1. Donation after Brain-Stem Death DBD
Dr Fran O’Higgins
Dr Dale Gardiner
Dr Gerlinde Mandersloot
9th July 2013
Suggest a local CLOD to present data

2. 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
Session Chair or CLOD presenting regional data
Organ Donation Past, Present and Future

3. Dr Fran O’Higgins Bristol Royal Infirmary
Regional Data
Dr Fran O’Higgins
Bristol Royal Infirmary
SOUTH WEST

4. Donation after Brain Death
(DBD)
Mechanically ventilated patient where death has been confirmed using neurological criteria.
36 donors
( )
20.0 % decrease
(from 5 years ago)
Explain what DBD is
Organs that can be donated
The number of DBD donors in region ( = last year) and the rise over the last 5 years region has seen.
Lungs
Heart
Small Intestine
Kidneys
Liver
Pancreas
SOUTH WEST

5. Donation in the South West Team
11.0%
60.7%
-20.0%
“Seen this slide already” – in 1st session
Organ Donation Past, Present and Future 5

6. Donation in the South West Team
If we just look at DBD over the last 10 years, like many regions we can see that DBD is falling.
Organ Donation Past, Present and Future 6

7. kidneys intestine lungs pancreas liver heart
best transplant outcome favours
DCD
DBD
kidneys
intestine
lungs
Slide to show why for certain organs DBD is best
Hearts and small intestine currently only from DBD
Pancreas and liver better outcomes with DBD compared to DCD
Only lungs and kidneys equivalent
pancreas
liver
heart

8. South West Neurological death testing rate
National rate 87 82 76 74 86 78 73
ND tested (%) 20 40 60 80
100
Team
Eastern
London
Midlands
North
West
Northern
Ireland
Scotland
South
Central
East
Wales
Yorkshire
5th
We are 5th. Comment…
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future

9. South West Neurological death testing rate
Large spread
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future

10. Tied 10th Mean no. of organs donated per DBD donor
SOUTH WEST
Mean no. of organs donated per DBD donor
Northern (1st) : Every 10 donors save 4 more lives than we do
Tied 10th
Donor optimization is important in DBD. If we could optimise and donate like the Northern region does: for every 10 donors they save 4 more lives than we do. [I know this headline comment is a stretch of the truth but will grab the attention for Gerlinde’s talk]
Optimization and retrieval surgeon acceptance is of course a two way process and this thanks may be to our surgeons in the audience as much as to those on the donation side.
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future