Health Policy

30.07.12

Radical changes could be in store for organ donation

The NHS is conducting a survey to test responses to suggestions for radically altering the legal, medical and ethical rules dictating organ donation in the UK.

NHS Blood and Transplant (NHSBT) has opened the Post 2013 Organ Donation Strategy Survey, which is due to close on September 21.

A number of ideas are being put forward by the survey, available on the NHSBT website. One of the most contentious decisions is on whether to change the current system so donation consent is assumed and acts on an opt-out principle.

Other proposals being floated include: reforming the financial reward scheme so that intensive care wards receive more funding per organ harvested – the current system sees hospitals get £2,000 per organ; the research and deployment of new organ preservation technology; and prioritising registered donors for transplants.

NHSBT has stressed that none of the ideas put forward have been endorsed but that the survey will be used to inform future strategy on transplants and donations.

The survey also asks if a review of current medical practices regarding “elective ventilation” should be carried out. The current system means that doctors have the discretion to withdraw treatment from those whose deaths are inevitable because it is not to the patient’s benefit.

A possible reform of this would be to maintain a patient on life-support equipment even after brain-stem death to maximise the number of organs that can be retrieved from a donor. The BMI has also started to consider the implication of “elective ventilation”.

At present roughly one thousand people die each year in the UK because they do not receive transplants. However, of the half a million people who die each year in the UK, only approximately three thousand can realistically act as organ donors. In 2001, nearly 2,150 donors provided roughly 4,000 organs for transplant.

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