1,713 lives transformed by 503 deceased … donation and... · 1 australian donation and...
TRANSCRIPT
1 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
AUSTRALIAN DONATION AND TRANSPLANTATIONACTIVITY REPORT 2016
LIVES TRANSFORMED BY
1,713503DECEASED ORGAN DONORS &
LIVING ORGAN DONORS IN 2016267
2 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
100
200
300
400
500
600
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Organ Donors
435
503
247
196
Transplant recipients and organs transplanted per donor 2009 – 2016
The number of organs retrieved and transplanted from each donor has decreased from 3.8 in 2009 to 3.4 organs per donor in 2016.
The decrease in organs utilised per donor reflects positive change in practice in Australia with broader acceptance of organs from donors who may not have previously been considered, for example donors from an older population.
Deceased organ donors 2000 – 2016
200
600
1000
1400
1800
0.0
1.0
2.0
3.0
4.0
2009 2010 2011 2012 2013 2014 2015 2016
3.83.5 3.5 3.5 3.4 3.5 3.4
Organs Per Donor Transplant Recipients
799
1239
1447
3.4
In 2016 a record 1,713 lives were saved and transformed through the generosity of 503 deceased organ donors and their families and 267 living donors.
Record outcomes from organ donation and transplantation
Donation and transplantation outcomes have increased substantially since 2009 under Australia’s national reform program.
Deceased organ donation has more than doubled, with 503 donors in 2016 compared with 247 in 2009, with an 81% increase in the number of organ transplant recipients (1,447 in 2016 compared with 799 in 2009).
2016 AUSTRALIAN DONATION AND TRANSPLANTATION ACTIVITY REPORT
+104%
PART 1: ORGAN DONATION AND TRANSPLANTATION
LIVES TRANSFORMED BY
1,713503DECEASED ORGAN DONORS &
LIVING ORGAN DONORS IN 2016267
3 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
The 2016 outcome of 646 consented organ donors represents a 140% increase over the 269 consented donors in 2009. This reflects the increased efforts of the donation sector to identify all potential donation opportunities, including increased donation after circulatory death.
100
200
300
400
500
600
700
2009 2010 2011 2012 2013 2014 2015 2016
Consented donors Actual Donors
269
247
564
646
435
503
Consented (Actual & Intended) & Actual donors 2009-2016
Growth in consented organ donors
In Australia, the family will always be asked to confirm the donation decision of the deceased before organ and tissue donation can proceed. However, in some cases where the family provides consent, organs are not suitable for transplantation and donation does not occur. These cases are referred to as intended donors. In a number of cases this does not preclude tissue donation.
Growth from 2009 and 2015 to 2016
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
0
300
600
900
1,200
1,500
’09
’15
’16
Organ transplant recipients and deceased organ donors 2009, 2015 and 2016
In 2016 1,447 lives were saved and transformed through the generosity of 503 deceased organ donors and their families.
When compared with 2015 figures, Australia’s 2016 outcomes represent:
- a 17% increase in the number of transplant recipients (1,447 recipients in 2016 compared with 1,239 in 2015)
- a 16% increase in the number of deceased organ donors (503 donors in 2016, compared with 435 donors in 2015).
2016: 503
2015: 435
2009: 247
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
0
100
200
300
400
500
’09
’15
’16
Organ Donors 2009, 2015 & 2016
Transplant Recipients 2009, 2015 & 2016
+104%
+81%
2016: 1,447 2015: 1,239
2009: 799
+140%
2009 2015 2016
4 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
VICNSW QLD SA WA TAS NT ACT
0
5
10
15
20
25
30
35
dpmp
17.2
21.2
15.1
24.7
16.2
17.4
16.4
21.2
17.7
23.1
21.9
23.4
18.0
21.2
24.5
32.3
VICNSW QLD SA WA TAS NT ACT
0
50
100
150
127
126
72
42 42
9 4
13
133 14
0
106
40
47
11
6
20
2015 Donors 2016 Donors
2015 dpmp 2016 dpmp
Organ transplantation and donation rates 2009, 2015 & 2016
In 2016 the transplant recipients per million population rate (trpmp) was 60.0, 15% higher than the 2015 outcome (52.1 trpmp).
The donor per million population rate (dpmp) for 2016 was 20.8 dpmp, 14% higher than the 2015 outcome (18.3 dpmp)
2009 2015 2016
0
10
20
30
40
50
60
pmp Donors per million population
Transplant recipients per million population
11.4
18.3
20.8
36.8
52.1
60.0
Deceased organ donors by donation pathway 2009 to 2016
In 2016 the majority (75% or 375 donors) of deceased organ donors came from the Donation after Brain Death (DBD) pathway, with the remaining 25% (128) from the Donation after Circulatory Death (DCD) pathway. Compared with 2015, this represents a 19% increase in donations realised from the DBD pathway and a 7% increase in donations from the DCD pathway.
