Organ Donation and Transplant Ireland ANNUAL REPORT 2014

ODTI Organ Donation and Transplant Ireland ANNUAL REPORT 2014

Contents

Message from the Director 3

Report from the ODTI 5

Overview of 2014 6

Donation and Transplant Programmes 8

Activity in 2014 10

Numbers on Waiting List (31st Dec 2014) 11

Organ Donation 13

Transplantation (2011-2014) 18

Survival Rate 20

Goals for 2015 23

Bibliography 25

Acknowledgements 26 Organ Donation and Transplant Ireland has been delegated the regulatory functions assigned to the HSE in Statutory Instrument 325, European Union (Quality and Safety of Human Organs Intended for Transplantation) Regulations 2012.

Statutory Instrument (SI) 325 (2012) Part 5

Reporting obligations of HSE

25. (1) The HSE shall— (a) keep a record of the activities of procurement organisations and transplantation centres, including aggregated numbers of living and deceased donors, and the types and quantities of organs procured and transplanted, or otherwise disposed of in accordance with European Union and national provisions on the protection of personal data and statistical confidentiality, (b) draw up and make publicly accessible an annual report on activities referred to in subparagraph (a), and (c) establish and maintain an updated record of procurement organisations and transplantation centres. (2) The HSE shall, upon the request of the Commission or another Member State, provide information on the record of procurement. organisations and transplantation centres.

Message from the Director

This report outlines the main activities of ODTI in I would like to acknowledge the contribution of 2014, and plans and goals for 2015. the three transplant centres in Ireland. Without exception, each transplant centre has provided a Thanks to the generosity of 63 families donating complete and responsive service for the Irish pub- the organs of their relatives, 211 people received lic. I would also like to particularly acknowledge the gift of life. In addition 40 people have gen- the ICUs in the organ donating hospitals across erously donated their kidney to a family member. Ireland who have worked closely, cooperatively Meanwhile outcomes for transplant recipients in and professionally with the transplant centres and Ireland rank amongst the best in Europe. ODTI. I would like to acknowledge my own team Living kidney donation plays a vital role in trans- in ODTI and the National Organ Donation and plantation. We have once again seen a record year Transplantation Advisory Group for their dedica- in the number of living kidney donors. 2014 was a tion, commitment and direction in 2014. significant year as the Living Donor Reimbursement Most importantly, I acknowledge the courage and Policy was introduced by the Minister of Health, generosity of families that have donated their Leo Varadkar. loved one’s organs. However, the need for organ transplants is increas- ing. There were 636 patients waiting for an organ transplant at the end of 2014.

Following receipt of much needed funding in 2014, ODTI are in the process of enhancing struc- Professor Jim Egan tures related to organ donation with the support Director of HSE senior management, the Minister of Health Organ Donation and Transplant Ireland and Department of Health. We have recruited 5 new procurement coordinators and 6 nurse leads across the country. Also six Intensive Care Unit (ICU) Consultants are to be appointed.

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 3

Report from the ODTI

Organ Donation and Transplant Ireland (formerly The Directive on standards of quality and safety the National Organ Donation and Transplantation of human organs intended for transplantation was Office) was established in 2011. It acts under legis- signed into Irish legislation in 2012 and assigns the lation SI 325 (2012) as the delegated body for the following responsibilities to the ODTI: HSE, to establish quality standards and protocols • Ensure that a framework for quality and safe- for the entire solid organ donation/transplantation ty is established to cover all stages of organ process and to comply with the EU Commission’s donation and transplant of organs 10 point action plan in relation to organ donation and transplantation. • Ensure that reporting systems are in place The ODTI was initiated to provide governance, in- for adverse events related to the quality tegration and leadership for organ donation and and safety of organs for organ donation and transplant in Ireland. The office is responsible for: transplantation

• The development, coordination and man- • Ensure data collection for publication annu- agement of a strategic framework for organ ally in relation to organ donation and trans- donation and transplant. plantation activities

• Informing the continual development of ser- • Ensure appropriate organ exchange agree- vices and ensuring best use of resources. ments and arrangements are in place between member states • Facilitating an integrated team approach to organ donation and transplant services with- • Ensure that a living donor register is kept in in Ireland. accordance with data protection legislation

National Organ Donation and Transplantation Advisory Group The National Organ Donation and Transplant Advisory Group provides recommendations and sets direction for ODTI.

