The Operating Theatre Journal July 2022

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NHS issues heartfelt plea for people to register their organdonation decision as thousands still wait for transplantFamily consent rates dipped by 3% last yearPeople are being urged to register or sharetheir organ donation decision and make theirloved ones know what they want to happen tothem when they die so that no opportunity tosave a life is lost.The latest annual figures published today(13 July) by NHS Blood and Transplant showthat last year (2021/22), despite transplantsincreasing by 30% compared to the numbercompleted during the first year of thepandemic (1), there are still thousands morewaiting for a transplant.The annual Organ and Tissue Donation andTransplantation Activity Report shows thatthere are currently 6,393 people on the activetransplant waiting list, with a further 3,990temporarily suspended. (2) This is despite4,324 patients successfully having the organtransplant they so desperately needed.Last year 429 patients died waiting for theirtransplant compared with 525 in the previousyear, a decrease of 18%. A further 644 wereremoved from the transplant list and manyof these patients would have died shortlyafterwards.Myles Tolley aged 32 from Walsall in the WestMidlands considers himself one of the luckyones. Myles, who suffered complications aresult of a blood clot when he was just 22,has incredibly received three liver transplantssince 2019. Sadly, after a successful firsttransplant in November 2019, Myles went onto contract covid followed by sepsis whichput him back in intensive care, and eventuallyurgently needing a second transplant inJune 2021, only for another bout of sepsis tolead him to require a third transplant thatNovember.He said: “The last ten years have been reallyhard, and I lost my 20’s due to complicationsthat arose from the blood clot although nocause for the blood clot was ever identified.I have had amazing support from my surgeon,hospital staff, family, friends and partnerbut it has been a tough journey. I have nevermet or heard of anyone becoming ill like thisand never did I expect to have needed threetransplants. A lot of my family and friends nowunderstand how important organ donation isand they have all joined the register.“Now my health is improving, and I am feelingthe best I have felt in a long time, my bloodtests are all coming back really well, and l amgetting stronger every day.“I feel like I am living life, not just for mebut for my donors also – they all gave me thegreatest gift and I want to honour them andlive the best life I can. They give me motivationon the tough days and help me through. I havewritten letters to their families and will sendon when I feel the time is right.”The number of families agreeing to donationat the point they were approached hasdipped for the first time in almost fiveyears. 66% of families supported donationin 2021/22 compared to 69% in 2020/21. It isnot immediately clear why the consent rateshave dropped, but it’s important to note thatthe challenges of the pandemic continue toimpact both hospitals and families, with manyrelatives over the past year still not able to bein hospital with their loved ones.100 families said they declined to supportdonation due to the length of the process,which may in part reflect the challenges ofCovid.In total, 605 families declined to supportorgan donation, for reasons other thanknowing that their relative didn’t wish to bea donor. Reasons given included, not knowingwhat their loved one wanted, the family notbelieving in donation or being divided overwhat their loved one would have wanted.With each donor donating an average ofthree organs, it is estimated that this couldequate up to 1,815 missed opportunities fortransplant.Families were far more likely to supportdonation when they already knew it waswhat their relative wanted. More than 92% offamilies honoured their family member whenthe donor had either proactively registeredtheir decision to donate on the NHS OrganDonor Register or spoken with their family. In92 out of the 605 family refusals, the patienthad registered or expressed their decision tobe a donor, which the family then overruled.(3)Anthony Clarkson, Director of OrganDonation and Transplantation at NHS Bloodand Transplant, said:“Organ donation and transplantation is afundamental part of the NHS work to savelives. This is shown by the increase in thenumber of patients last year receivingtransplants and the number of those whoare continually registering their decision tobe an organ donor. Sadly though, hundredsof people are still dying unnecessarily everyyear waiting for transplants. We know thatif everyone who supported donation talkedabout it and agreed to donate, most of thoselives would be saved.“We need families to support their lovedone’s decision and agree to donation whenapproached if they know that’s what theywanted. Last year, 3% fewer families agreed todo that when they were asked than the yearbefore, which may be due to a range of factorsincluding the challenges of the pandemic.“Whatever the reason, we need to encouragemore people to register their decision anddiscuss it with their families as organ donationreally does save lives.”There are currently more than 30 millionpeople in the UK who have registered theirorgan donation decision on the NHS OrganDonor Register with more than 27 million ofthem explicitly agreeing to be an organ donorwhen they die, but this still only representsaround 44% of the UK population.Even though the law around organ donationhas now changed to an ‘opt out’ system acrossEngland, Scotland and Wales, family memberswill still always be consulted before organdonation goes ahead. This means it is still justas important as ever to register your decisionon the NHS Organ Donor Register and ensureyour friends and family know what you want.To find out more, and register your organdonation decision, visit:www.organdonation.nhs.uk,call 0300 123 23 23 or use the NHS app.18 THE OPERATING THEATRE JOURNAL www.otjonline.com
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