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Government Commits to Optimise Transplantation Service

In an effort to "drive improvements to the transplantation service", the Government has welcomed the recommendations of a new independent report on improving the organ transplant system across the UK.

The Department of Health and Social Care (DHSC) said that backing the proposals would save lives.

The report, Honouring the gift of donation: Utilising organs for transplant, by the Organ Utilisation Group, set out its vision to make the best use of available resources, drive transplant infrastructure improvements, and support innovation. It aimed "to make sure as many donated organs as possible are used to save the lives of patients on the waiting list".

Organ Donation 'a Precious Gift of Life'

National Medical Director of NHS England, Sir Stephen Powis, a professor of renal medicine at University College London and chair of the Organ Utilisation Group, said: "Organ donation is a precious gift of life, helping to save or improve the lives of thousands of people each year. 

"The recommendations in this report will drive improvements to the transplantation service, ensuring that as many donated organs can be successfully transplanted as possible, and deliver real improvements for patients and their families, enabling them to have the best experience and outcomes possible.

"Transplants, organ donors, and the teams that make them possible give people a second chance at life, and these new recommendations will enable the NHS to change the lives of thousands more people in the years to come."

Fiona Loud, policy director at Kidney Care UK, co-chair of the Group's stakeholder forum and a transplant recipient herself, said: "These national recommendations are a great opportunity to really improve our transplantation system; giving more transplants to those in need, while also respecting and indeed honouring organ donors, without whom there can be no transplantation."

Number of Donors Almost Doubled – but Transplant Rate Lagging

The report noted that there had been "significant improvements" in donor numbers, with deceased donors increasing by 95% since 2008. However: "While there have also been improvements in the transplant rate, this has not kept pace with the increase in donation."

This meant that waiting lists have started to rise again in recent years, and "the shortfall in the availability of organs for transplant is worsening". In the year to 31 March 2022, 429 people died while on the transplant waiting list and a further 644 were removed due to deteriorating health. 

Current Disparity of Service Provision 'the Core Issue'

In his introduction to the report, Sir Stephen said that, while systems of donation and allocation were optimised "to ensure that an organ goes to exactly the right recipient", this also needed to happen "in a timely manner".

"It cannot be right that the certainty with which this happens varies from unit to unit, from one part of the country to another, or between patients," he said. "This disparity of service provision is the core issue that the report aims to resolve."

The review's 12 recommendations – all of which were accepted by the Government –were intended to maximise the potential for organ transplantation from both living and deceased donors.

Specific recommendations include:

  • Improved collaboration between transplant centres to share best practice and raise standards, reducing unwarranted variations in practice
  • Increasing successful matching between donated organs and patients, so that organs go to the most suitable patient, rather than the one who lives closest
  • A comprehensive review of cardiothoracic services by NHS England to ensure that they are sufficiently sustainable, resilient, and able to provide the best possible outcome
  • Establishing national multi-organ centres for organ assessment and repair prior to transplantation, particularly to increase availability of machine perfusion – this recommendation was noted to be “subject to funding”
  • Also subject to funding, establishing a national oversight system to make best use of innovation in assessment, perfusion and preservation of donated organs
  • Implementing ways quickly to identify and adopt proven technologies and scientific advances to put innovations into practice
  • Workforce planning to address difficulties in recruiting and retaining staff, developing a national template to provide definitions of the needed skill mix
  • An improved system of communication between patients and clinicians, partly designed by patients, to make the transplant process clearer and easier to understand, improving patients’ experiences
  • Regular feedback from transplant centres to help those on the transplant list to understand their clinical options and make informed evidence-based decisions
  • Better evaluation of patient-reported outcome and experience measures, including the emotional and psychological pressures of waiting for an organ, subjecting these to similar levels of focus and scrutiny as clinical outcomes

Ms Loud said: "The report pulls no punches in reflecting the variations in service delivery and is clear that people in need of a transplant must have equal access irrespective of ethnic, geographical, social status, or gender."

An estimated 7000 patients are currently on the active transplant list.