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 5 Overview of 2014

Service Planning Quality and Safety Framework ODTI received funding in the 2014 HSE Service The ODTI, in conjunction with the Health Products Plan for the development of Organ Donation and Regulatory Authority (HPRA), published in 2014 Transplant services in Ireland. The funding facili- A Framework for Quality and Safety of Human tates the implementation of an infrastructure of Organs Intended for Transplantation to cover all dedicated expertise at local and national level to stages of the chain from donation to transplan- strengthen service provision and to support ser- tation or disposal; in compliance with Part 3, vices to develop quality systems for the traceabil- Regulation 12, of S.I. No 325 of 2012 and the rules ity of organs from organ donation right through to laid down in the European Directive on the Quality transplantation and outcomes. and Safety of Organs intended for transplantation (2010/53/EU). ODTI recruited the Quality Management team and the National Organ Procurement Service team in The framework for quality and safety provides for, 2014. Recruitment commenced on a national net- and includes details on, the roles and responsibili- work of Organ Donation Nurse Managers. ties regarding the adoption and implementation of operating procedures for: Funding was assigned for the implementation of the Living Kidney Donor Reimbursement Scheme. a) The verification of donor identity; A policy document was developed in conjunction with the Department of Health and Beaumont b) The verification of the details of the donor’s Hospital and was signed by Minister Leo Varadkar, or the donor family’s consent; TD in November 2014. The reimbursement c) The verification of the completion of the or- scheme allows for living donors to claim loss of gan and donor characterisation in accord- earnings and out of pocket expenses directly due ance with Regulation 15 and the Annex to to the living donation, up to a maximum limit set the Directive; in the policy.

Organ donation awareness is an essential part of d) The procurement, preservation, packaging ensuring that a sustainable transplant programme and labelling of organs in accordance with can survive and thrive. It is only because of the Regulations 13, 14 and 16; generosity of the Irish public that patients can re- ceive the life saving treatment of an organ trans- e) The transportation of organs in accordance plant. The Irish Kidney Association has a long ex- with Regulation 16; perience of organ donation awareness, was given f) Ensuring traceability, in accordance with funding by the ODTI to deliver specific organ do- Regulation 18, guaranteeing compliance nation awareness initiatives in 2014. with the European Union and national provi- A working group on public awareness was es- sions on the protection of personal data and tablished in ODTI in 2014. Since then the group confidentiality; agreed to carry out a survey on public attitudes and awareness of organ donation, the results of which are expected to be available in 2015.

6 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 g) The accurate, rapid and verifiable reporting Organ Donation Infrastructure of serious adverse reactions and events in ac- ODTI has collaborated with hospitals around cordance with Regulation 19; the country to implement organ donation struc- h) The management of serious adverse reactions tures, commencing with Organ Donation Nurse and events in accordance with Regulation 19. Managers and Intensive Care Consultants with a special interest in Organ Donation. The Framework is used by the HPRA in association with other relevant guidance for authorisation of transplant centres and procurement organisa- National Organ Procurement Service tions. The three transplant centres in Ireland were Transition Programme assessed in 2014. Authorisation action plans have The National Organ Procurement Service (NOPS) been developed between the HPRA and each transition programme began with the recruitment transplant centre to complete the authorisation of a NOPS Nurse Manager in October 2014. The programme in 2015. NOPS Nurse Manager spent a week in an established Nurse Procurement Centre in the UK shad- owing the staff and witnessing the Health and Adverse Reaction/Events (SAR/E) Lifestyle questionnaire in practice. Following on The ODTI and the Health Product Regulatory from this a network has been built up with the Authority (HPRA) have joint responsibility to re- Centre for future training needs. The team ex- ceive serious adverse events in relation to organ panded with the commencement of four other donation and transplantation. All SAR/Es are re- NOPS Coordinators in January 2015. viewed by the NODTAG and advice is issued as appropriate to the relevant locations. The purpose of the reporting system is to learn and improve from Meetings And Collaboration the experience of the adverse events. In all cases with Stakeholders they are dealt with appropriately at location and at The office has worked closely and collaborated national level, where relevant, and the learning is with the HSE, regulatory bodies, the Department shared within the relevant organisations. of Health, stakeholders and patient organisations to advance and promote organ donation and transplantation in Ireland. The office led and Service Performance participated in meetings with the Department of ODTI continues reporting on organ donation Health, the HPRA, patient organisations, trans- and transplant activities on a regular basis. This plant centres, NHS Blood & Transplant other na- includes gathering and reporting on activities tional health services in 2014. Representatives as requested by parliamentary questions, pub- from the office attended European Regulatory and lic representations, media queries, European Clinical meetings and met with relevant personnel Commission, international bodies and other areas in other European Union Member States. of the health services looking for information. The office, in partnership with the procurement service and transplant centres, functions as the source for information for any European data that has been collected.

