s wishes are respected. In practice, the key change after this legal amendment is the starting point of the discussion with the next of kin, which is now from a position of deemed consent, and donation does not occur unless the next of kin are in agreement.

For this reason, we would encourage discussion with those closest to you, to give them the certainty they need to support your organ donation decision. It starts with us, “Leave them Certain.”

Why does ethnicity matter in organ donation? 

For many patients in need of a transplant the best match will come from a donor from the same ethnic background. Kidney donors and recipients are matched by blood group and tissue type, and people from the same ethnic background are more likely to have matching blood groups and tissue types. 

For other organs there is a need to match blood groups, but less or no requirement to match tissue types.

For more information: https://youtu.be/dJi1zpoaYzE

Did you know?  

As of 2021, all secondary school children (aged 14-16) in England are now being taught how to save lives through donation as part of the KS4 curriculum. It is hoped young people will drive donation conversations at home.

More information can be found in the links below. Ask any member of the ICU team about speaking with the SNOD for more information on organ donation.