Scottish Donation and Transplant Group written update: April 2025
Written updates from the meeting of the group held on 24 April 2025.
Deceased organ donation update
Update given by:
Joanne Brooks, Lead Nurse, Lead Nurse Organ Donation, NHSBT
Donation performance April 2024 to March 2025
From April 2024 to March 2025 the 12 months validated potential donor audit (PDA) data taken from the donating hospitals has highlighted a slight decrease in donor numbers in comparison to the previous year in Scotland. The performance target given from NHSBT was 120 donors, actual proceeding was 105 donors, a 12.5% decrease from the previous year. The graph below illustrates 10 year trend of organ donors, the average donors per year across this 10 year trend is 104.
10 year trend in donor numbers
| DBD donors Financial year to date |
DCD donors Financial year to date |
|
|---|---|---|
| 2015/2016 | 56 | 43 |
| 2016/2017 | 77 | 56 |
| 2017/2018 | 61 | 41 |
| 2018/2019 | 68 | 30 |
| 2019/2020 | 74 | 35 |
| 2020/2021 | 64 | 31 |
| 2021/2022 | 47 | 34 |
| 2022/2023 | 51 | 51 |
| 2023/2024 | 63 | 57 |
| 2024/2025 | 45 | 60 |
With a total of 105 donors the total number of organs retrieved for transplant was 290 (321 including eyes and heart valves) with 18 organs retrieved for research. In comparison to last year, donation after brain death (DBD) has seen a reduction of 29% from 63 to 45 (10 year average of 61 donors/year) and donation after circulatory death (DCD) slight increase of 5% from 57 to 60 (10 year average of 44 donors/year).
The referral rate to the Scotland organ donation service has consistently remained high at 97%, higher than the UK average of 94% and 690 referrals were made to the specialist nurse team. The number of potential donor families approached for organ donation was 186 with 121 authorised (willing to donate) with a 64% combined authorisation rate, 3% higher than last year with UK average 59%.
The DBD authorisation rate in Scotland is 70% and UK average is 69%. The DCD authorisation rate is 61%, the second highest in comparison to the other regional teams with the UK average of 53%.
A widening gap was noted last year between expressed/opt-in authorisation rate of 84% and deemed authorisation 63%, this 21% gap has reduced to 16% this year. Deemed authorisation rates in Scotland has seen an increase this year 70% compared to 63% last year, national average is 48%. The number of expressed/on organ donor register overrides is 11 which is three less than last year with 17 unsupported deemed compared to 28 last year.
The Specialist Nurse (SN) and Specialist Requestor (SR) combined presence when approaching potential organ donor families is 88% and remains lower in comparison to UK average of 92%. The main reason for this is consultant preference not to approach with SN which is more evident with DCD donors.
Challenges UK wide with continued reduced neurological death testing rate in DBD donors. The UK average and Scotland rate both at 72%, 6% lower than last year in Scotland with 31 cases not tested in comparison to last year 14 not tested.
Eye only authorisation was handed over to the National Referral Centre (NRC) in May 2024 due to the complexities of the eye donation pathways, capacity, and resources, annual refresher of Scottish legislation planned to the NRC team in April. Centralised Donor Recognition Funding (DRF) was accepted by six health boards, a panel is responsible for organising this new process of centralised funding to improve flexibility and resources for utilising promotional awareness more effectively across Scotland. This was successful with all involved having full access to funding, creating the opportunity to support organ and tissue donation in many ways, with all six health boards opting to retain this process for the year ahead. There has been an associated increased workload for the Scotland administration team which will be reviewed and streamlined where possible to improve efficiency.