LONDON Introduction Paula Aubrey Dr Andre Vercueil RCLOD

LONDON Introduction Paula Aubrey Dr Andre Vercueil R-CLOD 4 th June 2013 Organ Donation Past, Present and Future

Programme LONDON 10: 00 – 10: 05 Pauline’s story 10: 05 – 10: 15 Introduction Paula Aubrey and Dr Andre Vercueil 10: 15 – 11: 00 Donation in the UK (F 105, 2 C 06) Dr Paul Murphy 11: 00 – 11: 15 Coffee 11: 15 – 12: 30 Donor Identification and Referral (I 102, 2 C 06) Jeremy Brown Dr Huw Twamley 12: 30 – 13: 15 Lunch 13: 15 – 14: 30 Donor Family experience Pat Collins and Paula Aubrey Family approach and consent (F 101, I 106, 2 C 06) Dr Gus Vincent 1430 – 1445 Coffee 1445 – 1600 Donation after brain-stem death (1 A 01, 1 A 02, 2 C 06) Introduction Dr Farrel Igielman Diagnosis of death Dr Dale Gardiner Donor optimisation Dr Gerlinde Mandersloot 1600 – 1630 Discussion and next steps Organ Donation Past, Present and Future 2

LONDON Embed Pauline’s story -Start automatically -Full screen Organ Donation Past, Present and Future 3

LONDON Objectives 1. Update on progress since 2008 Organ Donor Taskforce Report and scene set for future challenges. 2. Outline best practice, using regional and local data, and the most recent national guidance around: – – – The referral and identification of donors Donation after Brain Death Family approach and consent 3. Secure commitment to change practice in your hospital around key pinch points in deceased donation pathways Attendance at this meeting has been recognised for 5 CPD credits by the Royal College of Anaesthetists Organ Donation Past, Present and Future 4

LONDON Organ Donation Services Team Regional Clinical Lead Andre Vercueil 19 Trusts (33 Hospitals) Population of 8. 17 million 4 Renal Transplant Centres 1 Cardiac Transplant Centres 2 Liver Transplant Centres Regional Manager Paula Aubrey SCOTLAND NORTHERN IRELAND YORKSHIRE NORTH WEST MIDLANDS EASTERN SOUTH WALES 32 Specialist Nurses SOUTH CENTRAL SOUTH WEST Organ Donation Past, Present and Future Team Managers Jeanette Foley Cliona Berman Emiliano Mazzaretto Jeremy Brown Julie Whitney SOUTH EAST 4 Admin Staff 5

LONDON Donation in London 2003 -2013 160 44. 8% 140 120 100 14. 8% 80 Donation after Brain Death 60 40 Total Deceased Donation 145. 8% 20 Donation after Circulatory Death 20 03 -0 20 4 04 -0 20 5 05 -0 20 6 06 -0 20 7 07 -0 20 8 08 -0 20 9 09 -1 20 0 10 -1 20 1 11 -1 20 2 12 -1 3 0 Organ Donation Past, Present and Future 6

Organ Donation Past, Present and Future st Ea W h So 26. 6 al ut es h W Yo est rk sh ire h ut So l 50. 8 ut ra 75 nt Ce nd la 81. 8 So h ut ot nd la Ire n 44. 8 Sc n er t 87. 5 So er es 25 rth No W s nd la 100 rth No id on nd n 50 M Lo er st Ea Percentage Achievement LONDON 50% Target by Donor Team 150 148. 4 125 74. 1 46. 4 19. 7 30. 4 7. 1 11 0 7

LONDON Yorkshireto 50% by Donor Team Contribution South West 7% 7% Eastern 13% South Wales 4% South East 8% London 13% Tied 1 st 50% Midlands 12% South Central 8% Scotland 8% Northern Ireland 3% Northern 8% Organ Donation Past, Present and Future North West 10% 8

Organs Transplanted from London Donors 2003 -13 LONDON 300 250 200 Kidneys 150 Livers Pancreases 100 Lungs Hearts 50 Organ Donation Past, Present and Future 3 /1 20 12 2 /1 20 11 1 /1 20 10 0 /1 20 09 /9 08 20 /8 07 20 /7 06 20 /6 05 20 /5 04 20 20 03 /4 0 9

LONDON 2007 - 2008 Organs Transplanted from London Donors 16 21 75 188 89 266 31 26 Kidneys Hearts 2012 - 2013 Organs Transplanted from London Donors 17 34 Pancreases Lungs Livers Organ Donation Past, Present and Future Kidneys Hearts Pancreases Lungs Livers 10

LONDON Where are potential donors in London lost? Organ Donation Past, Present and Future 11

BUT if we adopted BEST PRACTICE LONDON 1800 Target Actual 1600 19. 1 ppm 1400 1200 1000 50% 13. 4 ppm 800 600 400 2007/08 2008/09 2009/10 2010/11 Organ Donation Past, Present and Future 2011/12 2012/13 Best Practice 12

BUT if we adopted BEST PRACTICE LONDON 1800 Target 26. 3 ppm Actual TOP 5 in the WORLD 1600 19. 1 ppm 1400 1200 1000 50% 13. 4 ppm 800 600 400 2007/08 2008/09 2009/10 2010/11 Organ Donation Past, Present and Future 2011/12 2012/13 Best Practice 13

2008 2011

LONDON NHSBT Guidelines ED Strategy Donor Management Bundles and Guidance FICM & ICS endorsed: Brain-stem Death Forms www. odt. nhs. uk Organ Donation Past, Present and Future 15