The Operating Theatre Journal July 2022

NHS issues heartfelt plea for people to register their organ
donation decision as thousands still wait for transplant
Family consent rates dipped by 3% last year
People are being urged to register or share
their organ donation decision and make their
loved ones know what they want to happen to
them when they die so that no opportunity to
save a life is lost.
The latest annual figures published today
(13 July) by NHS Blood and Transplant show
that last year (2021/22), despite transplants
increasing by 30% compared to the number
completed during the first year of the
pandemic (1), there are still thousands more
waiting for a transplant.
The annual Organ and Tissue Donation and
Transplantation Activity Report shows that
there are currently 6,393 people on the active
transplant waiting list, with a further 3,990
temporarily suspended. (2) This is despite
4,324 patients successfully having the organ
transplant they so desperately needed.
Last year 429 patients died waiting for their
transplant compared with 525 in the previous
year, a decrease of 18%. A further 644 were
removed from the transplant list and many
of these patients would have died shortly
afterwards.
Myles Tolley aged 32 from Walsall in the West
Midlands considers himself one of the lucky
ones. Myles, who suffered complications a
result of a blood clot when he was just 22,
has incredibly received three liver transplants
since 2019. Sadly, after a successful first
transplant in November 2019, Myles went on
to contract covid followed by sepsis which
put him back in intensive care, and eventually
urgently needing a second transplant in
June 2021, only for another bout of sepsis to
lead him to require a third transplant that
November.
He said: “The last ten years have been really
hard, and I lost my 20’s due to complications
that arose from the blood clot although no
cause for the blood clot was ever identified.
I have had amazing support from my surgeon,
hospital staff, family, friends and partner
but it has been a tough journey. I have never
met or heard of anyone becoming ill like this
and never did I expect to have needed three
transplants. A lot of my family and friends now
understand how important organ donation is
and they have all joined the register.
“Now my health is improving, and I am feeling
the best I have felt in a long time, my blood
tests are all coming back really well, and l am
getting stronger every day.
“I feel like I am living life, not just for me
but for my donors also – they all gave me the
greatest gift and I want to honour them and
live the best life I can. They give me motivation
on the tough days and help me through. I have
written letters to their families and will send
on when I feel the time is right.”
The number of families agreeing to donation
at the point they were approached has
dipped for the first time in almost five
years. 66% of families supported donation
in 2021/22 compared to 69% in 2020/21. It is
not immediately clear why the consent rates
have dropped, but it’s important to note that
the challenges of the pandemic continue to
impact both hospitals and families, with many
relatives over the past year still not able to be
in hospital with their loved ones.
100 families said they declined to support
donation due to the length of the process,
which may in part reflect the challenges of
Covid.
In total, 605 families declined to support
organ donation, for reasons other than
knowing that their relative didn’t wish to be
a donor. Reasons given included, not knowing
what their loved one wanted, the family not
believing in donation or being divided over
what their loved one would have wanted.
With each donor donating an average of
three organs, it is estimated that this could
equate up to 1,815 missed opportunities for
transplant.
Families were far more likely to support
donation when they already knew it was
what their relative wanted. More than 92% of
families honoured their family member when
the donor had either proactively registered
their decision to donate on the NHS Organ
Donor Register or spoken with their family. In
92 out of the 605 family refusals, the patient
had registered or expressed their decision to
be a donor, which the family then overruled.
(3)
Anthony Clarkson, Director of Organ
Donation and Transplantation at NHS Blood
and Transplant, said:
“Organ donation and transplantation is a
fundamental part of the NHS work to save
lives. This is shown by the increase in the
number of patients last year receiving
transplants and the number of those who
are continually registering their decision to
be an organ donor. Sadly though, hundreds
of people are still dying unnecessarily every
year waiting for transplants. We know that
if everyone who supported donation talked
about it and agreed to donate, most of those
lives would be saved.
“We need families to support their loved
one’s decision and agree to donation when
approached if they know that’s what they
wanted. Last year, 3% fewer families agreed to
do that when they were asked than the year
before, which may be due to a range of factors
including the challenges of the pandemic.
“Whatever the reason, we need to encourage
more people to register their decision and
discuss it with their families as organ donation
really does save lives.”
There are currently more than 30 million
people in the UK who have registered their
organ donation decision on the NHS Organ
Donor Register with more than 27 million of
them explicitly agreeing to be an organ donor
when they die, but this still only represents
around 44% of the UK population.
Even though the law around organ donation
has now changed to an ‘opt out’ system across
England, Scotland and Wales, family members
will still always be consulted before organ
donation goes ahead. This means it is still just
as important as ever to register your decision
on the NHS Organ Donor Register and ensure
your friends and family know what you want.
To find out more, and register your organ
donation decision, visit:
www.organdonation.nhs.uk,
call 0300 123 23 23 or use the NHS app.
18 THE OPERATING THEATRE JOURNAL www.otjonline.com