Organ donationCulture Change Initiatives in the Procurement of Organs in the United Kingdom
Section snippets
Historical UK Model
Prior to 2000, the United Kingdom, unlike other Western countries, had no organized, unified strategy to increase organ donation. There was no mandatory centralized education, no centralized data collection, and no centralized management and reporting structure for the donor transplant coordinators (DTCs) who have primary responsibility for acquiring legal consents. DTCs were employed and managed at the hospital level, and common practice was for them to be called in only after a patient had
Development of the Current Strategy
In 2000, UK Transplant (UKT) was given the responsibility for organ donation rates overall and for providing professional leadership to the DTCs who, nevertheless, remained employed locally. The PDA quoted above was the first major undertaking, as prior to it, no national database relevant to donation and transplantation was available, so no baseline had been established against which to measure progress and no basis for a targeted strategy existed.
As other countries, mostly notably Spain and
Current Strategy
The overall aim of the strategy was to align practice in the United Kingdom with best practice findings in international research which have demonstrated that 100% identification of potential organ donors, their early referral to the attention of people who are specially trained in talking to families about donation, and a collaborative approach to families, involving both the physician and a trained DTC, improved consent/authorization rates. It was recognized from the start that the
Evaluation of the Strategy
An evaluation of the effectiveness of this strategy was performed utilizing PDA data (Hamilton, personal communication) obtained over the 4-year period from April 2003 to March 2007, and it must be viewed in light of a surprising finding from those same data. In the 4 financial years from 2003 to 2007, there was a remarkable and unanticipated 21% reduction in the number of cases where BSD was reported as a likely diagnosis. The reasons for this reduction were unclear, but any meaningful
References (20)
- et al.
Effect of population aging on the international organ donation rates and the effectiveness of the donation process
Am J Transplant
(2007) - Available at:...
- et al.
Potential for organ donation in the United Kingdom: audit of intensive care records
BMJ
(2006) - et al.
Evaluation and quality control of organ transplant coordination services, transplant procurement management based on the new vital cycle
Transplant Proc
(2002) Factors influencing the adaptation of the Spanish model of organ donation
Transpl Int
(2003)- et al.
A decade of continuous improvement in cadaveric organ donation: the Spanish model
J Nephrol
(2002) In-house Coordinator Program Training Manual
(2003)- et al.
Decloupling: what is it and does it really help increase consent to organ donation?
Prog Transplant
(2002) - et al.
Requesting organ donation: an interview study of donor and nondonor families
Am J Crit Care
(1998) - et al.
The impact of a comprehensive, hospital-focused intervention to increase organ donation
J Transpl Coord
(1997)
Cited by (9)
A Study of Concerns of Families of Potential Donation After Circulatory Death Donors and Recommendations for Raising Donation Rates
2020, Transplantation ProceedingsCitation Excerpt :Rather, the decision itself seems such a burden that many people find it almost unbearable. Two of the authors consulted with the National Health Service in the United Kingdom from 2004 to 2013, helping to ramp up their donation system, and, in the process, taught physicians to break bad news to families and to partner with coordinators who were being trained to request donations [17,18]. Historically, in the United Kingdom, the physicians made donation requests, and the nationwide shift to a trained coordinator staff was a difficult one.
Factors influencing organ donation in Fujian's Organ Procurement Organization: A retrospective study
2023, Clinical TransplantationThe physiology of brain death and organ donor management
2014, Pediatric Critical Care MedicineThe physiology of brain death and organ donor management
2014, Pediatric Critical Care Medicine: Volume 1: Care of the Critically Ill or Injured Child, Second Edition