Scottish Donation and Transplant Group written update: March 2023

Tissue donation update

Update given by:
•    Dr Sharon Zahra, Clinical Lead and Mr Neil Healy, Lead Nurse - Tissues and Cells, Scottish National Blood Transfusion Service (SNBTS)

Tissue referrals

The tissue donor referral rate remains lower than the pre-pandemic levels, however with the relaxation of the COVID-19 pandemic regulations the Tissue Donor Co-ordinators are now able to attend donating hospitals on a regular basis, providing teaching, training on tissue donation, and helping raise awareness.

During the 3 months since the last report (November 2022 to January 2023) there were seventy-five referrals for consideration of multi-tissue donation, up six compared to the previous quarter; and a further twenty-two referred for eye-only donation, two more than the previous quarter.

Of the seventy-five referrals (November 2022 to January 2023), fifty donors were deferred, most due to medical unsuitability for multi-tissue donation, some due to family decline, family being unavailable or no available bloods.

Of the seventy-five referrals there were thirteen occasions where relatives declined or were unavailable to discuss or authorise donation:

• six family declines to hospital staff
• two known unwillingness to donate
• five family unavailable or uncontactable

Tissue donation rates

In this quarter (November 2022 to January 2023) fourteen deceased donors donated multi-tissue. Eight of these fourteen donors donated tissue after organ donation, while the remaining six donors donated tissue-only. These fourteen donors donated fifteen heart tissue products and twenty-two tendons.

During this period there were also eighteen eyes retrieved by SNBTS from nine eye donors. There is currently ongoing work in collaboration with NHS Blood and Transplant (NHSBT) to identify ways of increasing the eye-donation rate in Scotland.

Pancreatic islet programme

The SNBTS Islet Isolation lab continues to provide an excellent life-saving service. In the first ten months of this fiscal year (April 2022 to January 2023), sixteen suitable pancreata were sent to Tissue, Cells, and Advanced Therapeutics (TCAT), leading to a successful islet cell product in ten cases (63%), and eight of these were transplanted (50%). This success rate remains one of the best in the world.

Live bone donation

Live bone donation remains problematic, and we have initial indications of clinical usage outstripping donation rate. SNBTS is working in collaboration with different hospitals to reinstate bone donation in hospitals who suspended donation during the COVID-19 pandemic.

In the first ten months of the current fiscal year (April 2022 to January 2023) 456 femoral heads have been donated and 430 have been used clinically.

Anticipated changes to donor assessments

The Safety of Blood, Tissues, and Organs (SaBTO) recommendations from the ‘For the Assessment of Individualised Risk (FAIR) III’ report are continuing to be progressed with draft changes being prepared and discussed for the JPAC guidelines. This work is currently ongoing.