Policy actions  2 of 4

Organ and tissue donation and transplantation

At any one time, due to a shortage of organs, more than 500 people in Scotland are waiting for an organ to become available to give them the transplant they desperately need. 

Organ donation can greatly enhance or save lives. Over 50% of the Scottish population have joined the NHS Organ Donor Register. However people are still dying every day waiting on a transplant and the more people that join the Organ Donor Register, the more lives that can be saved.

Our aim is to increase organ donation and transplantation rates in Scotland and to ensure that as many people in Scotland receive the life-saving or life-changing transplants that they need.  

Novel technologies

The Scottish Government aims to support the use of novel technologies to help both increase the numbers of organs which can be transplanted and improve the function of transplanted organs.

In particular, we are working with NHS Blood and Transplant to support the Edinburgh transplant team to use Normothermic Regional Perfusion (NRP) when they are removing a donor’s abdominal organs after death.  NRP helps improve the quality of organs and allows time for surgeons to assess them to ensure they are sufficiently safe to transplant. Evidence shows that NRP helps increase the number of livers in particular that can be transplanted and also reduces the proportion of patients who suffer complications or whose transplant fails.

In 2020, we are increasing funding for NRP in Scotland to over £80,000 to help increase its use.  This should enable more patients in Scotland to benefit from a transplant, particularly as transplant services are recovering following the impacts of COVID-19.

Organ donation and transplantation plan

We published our national plan for organ donation and transplantation 2013-2020 in July 2013 which set out the following priorities:

  • to increase the number of people in Scotland who have made their wishes about donation known
  • to increase the availability of organs for transplantation
  • to make every donation count
  • to make sure that all parts of NHS Scotland are knowledgeable about and support donation and transplantation
  • to make sure that the public in Scotland is informed and engaged about organ donation and transplantation

The majority of the recommendations outlined in the national plan have now been completed including:

Human Tissue (Authorisation) (Scotland) Act 2019

The Human Tissue (Authorisation) (Scotland) Act 2019, which provides for an opt out system of organ and tissue donation, gained Royal Assent in July 2019.  The new system will come into force in Autumn 2020.  

The 2019 Act amends the existing opt in system of authorisation in the Human Tissue (Scotland) Act 2006. Under the opt out system, if an adult does not opt in or opt out of donation they may be deemed to have authorised donation for transplantation. This is subject to the safeguards in the Act which seek to ensure that donation will not go ahead where it would be against the person’s wishes. 

Public information is being provided ahead of the law change about what the changes mean and what choices people have. For more information about the law change visit: organdonationscotland.org

The change in the law follows a consultation on ways of increasing the numbers of successful organ and tissue donations and transplantations, including proposals to introduce an opt out system of organ and tissue donation. We published the analysis of the responses to this consultation in June 2017. This showed that 82% of the respondents supported the move to an opt out system.

Living kidney donation  

Living kidney donation is an exceptional gift that can transform the life of someone on the transplant waiting list.

Our aim is to reduce waiting times for those in need of a kidney transplant by ensuring timely access and equity of access to pre-emptive live donor kidney transplantation.

Living kidney donation can lead to better outcomes for patients and one donor can trigger a ‘chain’ of transplants through the UK Living Kidney Sharing Scheme, meaning up to three people can receive a transplant as part of one person’s gift. 

The policy on reimbursement of living donor expenses sets out information for healthcare professionals in Scotland about the principles and processes that underpin payment of expenses to living donors.

A Living Kidney Donation and Transplantation Information Pack has been developed to provide healthcare professionals with a detailed overview of the process in Scotland.

Paediatric and neonatal organ and tissue donation

We worked with clinicians, nurses, midwives, charities, family members and other stakeholders to provide the following guidance on how to enable donation in cases where a baby or child has sadly died or is expected to die:  

Commissioning transplantation to 2020

All solid organ transplant services are nationally commissioned by National Services Division (NSD) which is part of NHS National Services Scotland.  NSD’s Commissioning Transplantation to 2020 report sets out current plans for organ transplantation services for Scottish residents.

Scottish Donation and Transplant Group

We formed the Scottish Donation and Transplant Group (SDTG) in 2001 to provide a regular forum for representatives of the donation and transplant communities in Scotland. 

In December 2017, we published an agreement between the Crown Office and Procurator Fiscal Service and the Scottish Donation and Transplant Group in regard to organ and tissue donation.