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Medical Director Bulletin

Monthly communication from the ODT Medical Director

April 2019

Message from Dr Dale Gardiner

Dr Dale GardinerI write this month's bulletin with John away, in an exotic locale, enjoying a well deserved break. I also write just before the final years donation and transplant numbers are fully known.

That's a good thing, as I want to reflect on the year without being weighed down by results.

I’d like to share three reflections on the year that has been.

Reflection 1

Our future lies in the donation and transplantation clinical communities working more closely together.

Nothing embodied that belief more than the success of the recent first joint BTS and NHSBT Congress at Harrogate. We are two sides of the same coin. Without donation there is no transplantation, but without transplantation there would be no reason to donate.

Max Johnson would not be the vibrant young man that he is without the gift of Keira Ball's heart. But the fact of Max living life well is what can validate for Keira's parents the decision to donate her organs.

Feedback from Congress revealed that 80% of the donation community had conversations with someone from the transplant community. What is the benefit of such conversations?

Our problems are your problems and your problems are ours.

The length of the donation pathway impacts donor families and surgical teams. The answer to this problem lies in both clinical communities.

Donor optimisation benefits the transplant recipient but also the donor families in knowing the gift was maximised. This is particularly relevant in the developing opportunity of interventional research on donors. This sort of research is quite impossible without collaborative effort between our two communities.

Reflection 2

Wales has done it. They have shown deemed consent makes a difference.

As we heard at Congress, quarterly monitoring of comparative consent rates between Wales and England has demonstrated statistically, Wales has a 10% better consent rate in donation after brainstem death.

While we hope to publish the results in a major peer reviewed journal, the big question is, how?

How has deemed consent legislation made this difference?

I know the arguments and debate will go on for years but this is my reflection. The answer is cultural not legal. I can see two big cultural shifts in Wales.

The first is in the public. It is no surprise to me that when families are being asked about donation in Wales, the frequent answer back is, "Oh, we were expecting this question." Public awareness, has increased and citizens are talking to their families about their donation decision. Will we see Welsh citizens soon having the same pride in the donation programme that Spanish citizens do?

The second is, what I have observed, an increased confidence in the donation teams (both SNODs, CLODs and wider ICU doctors and nurses) in Wales. You see, I was first trained to apologise for asking families about donation. I have had the need to verbally apologise ‘beaten’ out of me (why apologise for offering an end of life choice) but has it been ‘beaten’ out of our nonverbal communication with families?

In Wales I see no apology in the clinical teams when offering families the opportunity for their loved one to donate. Government and society stands with them in making this donation offer. This confidence, in the rightness of asking, imbued by the legislation and media campaign, has infused the clinical teams caring for potential donors in Wales with confidence.

Together, greater public awareness and support, combined with greater clinical confidence in the rightness of asking, is, what I think, has changed the donation culture in Wales. We eagerly look forward to seeing what more Wales can do and how legislation change elsewhere in the UK will change society and clinical confidence.

Reflection 3

I know I promised no results, but I can't resist highlighting two donation regional teams for their approaching end of year donor numbers. Already, Midlands have achieved more than 200 donors and Northern more than 100. A record number of donors for both regions. While these are just numbers - psychologically this is a great achievement and reflects the enormous hard work and commitment in both teams. Thank you.

I commend the year that has been and the year to be to our two community’s donation and transplantation.

Dale

Dr Dale Gardiner
National Clinical Lead for Organ Donation

Update from Katie Morley, Lead Nurse Recipient Coordinator, NHS Blood and Transplant

Firstly, thank you to everyone who has welcomed me to NHSBT. The question everyone is asking is, “has Laura delivered yet?” The answer is,no, not yet!Katie Morley

I have now been in post for 2 months and one of the most significant projects that I have been engaged with is working alongside Lee Coulthard (SNOD, SW team) and Ben Cole (Lead Nurse - Family Aftercare) to develop guidelines to help support both recipient co-ordinators and SNODS when contact between donor and recipient families is requested. Thank you to everyone who has voiced an interest in being a part of this project moving forward.

In conjunction with this there is an upcoming bereavement workshop designed for recipient co-ordinators, to facilitate tackling bereavement and acknowledging the benefits and difficulties that are endured when discussing letter writing and contact being made between donor and recipient families.

Collaborative working has been a key theme during my short period in post. I have delivered a shared practice workshop with Mick Stokes in which national transplant liaison co-ordinators and recipient co-ordinators shared their experiences of transplant co-ordination. The feedback is in support that this workshop should be repeated and that the benefits of being able to have face to face discussions was invaluable in forging better professional relationships and gaining an appreciation of the complexities faced in each other’s roles.

I am very much looking forward to seeing these projects develop in the coming months and meeting more people along the way.

Meetings and events

19th Congress of the European Society for Organ Transplantation

15 - 18 September 2019

We are truly delighted to cordially invite you to be Inspired and experience real Progress at the ESOT Congress in Copenhagen, a transplant meeting of truly great scientific substance delivered in great ESOT style!

The philosophy behind every ESOT Congress is that every two years we produce a totally New Congress in content and format; ESOT Copenhagen 2019 not only follows this rule but aspires to be the best transplant congress ever!

ESOT Copenhagen 2019 is designed to be Your Congress, tailoring and targeting its content to the discipline that you serve, the stage of your career journey in transplantation and your professional aspirations. Knowledge will be delivered through a plethora of networking opportunities leading to new collaborations so that the end of the Congress will mark many new beginnings in transplantation.

We aim to explore the edge of our current practice and achievements and also challenge each other about great things that have not yet happened, ask ourselves, Why Not? and pave together the way forward. Looking at the hot topics of the Congress (which are just the appetisers for a great feast…), we will learn from history and each other, make patients active partners in our endeavours, vigorously debate our ethical conduct, take deep dives in the waters of basic and translational science so that we can bring to the surface clinical solutions, admit the moments we reached our clinical limits and explore how to push them further, debate and design innovation with realism and all in the context of our palpable and substantial professional development.

Furthermore, the ESOT award winning Digital Congress Innovations have now reached new heights and they are designed to bring people together (even if they are not physically at the Congress!), maximise their interaction and advance their knowledge.

Last but most certainly not least, all these are going to happen in Copenhagen, a dream city that can make those who adore classic fairy tales and the enthusiasts of modern miracles equally happy and in the Bella Conference Centre that is designed to make your time at the Congress Productive and Enjoyable.

Join us in Copenhagen! Be Inspired and Drive Progress!

Vassilios Papalois and Allan Rasmussen
Scientific Program Committee Chairs

Further information about the event.

Certification of European Transplant Coordinators - EBSQ exams

On behalf of President of the Board of Transplant Coordinators we would like to announce that applications are available on UEMS Surgery website and the deadline for application is June 30th 2019.

ODT Care 
  • Tuesday 11th June 2019, 10:30 – 14:30
    • York (venue to be confirmed)
  • Tuesday 13th August 2019, 10:00 – 14:00
    • Telecon
  • Tuesday 8th October 2019, 10:30 – 14:30
    • York (venue to be confirmed)
  • Tuesday 10th December 2019, 10:00 – 14:00
    • Telecon

RINTAG DCD Hearts Working Group
  • Wednesday 22nd May 2019, 10:30 – 15:30
    • At The Fielding Room, The QEII Centre, Broad Sanctuary, Westminster, London SW1P 3EE (new CORAM premises)
  • Monday 2nd December 2019, 10:30 – 15:30
    • At The Fielding Room, The QEII Centre, Broad Sanctuary, Westminster, London SW1P 3EE (new CORAM premises) 

Other meetings

Details of upcoming group meetings: