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In December 2006, The UK Government set up the Organ Donation Taskforce to identify barriers to organ donation and recommend actions needed to increase organ donation and procurement within the current legal framework. [1]
The Taskforce was asked to:
The ODTF comprised medical professionals, National Health Service managers, patients and patient representatives and ethicists and is chaired by Elisabeth Buggins. [2]
The ODTF published its first report ‘Organs for Transplants’ on 16 January 2008. [3]
In the report, the Taskforce makes 14 recommendations to the Government, which could see a 50 per cent increase in organ donation in the UK within five years - resulting in an additional 1,200 transplants a year and saving thousands of lives. The report proposes a radical shift from existing arrangements for the UK’s transplantation system. Together with other measures to improve donor coordination services this could result in a 10% increase in the consent rate for donation (currently at 60%). [4]
At the time of launch of the First taskforce report, the UK Prime Minister called for a review of the legislation over consent for organ donation. [5]
The ODTF carried out an investigation and published its second report ‘The potential impact of an opt out system for organ donation in the UK’ on 17 November 2008 [6]
This report provided an in-depth examination of the potential impact of changing to an opt out system of consent for organ donation. It concluded that an opt out system should not be implemented in the UK at the current time.
The Taskforce concluded that there was no convincing evidence that a change to opt out consent would deliver significant increases in the number of donated organs. It felt that such a system has the potential to undermine the concept of donation as a gift, to erode trust in NHS professionals and the Government and negatively impact on organ donation numbers. It concluded a change in consent system would be costly to implement.
It also felt that an opt out consent system would distract attention away from the need to improve the systems and infrastructure around organ donation in the UK and the need to improve awareness and understanding of organ donation.
In putting together the report, the Taskforce had discussions and engagement with academics, health professionals, members of the public, organ recipients, families of donors and faith leaders. The report details the considerable volume of evidence the ODTF considered before coming to its conclusions.
Under Part 1 of the Human Tissue Act 2004, it is unlawful to remove, store, or use human organs and other tissue for scheduled purposes without appropriate consent. The removal, storage and use of an organ for the purpose of transplantation are scheduled purposes in this context.
Appropriate consent is defined within the Act [7] as:
a. If a decision of a deceased person to consent to the activity, or a decision of his not to consent to it, was in force immediately before he had died, his consent.
b. Where such a decision is not in force, then consent is required from either a nominated representative, or, a person in a qualifying relationship (such as next of kin).
The Human Tissue Act 2004 covers England, Wales and Northern Ireland. The Human Tissue (Scotland) Act 2006 covers Scotland and has broadly similar provisions as far as transplantation is concerned.
Transplants currently enable about 2,700 people to pursue an active life in the UK every year. Transplants are the best possible treatment for most people with organ failure.
Kidney transplants are the most common organ transplant performed in the UK. [8] Transplants of the heart, liver and lungs are also regularly carried out. As medicine advances, other vital organs including the pancreas and small bowel are also being used in transplants. Tissue such as corneas, heart valves, skin and bone can also be donated.
The increasing effectiveness of transplantation means that many more patients can be considered for treatment in this way but there is a serious shortage of donors. Around 8,000 people in the UK are currently awaiting a transplant. For some people this means waiting, sometime for years, and undergoing difficult and stressful treatment. Many will die before a suitable organ becomes available.
3,086 organ transplants were carried out, thanks to the generosity of 1,495 donors. 949 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney, liver/pancreas or heart/kidney transplant.
Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
A pancreas transplant is an organ transplant that involves implanting a healthy pancreas into a person who usually has diabetes.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
The Toronto General Hospital (TGH) is a major teaching hospital in Toronto, Ontario, Canada and the flagship campus of University Health Network (UHN). It is located in the Discovery District of Downtown Toronto along a portion of University Avenue known as "Hospital Row"; it is directly north of The Hospital for Sick Children, across Gerrard Street West, and east of Princess Margaret Cancer Centre and Mount Sinai Hospital. The hospital serves as a teaching hospital for the University of Toronto Faculty of Medicine. In 2019, Newsweek ranked TGH as seventh among the top-ten best hospitals in the world. In 2019, the hospital was ranked 1st for research in Canada by Research Infosource for the 9th year in a row.
Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage kidney disease. Kidney transplantation is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ.
Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.
Certain fundamental Jewish law questions arise in issues of organ donation. Donation of an organ from a living person to save another's life, where the donor's health will not appreciably suffer, is permitted and encouraged in Jewish law. Donation of an organ from a dead person is equally permitted for the same purpose: to save a life. This simple statement of the issue belies, however, the complexity of defining death in Jewish law. Thus, although there are side issues regarding mutilation of the body etc., the primary issue that prevents organ donation from the dead amongst Jews, in many cases, is the definition of death, simply because to take a life-sustaining organ from a person who was still alive would be murder.
Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occurs outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.
Transplantable organs and tissues may both refer to organs and tissues that are relatively often or routinely transplanted, as well as relatively seldom transplanted organs and tissues and ones on the experimental stage.
The Center for Ethical Solutions (CES), founded by Sigrid Fry-Revere, is a 501(c)(3) non-profit bioethics think tank based in Lovettsville, Virginia whose mission is to find practical solutions to controversial problems in the field of medical ethics. CES supports research and public education, seeking to achieve its goals through research and developing products including books and documentary films to educate the public. Lobbying and participation in political campaigns are specifically excluded from its activities.
The Ontario Online Donor Registry is a website where Ontario residents, age 16 and older, can register their consent to be an organ and tissue donor. This registry was created to help ease questions and ambiguities with organ donor wishes. The virtual registry also increases Ontario donations with increased accessibility. The registration process can be done through beadonor.ca. Online donor registries have also become popular in the United States, where one can register through Donate Life America; Malaysia, registering through their National Transplant Registry; and Saudi Arabia, registering through the Saudi Center for Organ Transplantation.
The Human Transplantation (Wales) Act 2013 is an act of the National Assembly for Wales, passed in July 2013. It permits an opt-out system of organ donation, known as presumed consent, or deemed concent. The act allows hospitals to presume that people aged 18 or over, who have been resident in Wales for over 12 months, want to donate their organs at their death, unless they have objected specifically. The act varies the Law of England and Wales in Wales, which relied on an opt-in system; whereby only those who have signed the NHS organ donation register, or whose families agreed, were considered to have consented to be organ donors.
Organ donation in the United States prison population is the donation of biological tissues or organs from incarcerated individuals to living recipients in need of a transplantation.
Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. Unfortunately the number of patients requiring organ transplants outweighs the number of donor organs available.
BC Transplant Society (BCTS) founded in 1985 is now an agency of Provincial Health Services Authority (PHSA) in the Canadian province of British Columbia that registers consent to be donors of organs for Organ transplantation.
The Trillium Gift of Life Network is an agency of the Government of Ontario responsible for the province's organ donation strategy, promotion, and supply. Ronnie Gavsie is the current President & CEO. The agency maintains the popular BeADonor.ca website.
The current law in Ireland requires the potential donor to opt in to becoming an organ donor. However, it is ultimately up to their family to make the decision whether or not the person is allowed to donate their organs after they die.
Organ transplantation in the Indian state of Tamil Nadu is regulated by India's Transplantation of Human Organs Act, 1994 and is facilitated by the Transplant Authority of Tamil Nadu (TRANSTAN) of the Government of Tamil Nadu and several NGOs. Tamil Nadu ranks first in India in deceased organ donation rate at 1.8 per million population, which is seven times higher than the national average.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.