Organ Donation | Science & Law

On the 20th of May, a big change in the law regarding organ donation in England was implemented. You might not be aware of this change as the majority of the media coverage at the moment is either about the COVID-19 pandemic, protests or politics. As of the 20th of May 2020, all adults within the UK are presumed to be organ donors unless they have opted out under ‘Max and Kiera’s Law’. This ‘opt-out’ system was firstly introduced successfully by Wales in 2015 and they have seen an 18% increase in deceased organ donation.

Screenshot 2020-06-08 at 09.24.08

Why is this change in law so important?

Under the historic ‘opt-in ‘system, only 38% of the UK population were registered as organ donors. However, surveys have shown 80% of the population agree with organ donation after death but not everyone has joined the donation register. Through the ‘opt-out’ system we’re hoping to see an increase in organ donation from this change. There are around 6000 patients on the UK transplant waiting list and around 400 people die every year while on this list waiting for a transplant. Although 400 deaths per year probably seem like a relatively small number compared to the recent COVID-19 deaths, organ transplants transform patient lives and drastically increase the quality of life. Patients waiting for a compatible kidney transplant are treated with dialysis in order to support their failing kidneys. On average, patients have dialysis three times a week, which typically takes four hours on average. I don’t know about you, but life is busy enough without having to take 16 hours out of my weekly schedule for treatment (and that doesn’t include all the hospital appointments).

But what does this change in law mean?

Decease donor organs are never taken without consent from family and friends. The donors family will always be considered during the donation process and they ultimately have the final say as to whether they consent even if the donor is on the organ donor register. There are incredible specialist nurses in organ donation (SNODs) that work with grieving families to support them through whatever decision they make. This is why it is so critical to discuss your donation decisions with your family. It’s not an easy conversation, and it’s not something that really pops up during dinner conversations. But if anyone reading this now hasn’t had the conversation with their family and organ donation is something you would consider, then please do have that chat.

A bit about the H&I laboratories role in organ donation

I couldn’t not squeeze in my lab’s role in organ transplant into this post, I will forever be an ambassador for raising awareness of healthcare scientists within Histocompatibility & Immunogenetics (H&I) also known as tissue typing. We truly are a small, often unknown specialism within pathology. I’m currently in my final year of the STP, specialising in H&I and I find my job incredibly rewarding and fascinating. I want to talk a bit about healthcare scientists’ role in transplantation. Once a family has consented to organ donation. H&I scientists receive blood samples from SNODs for HLA typing (tissue typing). Once the tissue typing report is generated, this is sent to Organ Donation Transplant (ODT) that use an algorithm to determine which donor centre or individual on the transplant waiting list is the most suitable and compatible for the organ. Prior to transplantation, H&I scientists can perform crossmatch tests using serum from recipient and lymphocytes from the donor to see if the tissue match is compatible. H&I scientists play a critical role in transplantation by helping to reduce the immunological risks of graft rejection, improving the longevity of the organ and improving the quality of life of the patients.

An organ transplant success story

Even during a global pandemic, transplant teams across the country have still been transplanting the most critically urgent patients. The Royal Papworth Hospital in Cambridge performs transplants for patients in need of heart and lung transplants. This is just one of the success stories about transplantation and how amazing donors and their families save lives of individuals most in need. This story is about a 32-year-old father and former army serviceman who spent five months in Royal Papworth hospital, 170 miles away from his wife and kids waiting for a heart transplant. Philip received his transplant in April and now has to self-isolate during the pandemic as he is now in the high-risk category.

In the article, Philip states “Transplants cannot happen without donors, and it is thanks to the bravery and selflessness of those who agree to donate their loved ones’ organs in a time of such adversity that people can still receive their lifesaving organ transplant. If you would like to read more on this story please go here.

A few facts about organ donation

–       Specialist nurses of organ donation (SNODs) are incredible, they support families through the bereavement and donation process.

–       Transplants can happen in the middle of the night, they occur 24 hours a day, 365 days a year.

–       Decease donation occurs following death after brain stem death or circulatory death.

–       1 deceased donor can save up to 8 lives.

–       Hearts, lungs, kidneys, liver, bowel, pancreas, tissues, corneas, bone, connective tissue, heart valves, vessels and skin can all be donated after death.

–       Lungs and livers can be split in two in order to save additional lives.

–       3953 deceased donor transplants were performed last year in the UK.

–       A transplanted kidney lifespan is on average 15 years.

–       Scotland is soon to follow Wales and England with an opt-out organ donation system next year.

If you would like more information on organ donation and the change in law. Please go to organdonation.nhs.uk. Lastly, giving blood is critically important. If you’re interested in donating blood (it really does only take 10 minutes, and you get biscuits afterwards) please check out this website to find local donation centres and time slots at https://my.blood.co.uk/preregister. We really can do our bit for society and bring some positivity in these uncertain times.

Thank you for reading, keep safe and look after yourselves.

Hannah.

Author: hannahturnbull94

STP in Histocompatibility and Immunogenetics at Addenbrookes Hospital

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