2009 2010 2011 2012 2013 2014 2015 2016
0
100
200
300
400
500
205
42
240
69
251
86
277
77
305
86
271
107
315 375
120
128
Donation after Brain Death Donation after Circulatory Death
247
309337
354
391378
435
503
Organ donation rates by jurisdiction 2015 and 2016
Jurisdictional outcomes in 2016 continued to demonstrate variation across states and territories, with annual donation rates ranging from 17.7 dpmp to 32.3 dpmp.
Australia dpmp: 20.8
5 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
In 2016 there were 1,687 organs transplanted from deceased donors, a 14% increase over 2015 (1,481).
Living Donors 2015 and 2016
In 2016 there were 265 living kidney and 2 living liver donors. This is an increase from the total of 245 living donors in 2015.
The majority of kidneys and livers transplanted from living donors were from donors genetically or emotionally related to the recipient, however there were also 44 donors through the Australian Paired Kidney Exchange program (AKX).
Living donors (minus AKX)
AKX donors
2010 2011 2012 2013 2014 2015 2016
0
100
200
300
231231297 223 230 200 223
1126
3
3138
45
44242
257
300
254268
245
267
The AKX program increases live donor kidney transplants by identifying matches for patients who are elligible for a kidney transplant and have a living donor who is willing but unable to donate because an incompatible blood type or tissue type.
The AKX program has resulted in 198 successful live kidney transplants since its establishment in 2010.
THE AKX
Organ transplant recipientsOrgans transplanted from deceased donors
Kidneys are the predominant organ donated and transplanted. In 2016, 821 lives were transformed by kidneys transplanted from deceased organ donors.
In addition:
- 314 lives were saved through liver transplants
- 196 lives were saved through lung transplants
- 124 lives were saved through heart transplants
- 52 lives were saved through pancreas transplants.
There was also one intestine transplant in 2016.
Kidney
Liver
Heart
Lung
Pancreas
2009 2015 2016
0
300
600
900
1,200
1,500
37
47
52
452 718 841
217
375
386
61
95
124
171
247
283
6 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
Knowledge of donation decisions makes a difference
In Australia, families of potential deceased donors are asked to confirm their loved one’s donation decision, including where a patient has previously registered a donation decision directly either on the Australian Organ Donor Register or through drivers licence issue or renewal. Registration and family knowledge of a potential donor’s wishes are key drivers of consent for donation.
Consent Rates
Organ Donation Registration 2016
Registration rates vary significantly across states and territories.
The highest registration rate is in South Australia where donation decisions are captured both directly to the Australian Organ Donor Register and through drivers licence issue and renewal.
Where potential donors have previously registered a donation decision and/or the family has prior knowledge of their decision, in most cases this is upheld by the family. In nine out of ten cases, families agree to donation proceeding when the deceased was a registered donor.
Where the family has prior knowledge of a patient’s wishes relating to donation, consent occurs in 75% of cases compared to an overall consent rate of 60%.
Consent Rates by Ethnicity and Culture
The ethnic and or cultural background of a potential donor and their family impacts the likelihood of consent for donation.
Consent rates for particular ethnic and cultural groups vary significantly1.
DonateLife Week
The DonateLife Week campaign ran from 1 July to 31 August. During this time more than 40,000 Australians joined the Australian Organ Donor Register (AODR).
This represented an increase of 68% on the same period in 2015.
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
0
4,000
8,000
12,000
16,000
20,000
24,000
DonateLife Week ‘16
Monthly AODR Registrations 2016
Australian average: 33.7%
GENERAL ETHNIC GROUPPOTENTIAL
DONORSCONSENTED
DONORS CONSENT RATE
North-West European - British 30 25 83%
Southern and Central Asian - Indian 15 11 73%
Oceanian - Australian 698 481 69%
Southern and Eastern European Italian 10 5 50%
Oceanian - New Zealander 11 5 45%
Oceanian - Maori 12 5 42%
Oceanian - Australian Aboriginal 47 19 40%
South-East Asian - Vietnamese 17 6 35%
Southern and Eastern European - Greek 11 3 27%
South-East Asian - Filipino 16 4 25%
North - East Asian - Chinese 25 3 12%
1 Ethnic and/or cultural groups with less than 10 potential donors have been excluded.
7 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
Australia’s potential deceased organ donor population 2016
Not everyone can be a deceased organ donor as particular circumstances must prevail in order for a patient to be medically suitable for donation. Deceased organ donation is only possible from a subset of end of life events that occur in intensive care units or hospital emergency departments. Potential deceased donors need to be recognised as such, and if medically suitable, the family will be asked to confirm the donation decision of their family member before donation can occur.
