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The Donation & Transplantation Symposium October 15, 2013

The Donation & Transplantation Symposium October 15, 2013. The Current State of Organ Donation and Transplantation. Thomas A. Nakagawa, M.D, FAAP, FCCM Professor and Section Head, Pediatric Critical Care Medicine Director, Pediatric Critical Care Medicine and Respiratory Care

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The Donation & Transplantation Symposium October 15, 2013

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  1. The Donation & Transplantation Symposium October 15, 2013

  2. The Current State of Organ Donation and Transplantation Thomas A. Nakagawa, M.D, FAAP, FCCM Professor and Section Head, Pediatric Critical Care Medicine Director, Pediatric Critical Care Medicine and Respiratory Care Wake Forest University Baptist Health, Brenner Children’s Hospital Winston-Salem, North Carolina Assistant Medical Director, Carolina Donor Services Durham, North Carolina

  3. CELEBRATING OUR SUSTAINED SUCCESS • We have achieved and sustained a 75% conversion rate nationally • We continue to transplant more organs annually • We continue to engage more partners to save more lives • We have continued to increase organ recovery from donors following circulatory determination of death

  4. (OPTN Data, September 2013)

  5. Conversion Rate 2009 – 2012 (Jan-Dec)

  6. Organs Transplanted Per Donor • Adults 3.09 • Pediatrics 4.06 • All donors 3.08 -DCDD donors-

  7. Organ Donors, Organs Transplanted & OTPD2006 vs. 2013 (Jan-Aug)

  8. Continued Growth of DCDD Adult DCDD donors Pediatric DCDD donors 2006 645 adult 77 pediatric 2007 793 adult 66 pediatric 2008 847adult 73 pediatric 2009 747 adult 81 pediatric 2010 939 adult 72 pediatric 2011 1053 adult 115 pediatric 2012 1102 adult 124 pediatric UNOS. OPTN data. 2013, Pediatrics patients < 18 years of age

  9. (OPTN Data, September 2013)

  10. DCD Donors 2009 – 2012 (Jan-Dec)

  11. Growing National Organ Transplant Waitlist

  12. Current State of Organ Donation & Transplantation • 120,188 people are currently on the national waiting list. • 16, 669 organ transplants have been performed from 8,215 donors*through July 2013 • 3,450 people have died waiting for a needed organ* • 2,973 people were removed from the waiting list because they became too sick to transplant* www.UNOS.org. Data obtained October 14, 2013 * Data through July 2013

  13. Facts About the Current State of Organ Donation and Transplantation • 28,052 organ transplants from 14,013 donors were performed in 2012 • 16, 669 organ transplants have been performed from 8,215 donors* through July 2013 • 3,450 people died waiting for a needed organ* • 2,973 people were removed from the waiting list because they became too sick to transplant* • 2012: 46,000+ corneas transplanted www.UNOS.org. Data obtained October 14, 2013 * Data through July 2013

  14. A National Issue That Continues to Escalate • October 23, 2012Growing transplant waiting list exceeding 112,000 • In 2011: • 7,370 died waiting for a needed organ* • 4,519 removed from wait list because they became too sick to transplant • 92 deaths were children • October 15, 2013 Growing transplant waiting list exceeding 116,000 • In 2012: • 7,040 died waiting for a needed organ* • 4,794 removed from wait list because they became too sick to transplant • 104 deaths were children *OPTN data accessed October 14, 2013

  15. Waiting for an Organ That Never Came • An average of 18 people die every day in the US waiting for a needed organ • Although the number of people that died waiting for an organ last year was decreased, more people were removed from the waiting list because their condition deteriorated to a point where they were too sick to transplant • In California, an average of 3 people die everyday waiting for a needed organ

  16. California Data 2012: 1,109 people died waiting for a needed organ transplant 575 deaths through June 2013 *OPTN data. Accessed October 14, 2013 www.OPTN.org

  17. The Solution: Recover more organs for transplantation

  18. Reducing the Number of Deaths Among Those Waiting for a Transplant • Transplant 2 more people every day • 2 more organs, 1 additional donor • 243 transplant programs • Reduce deaths on the waitlist to 6,303 (~10% decrease) • Continue to improve care with advancing technology for patients with end-organ failure • More time on the waiting list • Education programs to help keep people off the waitlist

  19. Recovering More Organs for Transplant • Ensure we never miss opportunities for donation • Preserve the option of donation for every person and their family facing end-of-life issues • Education • Healthcare professionals • Public • Donor registries

  20. Donor Designation in the U.S. 108,963,103 as of 12/31/12

  21. Summary: Donor Designations, Q4 2012 • 108,963,103 designated donors nationwide • 24 states have signed up more than 2 million designated donors • In 31 states, donor designation share is at least 50% of the adult population • The number of donor designations increased 7.5% over the last 12 months

  22. Donor Designation Highlights – Q4 2012 • In the 50 states, DC and Puerto Rico, 41.1% of recovered organ donors, 46.2% of recovered tissue donors, and 50.2% of recovered eye donors were authorized by state donor registries • Donor designation rate increased year-over-year in 16 of 28 states reporting

  23. Impact on Donation, 2007-2012 Designated Donors Among Recovered Donors

  24. Donation is a Process • The process of donation begins when a critically ill or injured patient is identified as a potential donor with a timely referral to the organ procurement organization (OPO) • Medical management of the potential organ donor requires knowledge of the physiologic derangements associated with this patient population • This process of donation relies on collaboration between the critical care team and the OPO to optimize organ recovery for transplantation

  25. Donation is more than just a question Donation is a conversation

  26. Success in Maximizing Organ Recovery • Identification of the potential donor • Declaration of death in a timely manner • Consent from the family • Management of the donor • Recovery of organs and tissues

  27. Tissue Donors2009 compared to 2013 (Jan-Aug)

  28. Bold Request • Be open • Listen, learn, and teach others • Be bold: Share your thoughts and experiences • Focus on what we can do, not what we can’t do • Determine what we as a community of health care professionals can do to decrease and eventually eliminate deaths on the waiting list

  29. "Sometimes our light goes out but is blown again into flame by an encounter with another human being. Each of us owes the deepest thanks to those who have rekindled this inner light." – Albert Schweitzer

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