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 7 Donation and Transplant Programmes

Organ Donation and Retrieval in Ireland National Kidney and Pancreatic Organ donation in Ireland is based on a voluntary Transplant Service (NKPTS) donation system (opt in) and occurs in 33 intensive The National Renal & Pancreatic Transplant Service care units throughout Ireland. is the longest established and largest transplant programme in Ireland and is based in Beaumont The three transplant centres, which have devel- Hospital. The first Kidney Transplant was- per oped independently of each other, have different formed in Jervis Street Hospital in January 1964 requirements in relation to organ donation. Each and by the end of 2014 over 4500 renal transplants transplant centre has its own organ retrieval team, have taken place. There are approximately 2300 which provides 24/7 service and which travels na- recipients alive with functioning kidney trans- tionwide to retrieve organs. plants. Pancreas transplantation was established in 1992, and since then over 130 simultaneous pan- National Organ Procurement Service creas and kidney transplants have been performed (NOPS) on patients with diabetes mellitus. The NKPTS also runs the Living Kidney Donor Programme and to The renal transplant coordinators based in date over 200 renal transplants have taken place Beaumont Hospital have provided procurement because of living donation. (donor) coordination services for liver, lung and heart transplantation as well as their own origi- Prior to 2003 any child requiring a kidney trans- nal primary function of coordinating renal and plant had to attend Beaumont Hospital. However, pancreas transplantation. The coordinators have for the past 10 years the Transplant team from delivered a 24 hour on-call service for the three Beaumont Hospital have been working with their transplant centres and deal with all organ donor paediatric colleagues to provide the paediatric referrals. Furthermore they have provided a valu- renal transplantation service within the Children’s able link between donor families and the recipi- University Hospital, Temple Street and to date ents, culminating in the organisation of, with the over 100 transplants have taken place there. Irish Kidney Association, an Annual Service of 2014 also saw the retirement of Mr. David Hickey Remembrance and Thanksgiving for organ do- following a long distinguished career dedicated to nors, their families and recipients. organ transplantation. A process began with regard to transferring NOPS to ODTI in the final quarter of 2014.

8 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 National Liver Transplant Service The National Heart and Lung The liver transplant programme has been running Transplant Service in St. Vincent’s University Hospital since 1993. By The National Heart Transplant Service has been the end of 2014, 889 liver transplants have been in place since 1985 and is based at the Mater performed, with outcomes very much in keeping Misericordiae University Hospital (MMUH). with the best results achieved in UK and European To date over 300 heart transplants have been per- centres. formed. The Lung Transplant programme is also located at the MMUH and has been in place since The continued success of the liver transplant pro- 2005 and since then the programme has grown gramme and the comprehensive multidisciplinary incrementally. In 2006 the first double lung trans- approach to liver disease, which is employed in plant was undertaken and in 2007 the first lung St Vincent’s University Hospital, has resulted in an transplant for a cystic fibrosis patient occurred. The increased rate of referral of patients for considera- 100th Lung Transplant took place in the summer of tion for liver transplantation. Liver Transplantation 2014, and marked with a Thanksgiving Service in is carried out for a wide variety of indications in- October. cluding both acute liver failure and chronic liver disease.

Paediatric Liver, Heart and Lung Transplants The paediatric liver and heart transplantation is managed via Our Lady’s Hospital, Crumlin, and the paediatric lung programme is managed via the Children’s University Hospital, Temple St. Due to the small numbers involved, the transplants take place in UK hospitals that are centres of excellence for paediatric transplantation.

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 9 Activity in 2014

Ireland continues to do well in comparison with Furthermore the kidney living donor programme other countries in the EU, ranking in the top 50% continues to expand achieving 40 living dona- for organ donation. tions in 2014, the highest number to date. For further information on the kidney transplant pro- While the number of donors decreased in 2014 (63 gramme see http://www.beaumont.ie/media/ compared to 86 in 2013), the utilisation of organs BeaumontHospital KidneyTransplantReport2013% per donor was higher at 3.4 : 1 (3.0 : 1 in 2013). 5B1%5D1.pdf Kidney transplantation is the most common form While the number of liver transplants was lower of renal replacement therapy in Ireland, with 55% than the previous year, the percentage of trans- of patients being treated with a transplant while plants from donations was higher (up by 6%). 45% are on some form of dialysis. Heart transplants were up 64% from 2013, the In 2014, there were a record number of paediatric highest this millennium. kidney transplants (n=20), resulting in an all time low of just sixteen children remaining on dialysis. The high number of lung transplants (n=31) continued in 2014, with Ireland having the third highest rate of lung transplantions in Europe.