By way of example, in 2016 the Australian population1 was 24,127,159 with an estimated 159,052 deaths occurring2. Of these, approximately 76,577 deaths occurred in hospitals3 with around 1,177 potential donors identified4.
Requests to families for donation were made in around 1,074 cases4, with 646 families consenting to donation5. In 143 cases5 where family consent was given, donation did not proceed for a variety of clinical reasons.
The resulting 503 deceased organ donors5 enabled 1,508 organ transplant procedures5 where 1,687 organs were transplanted5.
As a result, the lives of 1,447 transplant recipients5 and their families were transformed.
Source:
1 Estimated Resident Population 30 June 2016, ABS 3101.0 Australian
Demographic Statistics, (released 15 December 2016)
2 ABS 3302.0 Deaths, Australia, 2015 (released 28 September 2016)
3 AIHW Australian Hospital Statistics 2014 -15 (released 16 March 2016)
4 Estimated using DonateLife Audit Data (January 2017)
5 Deceased Organ Donation in Australia, ANZOD, February 2017.
Australian Population1 24,127,159
Australian deaths2 159,052
Deaths in hospital3 76,577
Potential Donors4 1,177
Requested Donors4 1,074
Consented Donors5 646
Actual Donors5 503
Transplant recipients5
1,447
Organs transplanted5
1,687
Organ transplant procedures5
1,508
8 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
Eye donors 2009-2016
In 2016 there were 1,281 eye donors, representing a 1% increase in eye donors compared with the 2015 outcome (1,266).
This outcome represents a 39% increase in eye donors over the 2009 baseline (922 donors).
Corneal transplants 2012–2016
In 2016 there were 2,085 corneal transplants. Australian eye banks continued to meet all requests for eye tissue for transplantation in 2016 with transplant rates remaining relatively consistent since 2012.
Eye donors by state 2016 Tissue transplants 2013–2016
In 2016, there were 7,468 notified tissue transplant recipients, an increase of 17% on 2015 (6,421). These included 7,073 recipients of musculoskeletal tissue, 230 recipients of cardiovascular tissue and 165 recipients of skin tissue.
Donated bone and tendons can be grafted to replace bone and ligaments that have been lost as a result of tumors, disease such as debilitating arthritis or traumatic injury. Tissue donation can save a limb of a person who has developed cancer and would otherwise face limb amputation. It can also aid fracture healing, strengthen hip and knee joint replacements, replace and repair spinal deformities.
Cardiovascular tissue donations in the form of heart valves are often used to repair congenital defects in young children and babies and to replace diseased valves in adults.
2009
2010
2011
2012
2013
2014
2015
2016
+39%
1,266
1,162
1,144
1,169
1,083
957
922
1,281
2011
2012
2013
2014
2015
2016
2,124
1,897
1,932
1,942
2,085
107
0
93
420
278
33
6
343
2013 2014 2015 2016 2013 2014 2015 2016 2013 2014 2015 2016
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000 Skin Cardiovascular Musculoskeletal
89 16616589 212 230103 203
3,436
5,247
6,107
7,073
PART 2: EYE AND TISSUE DONATION
2016 AUSTRALIAN DONATION AND TRANSPLANTATION ACTIVITY REPORT
9 donatelife.gov.auAustralian Donation and Transplantation Activity Report 2016
Living tissue donation 2012–2016
There were 3,923 living tissue donations in 2016 from 3,867 donors, predominantly patients undergoing joint replacement surgery.
Deceased Donors
More than half of deceased organ donors are also eye and/or tissue donors.
2014
2015
2016
2013
3,928
3,649
3,805
Living Tissue Donors
3,867
2012 2013 2014 2015 2016 2012 2013 2014 2015 2016 2012 2013 2014 2015 2016 2012 2013 2014 2015 2016
Skin Cardiovascular Musculoskeletal Pancreas
0
50
100
150
200
250
300 Deceased organ and tissue donations
Deceased tissue only donations
35 45 43 52 70 53 75 84 100 105 43 57 62 85 90 4 110 14
8
73
78
122119
151
36
35
6051
55
83
101
141
148
171
Deceased tissue donation 2012–2016
The provisional 2016 outcome of 4,291 tissue donors includes 3,867 (90%) living tissue donors and 424 (10%) deceased tissue donors.
The 424 deceased donors resulted in 650 tissue donations. This represents a 14% increase over 2015 (562), and almost
double the number of tissue donations from deceased donors in 2012 (327), the first year in which national tissue donation outcomes were reported for Australia.
There were 261 musculoskeletal, 221 skin, 160 cardiovascular and 8 pancreas tissue donations.
Eye Donors (1,281)
Tissue Donors (424)
Organ Donors (503)
938
67
62
249
86101
175