Organ donation guidelines from NICE

New guidelines on identifying potential organ donors and improving consent rates have been published by NICE.

NICE recommends that organ donation should be considered as a usual part of end-of-life care planning and that each hospital should have a policy and protocol for identifying potential donors and managing the consent process. All patients who are potential suitable donors should be identified as early as possible based on defined clinical trigger factors (indicating a high likelihood of brainstem death) and the intention to withdraw life-sustaining treatment which is expected to result in circulatory death.

Patient with capacity to make their own decisions should be asked for their views on organ donation and consent obtained if possible. In patients without capacity, the guideline recommends that healthcare professionals seek to establish whether taking steps before death to facilitate organ donation would be in the patient’s best interests. This includes consideration of known wishes and feelings, any advance statement, registration on the NHS Organ Donor Register and also any views expressed by the patient to those close to them.

Although 90 per cent of the UK general public approve of organ donation, only 28 per cent have signed up to the NHS Organ Donor Register. Consequently, there is a serious shortage of organs for transplant, with around 10,000 people on waiting lists for transplantation in the UK. Of these, 1,000 will die each year waiting for a transplant as there are not enough organs available. The median wait for a new adult kidney went up from 995 days during 2002-06 to 1191 days during 2005-09, an increase of almost 20 per cent.

Dr Fergus Macbeth, Centre for Clinical Practice Director at NICE said: "Organ donation can be a sensitive subject, particularly if decisions are made at a time of bereavement. It is, therefore, crucial that there is a clear guideline in place to support and assist healthcare professionals at this time. I am sure it will be helpful to all those involved in this important process."

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