Organ transplants—knowing more about where donors live could save lives

June 1, 2018 by Nicholas Page, The Conversation
Credit: Panint Jhonlerkieat/Shutterstock

In 2017-18, a record number of people (1,575 in total) in the UK donated their organs after death, resulting in more than 5,000 life-saving or life-improving transplants. These figures, released by NHS Blood and Transplant, show numbers of deceased donors continue to rise in the UK. The 2017-18 figure was an 11% increase on the previous year, and a near 20% increase in donor numbers since 2013-14.

These numbers are encouraging. More than 50,000 people are alive in the UK today following . Yet 457 people still died in 2016-17 waiting for a transplant and more than 6,000 patients remain on the transplant waiting list.

England, Scotland and Northern Ireland operate an opt-in system of consent for organ donation. Willing donors provide consent by actively signing up to the organ donor register. Wales, however, has had an opt-out system since December 2015 (which England and Scotland are also expected to implement). All adults in Wales are now presumed to be consenting organ donors unless they explicitly register to opt out of donation, although people can still choose to opt in (known as express consent).

Even given these policy differences, family refusal remains one of the biggest barriers to donation. Under each country's laws, following the death of a loved one, consent must first be obtained from the family before any organ can be taken for transplant (even in Wales), regardless of the wishes of the deceased. While consent is granted in around two-thirds of cases, this rises to over 90% when the deceased was a registered donor.

Donation and location

At the time of writing, more than one-third of the UK's population (24.9m people) have signed up to the NHS organ donor register, making clear their willingness to donate their organs after death. But recent figures show that levels of registration differ across areas of the UK. The number of registered donors is lower in England (35% of the population) than Wales (38%), Northern Ireland (40%) and Scotland (44%).

Between health authorities in England, higher numbers of donors are found in the South (42%), compared to the North (34%), Midlands and East (34%) and London (29%). Similar disparities also exist among Welsh local authorities. Whether these figures point to a geography of potential donors is currently unclear, but these numbers surely warrant further investigation – especially given the strong relationship between registered donor status and familial consent for donation.

Research from the US has already identified local differences that correspond to different levels of registered organ donors. In one study, areas characterised by higher income were found to have greater numbers of registered donors, for example. Until recently, however, research linking location factors with organ donation rates had not been conducted in the UK.

In our recently published analysis of local patterns in registered organ donors, we found notable difference in rates of sign-up to the organ register across Welsh communities in the five years before Wales switched to an opt-out system. Among those aged 16-70, we found levels of new sign-up over this period ranged from as little as 6% of residents in some communities to as much as 24% in others. Higher rates of new sign-up during this period were generally found in and around major urban areas in the south east and north east of Wales, while lower rates were shown in south Wales valley communities.

Exploring the local geography of registered donors will undoubtedly raise questions about whether these differences are caused by variations in people or place – and rightly so. But having a better understanding of the potential geography of registered donors could be of considerable benefit to all the UK nations – especially to those local policymakers and practitioners working within them.

For now, rates of organ donation in the UK are still someway behind high performing countries such as Spain, which had 46.9 donors per million people in 2017, compared to 23 donors per million in the UK. Figures for 2017-18 also show the number of people registering a decision to opt-out of organ donation in the UK has increased to more than 500,000.

Tracking local trends can provide important information that will help identify areas where fewer people are opting in to organ donation, or, in the future (or now in Wales), areas where more people are opting out. Information that could play a vital role in helping specific groups and communities learn about the importance of , and ultimately help save lives.

Explore further: Dutch agree law to list all citizens as organ donors

Related Stories

Dutch agree law to list all citizens as organ donors

February 13, 2018
The Netherlands approved ground-breaking legislation Tuesday that will in future register all citizens over the age of 18 as potential organ donors—unless they explicitly opt out.

Opt-out system for organ donation is well intentioned but misguided

October 21, 2015
As Wales prepares to become the first country of the United Kingdom to introduce an opt-out system for organ donation, a doctor writing in The BMJ this week, says support for such a system "is well intentioned but misguided."

Organ donation clubs aren't the solution to transplant shortages

August 15, 2017
Anyone in the UK, of any age, can sign the Organ Donor Register, and give permission for their organs and tissue to be donated after death. How you register your wishes depends on where you live: in Northern Ireland and England, ...

Parent misconceptions may hinder child organ donation

January 23, 2018
Children in need of an organ transplant often wait longer than adults for available organs, as in many cases, they require organ donations from another child of a similar age or size.

Grief symptoms similar in donor vs non-donor decision families

April 2, 2018
(HealthDay)—Perceptions of the organ donation experience vary between relatives who decide to donate their relative's organs and those who do not, but the decision does not appear to be associated with subsequent grief ...

Study shows people reading about organ donor recipients more receptive to donating than when reading about donors

May 2, 2017
(Phys.org)—A small team of researchers affiliated with Ben-Gurion University of the Negev in Israel and Decision Research and the University of Oregon in the U.S. has found evidence that suggests people are more open to ...

Recommended for you

Tongue-in-cheek Nobels honor nutritional analysis of cannibalism, roller-coaster kidney stones treatment

September 14, 2018
A nutritional analysis of cannibalism and treating kidney stones on roller-coasters were research projects honored by tongue-in-cheek awards at Harvard University Thursday, designed to make you laugh first, and think later.

Pediatric robot patient offers new level of realism for doctors in training

September 10, 2018
A team of researchers and engineers at Gaumard Scientific has unveiled a new robot that raises the bar on medical training devices. The robot, called HAL, has been made to look like a five-year-old male patient and offers ...

Why men say they've had more lifetime sexual partners than women

July 25, 2018
The disparity between the number of sexual partners reported by men and women can largely be explained by a tendency among men to report extreme numbers of partners, and to estimate rather than count their lifetime total, ...

Censors jump into action as China's latest vaccine scandal ignites

July 22, 2018
Chinese censors on Sunday deleted articles and postings about the vaccine industry as an online outcry over the country's latest vaccine scandal intensified.

Revenge of a forgotten medical 'genius'

June 30, 2018
It's not an uncommon fate for a pioneering scientist: languishing unrecognised in his time before dying in obscurity. But as his 200th birthday approaches, the life-saving work of a Hungarian obstetrician is finally getting ...

Yes, you can put too much chlorine in a pool

June 2, 2018
(HealthDay)—Before you take a dip in the pool this summer, be sure there's not too much chlorine in the water.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.