Overview of Organ Donation and Transplantation

Transcription

1 2 Overview of Organ Donation and Transplantation Overview of Organ Donation and Transplantation A summary of organ donation and transplantation activity in the UK during the financial year from 1 April 2014 to 31 March

2 2.1 Summary of activity The total number of deceased donors and transplants fell this year for the first time in 11 years. The number of patients on the active transplant list at 31 March 2015 is 83 fewer than on the same date last year. This drop reflects an increasing number of transplants performed over the last 10 years, and a reasonably steady number of patients joining the transplant list each year. In the most recent year there have been fewer transplants but an increasing number of patients have been suspended from the transplant list. Donor and transplant numbers (1 April 2005 to 31 March 2015) and the number of patients registered on the transplant lists at 31 March each year are shown in Figure 2.1. There were 169 fewer deceased donor transplants in than in the previous year, representing a 5% decrease. The corresponding decrease in the number of deceased donors was 3%. Figure 2.1 Number of deceased donors and transplants in the UK, 1 April March 2015, and patients on the active transplant list at 31 March Number Donors Transplants Transplant list Year - 4 -

3 Figure 2.2 shows the number of deceased and living donors during The number of deceased organ donors in the UK remained stable over a number of years but following the implementation of the Organ Donation Taskforce recommendations in 2008, the numbers rose. This increase has continued for 6 years until this year when there has been a slight fall in donor numbers. There have been 1,050 to 1,150 living donors each year in the last 6 years. Compared with last year s high, there was a 5% fall to 1,092 living donors this year. Figure 2.2 Number of deceased and living donors in the UK, 1 April March DBD donors DCD donors Living donors Number Year Figure 2.3 shows the potential deceased organ donor population in the UK. Not everyone can be a deceased organ donor and this figure highlights the small proportion of deaths in the UK that represent potential donors. Please note that the information presented comes from several different sources. The NHSBT Potential Donor Audit, collects information on most but not all actual donors and the potential for donation could therefore be slightly underestimated. The quoted numbers of transplants and organs transplanted are those achieved using organs from deceased actual donors in the UK, some of which may have been performed overseas, and does not reflect the number of deceased donor transplants in the UK, which may have used organs from overseas donors

4 Figure 2.3 UK potential deceased organ donor population, 1 April March 2015 UK population 1 ~64,000,000 UK deaths 2 ~576,000 Deaths in hospitals 3 ~ 287,000 Potential donors 4,5 7,450 Eligible donors 4,6 5,636 Donation requests 4 3,295 Consented donors 7 1,923 Actual donors 7 1,282 Transplants 7,8 3,322 Organs transplanted 7,8 3,736 1 Mid 2013 estimates: data: England & Wales Scotland Northern Ireland data: England & Wales Scotland Northern Ireland /2015 data: NHSBT, Potential Donor Audit 5 Potential donor - patients for whom death was confirmed following neurological tests or patients who had treatment withdrawn and death was anticipated within four hours 6 Eligible donor - Potential donor with no absolute medical contraindications to solid organ donation /2015 deceased donor data: NHSBT, UK Transplant Registry 8 Using organs from actual donors in the UK Table 2.1 shows the number of deceased donors and transplants in and patients on the transplant list at 31 March 2015 for each country in the UK

5 Table 2.1 Deceased donors and transplants 1 April March 2015, and transplant lists as at 31 March 2015, by Country of residence Country of residence¹ England Wales Scotland Northern Ireland Organ N (pmp) N (pmp) N (pmp) N (pmp) Kidney Deceased donors 992 (18.4) 64 (20.8) 94 (17.6) 48 (26.2) Transplants 2, (29.9) 66 (21.4) 153 (28.7) 44 (24.0) Transplant list 4927 (91.5) 159 (51.6) 442 (82.9) 141 (77.0) Pancreas Deceased donors 378 (7.0) 26 (8.4) 41 (7.7) 16 (8.7) Transplants (3.4) 17 (5.5) 20 (3.8) 3 (1.6) Transplant list 175 (3.2) 11 (3.6) 24 (4.5) 6 (3.3) Heart Deceased donors 144 (2.7) 6 (1.9) 19 (3.6) 4 (2.2) Transplants (2.9) 7 (2.3) 16 (3.0) 0 (0.0) Transplant list 239 (4.4) 13 (4.2) 13 (2.4) 8 (4.4) Lung Deceased donors 172 (3.2) 6 (1.9) 16 (3.0) 9 (4.9) Transplants (3.0) 9 (2.9) 8 (1.5) 7 (3.8) Transplant list 270 (5.0) 23 (7.5) 26 (4.9) 12 (6.6) Liver Deceased donors 755 (14.0) 55 (17.9) 77 (14.4) 32 (17.5) Transplants (12.3) 28 (9.1) 103 (19.3) 25 (13.7) Transplant list 494 (9.2) 22 (7.1) 52 (9.8) 21 (11.5) Intestinal Deceased donors 19 (0.4) 1 (0.3) 1 (0.2) 0 (0.0) Transplants 2 21 (0.4) 1 (0.3) 0 (0.0) 0 (0.0) Transplant list 8 (0.1) 0 (0.0) 0 (0.0) 0 (0.0) Total Deceased donors 1060 (19.7) 71 (23.1) 97 (18.2) 48 (26.2) Transplants (51.9) 128 (41.6) 300 (56.3) 79 (43.2) Transplant list 5941 (110.3) 221 (71.8) 550 (103.2) 179 (97.8) 1 Excludes patients residing in Channel Islands, Isle of Man, overseas and in the Republic of Ireland 2 Deceased donor transplants 3 Kidney only transplants - 7 -

