Organ and tissue donation and transplantation: consultation

This consultation seeks views on increasing the number of deceased organ donation and tissue donors in Scotland.

Glossary of terms and acronyms used in this consultation

Authorisation - under the Human Tissue (Scotland) Act 2006, organ or tissue donation can proceed where it has been 'authorised', either by the donor themselves or their nearest relative. Authorisation can be given in writing (such as by joining the ODR) or by telephone. This is similar to 'consent', which is required in England, Wales and Northern Ireland. However, in the case of consent, the donor or their nearest relative has to have been given certain detailed information before they can consent; for authorisation, information is available if people want it, but they do not have to show they have seen the information before they can authorise donation.

DBD - Donation after Brain-stem Death (or Brain Death) - this is where donation takes place after two doctors have confirmed that the person is dead using neurological criteria to show that the person no longer has any brain-stem function, (where the patient is on life support and has completely and irreversibly lost the capacity for consciousness and the ability to breathe independently). The patient will usually have suffered either some form of severe head trauma, for example in a car accident, or have had a severe stroke.

DCD - Donation after Circulatory Death - this is where donation takes place after doctors have confirmed that the person is dead using cardio-respiratory criteria (where their heart has stopped beating and they have stopped breathing for a period of five minutes). The person will have suffered some form of critical illness and death happens after it is agreed that their life-sustaining treatment should be withdrawn because they cannot recover or breathe without life support.

CLOD - Clinical Lead for Organ Donation - each Scottish hospital where donation can take place has a doctor who leads on championing organ donation in their hospital and making their colleagues aware of developments in procedures or opportunities associated with donation. There are also two Regional CLODs who oversee the work of the CLODs in their area.

HTA - Human Tissue Authority - this is the organisation which regulates organ donation and transplantation across the UK. It carries out certain checks to ensure, for example, that no living donors are being paid to donate a kidney or any other organ.

NHSBT - National Health Service Blood and Transplant - a UK NHS body which coordinates preparations for organ donation and manages operations to remove organs from donors. It also oversees the allocation of organs to transplant recipients. Its staff work with NHS staff in Scottish hospitals to ensure the donation process works as smoothly as possible. The Scottish Government provides funding to NHSBT to cover its costs for delivering its service in Scotland. NHSBT also provides blood and tissue services, but these do not operate in Scotland, although they do manage Scottish eye donations (see SNBTS below for the Scottish equivalent).

ODR - the National Health Service Organ Donor Register - this is the UK-wide register of people who have confirmed that they agree that some or all of their organs or tissue can be donated after their death. People can either join the register online or by filling in a paper form. People can now also use the ODR to confirm if they do NOT wish to donate any of their organs, known as 'opting out'. If someone has just died or is about to die, SNODs or TDCs (defined below) can access the register to check if that person had either signed up to the register or opted out of donation.

Opt in system - an opt in system of organ donation is one where donation can only proceed if there is explicit authorisation or consent for donation, either from the donor themselves or in some cases from their family. Scotland currently has an opt in system of donation.

SDTG - Scottish Donation and Transplant Group - this Group brings together a range of stakeholders with different interests and/or expertise to provide advice to Ministers on donation and transplantation. The Group aims to help increase donation and transplantation, particularly by implementing the recommendations in the Scottish Government's A Donation and Transplantation Plan for Scotland 2013-2020 .

Soft opt out - this is a system of organ and tissue donation, also known as a deemed consent (or authorisation) system. A soft opt out system starts from the assumption that most adults can be a donor when they die unless they have stated that they do not wish to donate, but it normally allows for the family's views to be taken into account in some way.

SNBTS - Scottish National Blood Transfusion Service - SNBTS is part of NHS Scotland and is the Scottish body which collects blood in Scotland and delivers it to Scottish hospitals so it is available, for example, where someone needs a blood transfusion. It also manages Scottish tissue donations and services, such as donations of skin, heart valves and tendons.

SNOD - Specialist Nurse for Organ Donation (or Special Nurse - Organ Donation) - these nurses are employed by NHSBT and work in hospitals to support donor families and, where donation is likely to proceed, they help make arrangements to ensure the donation can take place and that the organs have been allocated to transplant recipients by NHSBT.

TDC - Tissue Donor Co-ordinator - these nurses are employed by SNBTS and work in hospitals to raise awareness and provide teaching about tissue donation. Where donation is likely to proceed, they help make arrangements to ensure the donation can take place.


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