Donation after Brain-Stem Death DBD

Dr Ranjit Dulai Dr Dale Gardiner Dr Gerlinde Mandersloot 26 th June 2013 Organ Donation Past, Present and Future

Session Objectives

• • • • Present regional data for DBD Understand that DBD gives better organs than DCD Increase rate of neurological confirmation of death by increasing confidence in the Diagnosis of Death Increase quality of DBD organs – adoption of extended care bundle and compliance with the six early interventions in donor optimisation – collaboration in Scout pilot 2

Organ Donation Past, Present and Future

Regional Data

Dr Ranjit Dulai East Kent Hospitals, CLOD

SOUTH EAST 3

Organ Donation Past, Present and Future

Donation after Brain Death (DBD)

Mechanically ventilated patient where death has been confirmed using neurological criteria.

61 donors (2012-2013) 8.9% increase (from 5 years ago)

Lungs Heart Small Intestine Kidneys Liver Pancreas SOUTH EAST

Organ Donation Past, Present and Future

Donation in the South East Team 2003-2013

SOUTH EAST 100 90 80 70 60 50 40 30 20

8.9%

10 0 20 03 /0 4 20 04 /0 5 20 05 /0 6 20 06 /0 7 20 07 /0 8 20 08 /0 9 20 09 /1 0 20 10 /1 1 20 11 /1 2 20 12 /1 3

19.7% 50.0%

Total Deceased Donation Donation after Brain Death Donation after Circulatory Death 5

Organ Donation Past, Present and Future

Donation in the South East Team 2003-2013

100 90 80 70 60 50 40 30 20 10 0 20 03 /0 4 20 04 /0 5 20 05 /0 6 20 06 /0 7 20 07 /0 8 20 08 /0 9 20 09 /1 0 20 10 /1 1 20 11 /1 2 20 12 /1 3 SOUTH EAST Donation after Brain Death 6

Organ Donation Past, Present and Future

best transplant outcome favours DCD

kidneys lungs pancreas liver

Organ Donation Past, Present and Future

DBD

intestine heart

South East Neurological death testing rate

SOUTH EAST

100 80 87 82 76 74 86 78 73 76 5 th 76 74 76 74 60 40 20 0 1 April 2012 to 31 March 2013, data as at 4 April 2013 Team Organ Donation Past, Present and Future -------- National rate

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South East Neurological death testing rate

SOUTH EAST

100

5 27 23 21 2

80 60 40

4 7 24 12 9 1 3 18 13

20

25

0 0 5 10 15 20 25 30 35 40 45 Number of neurological death suspected patients

Hospital 95% Upper CL National rate 99.8% Lower CL 95% Lower CL 99.8% Upper CL

1 April 2012 to 31 March 2013, data as at 4 April 2013 50 55 Organ Donation Past, Present and Future

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Mean no. of organs donated per DBD donor

4,3 4,2 4,1 4,0 3,9 3,8 3,7 3,6 3,5 3,4 3,3 Northern (1 st ) : Every 10 donors save 2 more lives than we do SOUTH EAST

1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

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