10 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Numbers on Waiting List (31st Dec 2014)

Kidney Waiting List (Median time 31 Months in 2014)

600 551 544

450

300 226 202

150

0 2013 2014

Total Newly Listed

Liver Waiting List (Median time 5 Months in 2014)

88 74 75

63 49 50 39 38

25 19

13 1 3 0 2013 2014

Total Newly Listed Mortality

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 11 Lung Waiting List (Median time 4.5 Months in 2014)

50 46 44 45 42 40 35 37 30 25 20 15 20 10 5 0 9

2013 2014

Total Newly Listed Mortality

Heart Waiting List (Median time 2.6 Months in 2014) 20 19 18 18 17 17 16 16 15 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 1 1 0 2013 2014

Total Newly Listed Mortality

12 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Organ Donation

Total Organ Donors and Transplants (2013-2014)

375

294 300 251

225

150

86 75 63 38 40

0 Deceased Donors Living Donors Transplants

2013 2014

Ratio of transplants to donors 3.0 : 1 3.4 : 1

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 13 Organs Transplanted (2014)

152

44 31 18 6

Kidney Liver Lung Heart Pancreas

Transplant Summary 2010 - 2014

Organ Transplant 2010 - 2014 5 2010 2011 2012 2013 2014 year 5 year average total Transplantation Kidney 98 165 131 147 112 653 131 From Liver 38 61 50 55 44 248 50 Deceased Lungs 4 8 14 32 31 89 18 Heart 3 6 10 11 18 48 10 Pancreas 8 8 1 11 6 34 7 Sub-total 151 248 206 256 211 1072 214

Living Kidney Transplants 23 27 32 38 40 160 32

Living and Deceased 121 192 163 185 152 813 163 Kidney Transplants

Total Organ Transplants 174 275 238 294 251 1232 248

14 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Donor Figures Per Hospital Group (2010-2014)

Dublin North East 2010 2011 2012 2013 2014 19 29 20 28 21 *Beaumont Hospital; Our Lady of Lourdes Hospital, Drogheda; Connolly Hospital; Cavan General Hospital; Rotunda Hospital; Louth County Hospital; Monaghan Hospital.

Dublin Midlands 2010 2011 2012 2013 2014 6 14 12 11 9 *St James’s Hospital; Tallaght Hospital; Midlands Regional Hospital, Tullamore General Hospital; Naas General Hospital; Midlands Regional Hospital, Portlaoise General Hospital.

Dublin East 2010 2011 2012 2013 2014 11 14 19 11 8 *Mater Misericordiae University Hospital; St Vincent’s University Hospital; Midland Regional Hospital, Mullingar; St Luke’s General Hospital, Kilkenny; Wexford General Hospital; Our Lady’s Hospital Navan; St Columcille’s Hospital; St Michael’s Hospital Dun Laoghaire.

South/South West 2010 2011 2012 2013 2014 11 20 15 20 12 *Bantry General Hospital; Cork University Hospital; Cork University Maternity Hospital; Kerry General Hospital; Mallow General Hospital; Mercy University Hospital; South Infirmary Victoria University Hospital; South Tipperary General Hospital; Waterford Regional Hospital.

West/North West 2010 2011 2012 2013 2014 8 9 7 10 5 *University Hospital Galway; Merlin Park University Hospital; Sligo Regional Hospital; Letterkenny General Hospital; Mayo General Hospital; Portiuncula Hospital; Roscommon County Hospital.

Midwest Group 2010 2011 2012 2013 2014 2 4 4 4 4 *Mid-Western Regional Hospital, Limerick; Ennis General Hospital; Nenagh General Hospital; St John’s Hospital Limerick.

Acute Paediatric Dublin 2010 2011 2012 2013 2014 1 1 1 2 4 *Our Lady’s Children’s Hospital, Crumlin; Children’s University Hospital, Temple Street; National Children’s Hospital, Tallaght

Others 2010 2011 2012 2013 2014 0 2 0 0 0 Mater Private Hospital; Bon Secours Hospital, Cork; Blackrock Clinic.

