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Organ Donation and Transplantation Activity Report 2019/20

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Organ Donation and Transplantation Activity Report 2019/20 Organ Donation and Transplantation Activity Report 2019/20 Preface This report has been produced by Statistics and Clinical Studies, NHS Blood and Transplant. All figures quoted in this report are as reported to NHS Blood and Transplant by 12 May 2020 for the UK Transplant Registry, maintained on behalf of the transplant community and National Health Service (NHS), or for the NHS Organ Donor Register, maintained on behalf of the UK Health Departments. NHS regions have been used throughout the report for convenience in comparisons with the previous year's figures. The information provided in the tables and figures given in Chapters 2-10 does not always distinguish between adult and paediatric transplantation. For the most part, the data also do not distinguish between patients entitled to NHS treatment (Group 1 patients) and those who are not (Group 2 patients). The UK definition of an organ donor is any donor from whom at least one organ has been retrieved with the intention to transplant. Organs retrieved solely for research purposes have not been counted in this Activity Report. Organ donation has been recorded to reflect the number of organs retrieved. For example, if both lungs were retrieved, two lungs are recorded even if they were both used in one transplant. Similarly, if one liver is donated, one liver is recorded even if it results in two or more transplants. The number of donors after brain death (DBD) and donors after circulatory death (DCD) by hospital are documented in Appendix I. Donation and transplant rates in this report are presented per million population (pmp): population figures used throughout this report are mid-2018 estimates based on ONS 2011 Census figures and are given in Appendix III. All charts presented in this report are available as an accompanying slide set available from http://www.odt.nhs.uk. A supplementary report on organ donation and transplantation activity for Black, Asian and Minority Ethnic (BAME) groups is published alongside this Activity Report – Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities. It provides additional information on trends in organ donation and transplantation for BAME communities. The COVID-19 pandemic has led to unprecedented challenges for UK transplantation. Concerns about the ability to care for transplant recipients, lack of access to resource because it is being used for patients in the pandemic, and the risk versus benefit for immunosuppressed transplant recipients, have resulted in a major reduction in the number of organ transplants undertaken. Waiting list figures at the 31 March 2020 do not accurately reflect the need for an organ transplant due to the COVID-19 pandemic. Different practices have been established across the UK and across organ groups with regards to waiting list management. Due to this, a snapshot of the waiting list at 29 February 2020 has been used to better reflect activity near the end of the 2019-2020 financial year. Acknowledgement NHS Blood and Transplant would like to thank all those in the donation and transplantation communities responsible for providing data to the UK Transplant Registry and the Potential Donor Audit, without whom this report would not be possible. Thanks also go to NHS Blood and Transplant staff responsible for data entry and accuracy and completeness of the data. Foreword The last decade has seen a huge increase in the number of deceased donors and lifesaving or life transforming transplants. Until February 2020, we were confident that we would once again see a UK record number of organ donors and transplants. Then the global COVID-19 pandemic hit in March and the impact was felt across the whole of the NHS and in every aspect of UK society. In March 2020 we witnessed a sharp reduction in activity with a decline in deceased donors as well as the number of transplants. This was due to concerns for patient safety and the fact NHS resources were required to deal with the COVID-19 crisis. Through dedication, effort and with the support of the wider NHS, we were able to keep aspects of organ donation and transplantation available for highly urgent patients even during the peak of the surge of COVID-19. Yet there was still a fall in the overall number of deceased organ donors - 1,580 compared to 1,600 last year. Subsequently, the number of patients who received a deceased organ donor transplant fell from 3,952 to 3,760. Unfortunately COVID-19 also had a big impact on living donation kidney transplant numbers just as it did in most other countries. Living donor transplants fell by 4% to 1,001. We fully realise that this has been a very worrying time for patients who are awaiting a transplant and for the families of those patients. We would like to take this opportunity to reassure them that the recovery of donation and transplantation is well underway and the majority of transplant units have reopened, with all heart, lungs and liver transplant units functioning at the time of writing. Despite these challenges, it is testament to the strong foundations laid in the UK that we have seen incredible family support for organ donation. Even during the worst days of the pandemic there were 91 deceased organ donors (March 2020) from UK intensive care units. Impressively the overall consent/authorisation rate for organ donation has continued to rise over the last year to 68%. During the pandemic crisis this consent rate was even higher at 74.5% (March 2020). Looking forward we are committed to do all that we can to increase the number of organ donors and transplants even as we continue to fight COVID-19. We hope that, with England’s move to an opt out system as a result of Max and Keira’s law, we will continue to see improved public support for organ donation as Wales has seen since the legislative change in December 2015. Scotland is intending to commence its own deemed authorisation legislation in the Spring of 2021. With the new law in effect in England since 20 May 2020, it is important that people know that they still have a choice whether or not to donate. Families will still be consulted, and people’s faith culture and beliefs will continue to be respected. We are grateful to all those in the faith and belief community across the UK who advised us during the preparation for the legislative change. As the current pandemic situation improves, we believe that the new law and growing public support will lead to even more lives saved. Anthony Clarkson Prof John Forsythe Dr Dale Gardiner Director - Organ and Tissue Medical Director - Organ and National Clinical Lead For Organ Donation and Transplantation Tissue Donation and Donation Transplantation Contents 1 Summary of Donor and Transplant Activity .......................................................................... 1 2 Overview of Organ Donation and Transplantation ............................................................... 3 2.1 Summary of activity ............................................................................................................. 4 2.2 Transplant list ...................................................................................................................... 8 2.3 Transplants .......................................................................................................................... 9 3 Organ Donation Activity ........................................................................................................ 12 3.1 Summary of activity ........................................................................................................... 13 3.2 Organ donors .................................................................................................................... 14 3.3 Demographic characteristics ............................................................................................. 17 4 The National Organ Retrieval Service and Usage of Organs ............................................. 19 4.1 The National Organ Retrieval Service (NORS) ................................................................. 20 4.2 Retrieval and usage of organs ........................................................................................... 22 5 Kidney Activity ....................................................................................................................... 32 5.1 Overview ........................................................................................................................... 33 5.2 Transplant list .................................................................................................................... 36 5.3 Donor and organ supply .................................................................................................... 40 5.4 Transplants ........................................................................................................................ 41 5.5 Demographic characteristics ............................................................................................. 49 6 Pancreas Activity .................................................................................................................. 51 6.1 Overview ........................................................................................................................... 52 6.2 Transplant list .................................................................................................................... 53 6.3 Donor and organ supply ...................................................................................................
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