Organ Utilisation Programme

The new phase of the Clinical Leads for Utilisation (CLU) scheme is now in operation, following the appointment of local and organ lead CLUs.

The five organ lead CLUs are:

• Heart: Aaron Ranasinghe
• Lung: Vicky Gerovasili
• Kidney: Nick Inston
• Pancreas: David van Dellen
• Liver: Anya Adair

The Organ Lead CLUs have met with NHSBT colleagues to share ideas and plan next steps. The first of a series of engagement calls are being led by Organ Leads within each of the five Organ Communities over the next two weeks, Local CLUs have been asked to consider the main barriers to organ utilisation along with their proposed solutions. Organ Lead CLUs will set up working groups to focus on issues within their organ communities. The Organ Utilisation Programme will track projects emerging from the CLU scheme to minimise duplication and enable cooperation between units. Many local CLUs from the first scheme have continued in the role and are looking forward to continuing their projects - some of which were disrupted by the pandemic.

For those Boards/Trusts with both an Organ Donation Committee and one or more transplant units, we are asking the CLUs, Committee Chairs, Clinical Leads for Donation and embedded Specialist Nurses for Organ Donation to work together, to address logistical and resource issues that may be common across the care pathway (e.g. access to theatre) and identify potential solutions. Our thanks to all centres and CLUs for their enthusiasm and engagement with this important scheme to date.

The Assessment and Recovery Centres (ARCs) project brings together people who are already taking forward work in this area to ensure we share learning and best practice, and seeks to establish a national service for organ assessment and recovery using ex-situ machine perfusion (ESMP). This will improve the UK’s organ utilisation rates across solid organ types.

NHSBT is not seeking bids from transplant centres to establish Assessment and Recovery facilities.

ESMP offers an opportunity to increase the utilisation of organs, including from higher risk donors. The three core benefits of this novel technology include:

• Improved and prolonged preservation of organs due to less ischaemic injury
• Assessment of the organ’s functional state (viability assessment)
• Repair of the donor organs (reconditioning)

While funding has yet to be secured for future years, a comprehensive outline business case has been developed. In the interim, engagement is taking place with colleagues across the transplant community to establish the appropriate governance arrangements that will be required for future implementation, including the data collection, processes and protocols for an ARC service. We are hugely grateful to the many colleagues who have given their time and expertise to the project to date.

The Digital Infrastructure for Utilisation (DIU) project is a new initiative within the Organ Utilisation Programme (OUP). It is developing plans for the critical IT infrastructure that will be required for the ARCs of the future and to digitise systems that support transplantation.

In the first stage, the DIU project will explore the requirements of a replacement for the Electronic Offering System (EOS) platform. EOS allows transplant centres to view documentation in support of a decision on the suitability of a donor. An upgrade/replacement for this system could support improvements in the efficiency of assessment. Additionally, the project will explore needs for an enhanced image sharing capability, to provide a robust, safe platform for communication between clinicians. Pending the outcome of this first stage, the project will be seeking approval and funding to begin delivery of these IT changes.