National Overall Total 2010 2011 2012 2013 2014 58 93 78 86 63

Donors Per Million of Population 2010 2011 2012 2013 2014 12.8 20.6 17.3 19 14

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 15 European Deceased Organ Donor Rates 2013 per million of population

Croatia Spain Malta Belgium Portugal France Austria Estonia Slovenia Italy Czech Republic United Kingdom

Ireland Finland Latvia Lithuania Poland Sweden Hungary Netherlands Luxembourg Slovakia Germany Denmark Romania Greece Bulgaria

5 10 15 20 25 30 35 40

Heart Beating Non Heart Beating

from Irish Kidney Association Report October 2014

16 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 European Living Kidney Donors Rates 2013 per million of population

Netherlands Turkey Cyprus Iceland Denmark Macedonia United Kingdom Sweden Montenegro Switzerland Norway Germany Austria Ireland Spain Czech Republic Georgia Malta France Belgium Portugal Serbia Hungary Greece Italy Bosnia & Herz Latvia Romania Ukraine Belarus Finland Lithuania Slovakia Muldova Bulgaria Poland Estonia Croatia

5 10 15 20 25 30 35

from Irish Kidney Association Report October 2014

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 17 Transplantation (2011-2014)

Kidney & Pancreas Transplants

250

192 200 185 163 152 150

100

38 40 50 27 32 12 7 0 1 0 0 5 1 0 2011 2012 2013 2014

Total Kidney & Pancreas Living Donor Pancreas Only

Liver, Heart and Lung Transplants

70 61

60 55 50 50 44

40 32 31 30

18 20 14 10 11 8 10 6

0 2011 2012 2013 2014

Liver Lung Heart

18 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Paediatric Kidney Transplants

20 20

15 12

10 9 9 9 7 7 6 5 5 4 3 1 0 0 0 0 2011 2012 2013 2014

Total Deceased Donor Living Donor Living Donor (UK)

Irish Paediatric Transplants Performed in UK

14 13

7 7

4 4 3 4 2 2 2 2 2 1 0 0 0 2011 2012 2013 2014

Liver Heart Lung Kidney

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 19 Survival Rate

Irish 5 Year Kidney Transplant Survival

100 2010-2013 n=659 90 2005-2009 n=738 80 2000-2004 n=679 1995-1999 n=646 70 1990-1994 n=650 1985-1989 n=434 60

Graft survival (%) 50

0 0 1 2 3 4 5 Post-transplant time (years)

European 5 Year Kidney Transplant Survival

100

80 2010-2013 n=49,980 2005-2009 n=72,238 2000-2004 n=73,536 70 1995-1999 n=75,024 1990-1994 n=75,152 60 1985-1989 n=66,952

Graft survival (%) 50

0 0 1 2 3 4 5 Post-transplant time (years)

From Collaborative Transplant Study Heidelberg Germany

15 Year Survival for Pancreas Transplants

100

25 % pancrease survival % pancrease

0 5 10 15 Analysis time (years)

20 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 1 year 5 year 10 year

Kidney Transplant 96% 87% 65% Deceased Donor Survival *UK Kidney Transplant Deceased Donor Survival 94% 85% 72%

Pancreas Transplant 80% 72% 54% Deceased Donor Survival *UK Pancreas Transplant Deceased Donor Survival 84% 76% N/A

Kidney Transplant 95% 87% N/A Living Donor Survival *UK Kidney Transplant Living Donor Survival 97% 91% 77%

10 Year Survival After Liver Transplant (1993 to 2013)

100

50 % survival 40

0 2 4 6 8 10

Number of years since transplant

1 year 5 year 10 year

Liver Transplant Survival 90% 78% 63% *UK Liver Transplant Survival 93% 80% 62%

* Figures from NHSBT Organ Donation and Transplant Activity Report 2012/13

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 21 10 Year Survival after Lung Transplant

100

50 Percent survival Percent

0 0 5 10

Survival (years)

30 Year Survival after Heart Transplant

100

50 Percent survival Percent

0 0 10 20 30

Survival

1 year 5 year 10 year

Irish Lung Transplant Survival 97% 77% 56% *UK Lung Transplant Survival 82% 55% 32%

Irish Heart Transplant Survival 80% 73% 62% *UK Heart Transplant Survival 81% 78% 59%

* Figures from NHSBT Organ Donation and Transplant Activity Report 2012/13

22 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Goals for 2015

Planned Deliverables

Transplant Activity Expected 2015

Living donor Kidney 40

Deceased donor Kidney 160

Liver 51

Lung 30

Heart 15

Pancreas 4

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 23 Priorities In 2015, ODTI will continue to recruit and train specialist staff in the field of organ donation, procurement and transplantation. We will work closely with health service providers to plan for and improve services. We will also engage with stakeholders in initiatives to increase awareness in organ donation. In 2015, ODTI will establish the National Organ Procurement Service.

