Doctors praise plan for organ donor presumed consent in England

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By:  Health policy editor

Proposal announced in Theresa May’s Tory conference speech is ‘fantastic news’ for people awaiting transplants

Transplant doctors and health charities have praised Theresa May’s decision to change how organ donation works in England in an attempt to provide more hearts, kidneys and livers for patients in need.

The prime minister announced plans to move to a system of presumed consent – meaning everyone is presumed to agree to the removal and reuse of body parts after their death unless they opt out – in her speech to the Conservative party conference in Manchester on Wednesday.

She said change was needed because 500 people died last year while waiting in vain for a replacement heart, lungs, kidney or liver.

With 6,500 patients on the organ transplant waiting list, “our ability to help people who need transplants is limited by the number of organ donors that come forward,” May said.

Roberto Cacciola, a kidney transplant specialist at Barts Health NHS trust in London, said: “As a transplant surgeon I’m delighted with and excited by this initiative because there’s a chronic need for more organs and therefore for more donors to come forward.

“We’ve been waiting a long time for this to happen. I have 400 patients on my waiting list for a kidney, of which I manage to transplant 120 a year. I would do more if more kidneys were available. I hope that in future I will be able to do more.”

According to NHS Blood and Transplant, the agency responsible for boosting donation rates, there are more than 50,000 people alive today in the UK who would have died if they had not undergone an organ transplant. Of those, 36,300 received a kidney, 9,800 a liver, 3,900 either a heart, lungs or both, and 1,900 a replacement pancreas.

Last year 4,753 people – the highest number ever – received an organ. The number of recipients has risen by 20% over the past five years. The number of people who have signed the NHS organ donor register, signalling their willingness to have their organs harvested after their death, has risen by 4.9 million over the same period and now stands at 23.6 million, also a record high.

Fiona Loud, policy director at the charity Kidney Care UK, said: “The government has done the right thing and made a vital step towards increasing donations and transplantation, which is fantastic news for the thousands of people currently waiting for a kidney transplant.”

The proposed switch to presumed consent, which will be subject to a public consultation, could prove “truly transformational”, Loud said. “With one person dying every day in the UK whilst waiting for a kidney transplant, this change cannot come soon enough.”

Wales introduced presumed consent in December 2015 and has seen organ retrieval rates rise as a result. Scotland and Northern Ireland have both expressed interest in following suit.

Gordon Brown, the last Labour prime minister, wanted to bring in the same system in 2008, but he did not pursue the plan after a taskforce he set up to investigate the practicalities of doing so advised against it. Although many doctors backed the move, others were concerned hat it could cause tension in the relationship between doctors providing end-of-life care and patients and their relatives.

Brown abandoned the plan after the taskforce concluded 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”.

The taskforce added: “Furthermore, it would be challenging and costly to implement successfully. Most compelling of all, we found no convincing evidence that it would deliver significant increases in the number of donated organs.”

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