Organ and tissue donation: baseline report 2021

Footnotes

1 Although increased donation and transplantation rates are the ultimate aim of the Act, an increased donation authorisation rate is a priority outcome according to the aims of the legislation.

2 'Potential donors' are defined as patients who met the criteria for neurological death tests i.e. those for which neurological death was suspected or patients for whom treatment was withdrawn and death was anticipated within four hours.

3 This outcome is a stipulated aspect of the legislation but one which is not dependent on the other outcomes for fruition. This outcome is already supported by current Specialist Nurse for Organ Donation (SNOD) operations.

4 Our Voice Citizen's Panel: October 2019

5 The campaign this survey evaluated sought to address public knowledge about what to do or who to contact to opt out or find out more about the law change.

6 As explained in paragraph 178 in 'The HTS Act is based on the concept of authorisation. 'Authorisation' is the expression of the principle that a person has the right to specify, during their lifetime, their decision about what should happen to their body after their death, in the expectation that this decision will be respected.'

7 The Organ and tissue donation - authorisation requirements: guidance explains that under the Human Tissue (Authorisation) (Scotland) Act 2019[1] ("the 2019 Act"), duty to inquire is a core principal that requires that health workers should make every effort to establish the decision or views of the potential donor, and then to support their decision being fulfilled.

8 Specialist Nurses-Organ Donation support potential donor families and the operational processes of organ donation. The specialist nurse receives detailed training in communication and family support, especially in the end of life wishes conversations. Further information can be found on the NHSBT website.

9 The primary roles of CLODs is to provide clinical leadership within the hospital, to champion and promote the value of deceased organ donation. Further information can be found on the NHSBT website.

10 This feedback has helped to inform NHS Training plans.

11 The Organ and tissue donation - authorisation requirements: guidance explains that under the Human Tissue (Authorisation) (Scotland) Act 2019[1] ("the 2019 Act"), duty to inquire is a core principal that requires that health workers should make every effort to establish the decision or views of the potential donor, and then to support their decision being fulfilled. Please note that this guidance was published after research interviews took place.

12 Turas is a modern and accessible digital platform developed by NHS Education for Scotland to support health and care professionals working in the public sector.

13 SNBTS have informed Scottish Government that this data will be collected post implementation of the Act and shared with Scottish Government.

14 For more information on how death is diagnosed and confirmed in the UK, please see the guidance published by the Academy of Medical Royal Colleges, A CODE OF PRACTICE FOR THE DIAGNOSIS AND CONFIRMATION OF DEATH

15 For further information on DBD, please see Donation after brainstem death - ODT Clinical - NHS Blood and Transplant

16 For further information on DCD, please see Donation after circulatory death - ODT Clinical - NHS Blood and Transplant

17 Organ Donation and Transplantation Activity Report 2019/2020.

18 Data from Table 13.13 Organ Donation and Transplantation Activity Report 2019/2020.

19 Table 2.1 in Scotland Organ Donation Services Team: Detailed Report Actual and Potential Deceased Organ Donation 1 April 2019 - 31 March 2020

20 Data from Figure 2.2 in Scotland Organ Donation Services Team: Detailed Report Actual and Potential Deceased Organ Donation 1 April 2019 - 31 March 2020.

21 Data from Figure 2.2 in Scotland Organ Donation Services Team: Detailed Report Actual and Potential Deceased Organ Donation 1 April 2019 - 31 March 2020.

22 Data from Table 3 was provided by NHSBT on request but not published in their annual reports.

23 See Table II in Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities.

24 Please note that the term 'BAME' is being used here to accurately reflect the reporting within NHSBT reports, however Scottish Government uses the term 'ethnic minority communities'.

25 Data is from Table 3.1 in the Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities. The data reports on a five-year period due to a small number of eligible BAME donors in some regions. Please note that the approach rates were not reported by NHSBT, but instead calculated for the purpose of this report.

26 See Table 3.3 in Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities for more detailed information on the reasons recorded for family refusal to give consent/authorisation for organ donation by ethnicity between 1 April 2015 - 29 February 2020.

27 Data from Table 1.1 in Detailed Report Actual and Potential Deceased Organ Donation 1 April 2019 - 31 March 2020

28 Note that this relates to Emergency Departments only and not all potential tissue donors in other areas. Further information on the Potential tissue donor audit between April 2019 to March 2020 can be found in the Annex.

29 SNBTS report that they moved premises just prior to 2019 and tissue retrieval/processing in the new premises did not start until mid-October 2019, therefore the figures quoted represent only the last 5.5 months of the 2019/2020 financial year and an under-representation of the true tissue donation potential.