• Implement initiatives to improve levels of organ donation and transplantation in Ireland such as appointing an abdominal retrieval team

• Commence National Organ Procurement Service in April 2015

• Increase public awareness of organ donation through public attitude survey, publications and collaborative initiatives

• Publication of information regarding organ donation and transplant activity

• Participate in International programmes

• Recruit, train and develop a national team of experts in organ donation

• Provide ring fenced facilities for National Transplant Programmes in the respective acute hospital environments

• Develop policies and standards in relation to organ donation and transplantation

• Develop an enhanced national database for all organ donation and transplant activity

• Place key performance indicators relating to organ transplantation in the public domain.

• Engage with NHS BT in regard to synergies in providing and accessing services for Northern Ireland.

24 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 Bibliography

• S.I No: 158 of 2006, European Communities • Commission Directive 2006/86/EC of 24 (Quality and Safety of Human Tissues and October 2006 implementing Directive Cells) Regulations 2006. 2004/23/EC of the European Community and of the Parliament as regards traceability • S.I. No: 598 of 2007, European Communities requirements, notification of serious adverse (Human Tissues and Cells Traceability reactions and events and certain technical re- Requirements, Notification of Serious quirements for the coding, processing, pres- Adverse Reactions and Events and Certain ervation, storage and distribution of human Technical Requirements) Regulations 2007. tissues and cells.

• S.I. No: 325 of 2012, European Union ( Quality • Commission Directive 2010/53/EC of 7 July and Safety of Human Organs Intended For 2010 of the European Parliament and the Transplantation) Council of the European Union on standards of quality and safety of human organs intend- • Directive 2004/23/EC of the European ed for transplantation. Parliament and of the Council of 31 March 2004 setting standards of quality and safety • ODTI, A Framework for Quality and Safety of for the donation, procurement, testing, pro- Human Organs Intended for Transplantation cessing, preservation, storage and distribu- (2014). tion of human tissues and cells.

• Commission Directive 2006/12/EC of 8 February 2006 implementing Directive 2004/23/EC of the European Community and of the Parliament as regards certain technical requirements for the donation, procurement and testing of human tissues and cells.

ODTI Organ Donation and Transplant Ireland – Annual Report 2014 25 Acknowledgements

The National Organ Donation and Transplant Advisory Group (NODTAG) Dr Diarmuid Houlihan The NODTAG is the clinical advisory group to the Consultant Hepatologist ODTI which provides recommendations and sets direction for the office. In 2014 the NODTAG met Dr Mary Keogan six times and was attended by seventeen commit- Consultant Immunologist tee members. Mr James McCarthy Professor Jim Egan Consultant Cardiothoracic Transplant Surgen Director ODTI and Chair NODTAG Consultant Respiratory Physician Ms Ciara Norton Chief Operations Officer Professor Peter Conlon Consultant Nephrologist and Renal Transplant Dr Colman O’Loughlin Physician Consultant Intensivist

Mr Michael Conroy Ms Karen Redmond Principal Officer, Department of Health Specialist Thoracic Lung Transplant Surgeon

Dr Philip Crowley National Director of Quality and Patient Safety Three additional members were appointed to the group in 2014: Ms Phyllis Cunningham Transplant Coordinator Mr Mark Murphy CEO, Irish Kidney Association Dr Rory Dwyer Consultant in Anaesthesia and ICU Medicine Ms Angela Fitzgerald Deputy National Director, Acute Hospital Ms Margaret Giffney Directorate, HSE Administrator Ms Regina Reynolds Procurement Coordinator Manager Mr David Hickey Director of Kidney & Pancreas Transplantation & Organ Procurement in Ireland The ODTI would like to acknowledge Mr David Hickey and Ms Phyllis Cunningham who retired from the group in 2014. Mr Emir Hoti Consultant Hepatobiliary Liver Transplant Surgeon

26 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 ODTI Organ Donation and Transplant Ireland – Annual Report 2014 27 28 ODTI Organ Donation and Transplant Ireland – Annual Report 2014

ODTI Organ Donation and Transplant Ireland ANNUAL REPORT 2014

ODTI Organ Donation and Transplant Ireland Kings Inn House, 200 Parnell Street, Dublin 1 Tel: +353 (0) 1 8287142 Web: www.odti.ie