6 2.2 Transplant list At 31 March 2015, 6,943 patients were registered for an organ transplant in the UK on the active transplant list. A further 3,375 patients were temporarily suspended from the active national transplant list because they were unfit or otherwise unavailable for transplant. Details of numbers of patients on each of the organ transplant lists are given in Table 2.2 for 31 March 2014 and Between these dates, the total number fell by 83 patients (1%) due to decreases in the number of patients on the kidney, pancreas and intestinal transplant lists. Table 2.2 Active transplant lists in the UK at 31 March 2014 and % Change Kidney & pancreas patients Kidney Kidney & pancreas Pancreas Pancreas islets Cardiothoracic patients Heart Heart/lung Lung(s) Liver patients Intestinal patients Other multi-organ patients ALL PATIENTS Percentages not reported when fewer than 10 in either year 1 Includes patients waiting for kidney and liver transplants (16 in 2014, 13 in 2015), kidney and heart transplants (1 in 2014, 4 in 2015), liver and lung transplants (1 in 2014, 1 in 2015), liver and pancreas transplants (1 in 2014), liver and heart transplants (1 in 2015) During , 429 patients died whilst active/suspended on the transplant list. This information is shown by organ in Table

7 Table 2.3 Number of patient deaths on transplant lists in the UK, 1 April 2014 and 31 March 2015 Kidney & pancreas patients 269 Kidney 243 Kidney & pancreas 26 Pancreas 0 Cardiothoracic patients 79 Heart 34 Heart/lung 4 Lung 41 Liver patients 80 Intestinal patients 1 ALL PATIENTS Transplants There was a 5% fall in the total number of organ transplants (from deceased and living donors) last year: 4,431 transplants were performed in compared with 4,655 in (Table 2.4). All multi-organ transplants are identified separately as are transplants from living donors. There was a 5% fall in total organ transplants last year. The fall was seen across the organs although DBD kidney transplantation increased by 1% and there were small increases in the number of DBD pancreas, DCD lungs and livers and living donor liver lobes. The greatest increase was in the number of DCD kidney and pancreas transplants (57%)

8 Table 2.4 Transplants performed in the UK, 1 April March 2015 Transplant % Change DBD kidney DCD kidney Living donor kidney DBD Kidney & pancreas DCD Kidney & pancreas DBD Pancreas DCD Pancreas Pancreas islets Deceased heart Heart/lung DBD Single lung DCD Single lung DBD Double lung DCD Double lung DBD liver DCD liver Domino liver DBD liver lobe DCD liver lobe Living donor liver lobe Bowel only Liver, bowel & pancreas Multivisceral Modified multivisceral Kidney & heart Kidney & liver Liver & pancreas Lung & kidney TOTAL ORGAN TRANSPLANTS Total kidney transplants Total pancreas transplants Total cardiothoracic transplants Total liver transplants Total intestinal transplants Percentage not reported when fewer than 10 in either year 1 Including DCD heart (1 in , 1 in ) 2 Including a kidney (1 in ) 3 Including a kidney (1 in ) 4 Includes intestinal transplants

9 The total approximate number of patients with a functioning transplant in the UK on 31 March 2015 is 47,100 (Table 2.5). This reflects information held on the UK transplant registry database and excludes those patients who are known to be lost to follow-up. Table 2.5 Number of transplants reported as functioning at 31 March 2015 Functioning transplants 1 Kidney Pancreas 1900 Cardiothoracic 3700 Liver 8700 Intestinal 100 ALL PATIENTS² Approximate number being followed up ² Number of patients with a functioning transplant Multi-organ transplants (excluding intestinal transplants) are counted in each organ Excludes those patients known to be lost to follow-up