Organ Donation & Transplant Facts

• You are far less likely to become a donor than you are to need a lifesaving transplant yourself.
• A donor can save more than one life. In fact one person could give both kidneys, heart, lungs, small bowel AND their corneas thus restoring the sight of two people!
• Joining the NHS Organ Donor Register (http://uktransplant.org.uk) makes a permanent record of your wishes. Please also let your family know your wishes as they will have the final say.
• The vast majority of relatives do agree to organ donation.
• Not just Organs can be donated but bone and tissue such as tendons, skin and heart valves.
• Organ donors generally come from two particular groups: those who have suffered brain haemorrhage or those involved in car accidents.
• Those who have died whilst on a ventilator in an intensive care unit (ICU) are where most organ donations come from.
• Organs deteriorate very quickly without oxygen, especially heart and lungs, so the ventilator continues the job of circulating blood and oxygen after death.
• A steep rise in the amount of people requiring transplant is expected over the next 10 years due to an ageing population, increases in the failure of Kidneys and more people being suitable for transplant due to scientific advances.

• Department of Health estimates suggest treating people for kidney failure cost the NHS in England more than £600 million in 2004-05 – around 1% of its total budget. There are currently close to 21,000 people on dialysis. The number rises by about 5% annually – costing an additional £24 million.
• The average cost of dialysis is £30,800 per patient per year.
• The indicative cost of a kidney transplant (including induction therapy but excluding NHSBT costs) is £17,000 per patient per transplant.
• The immuno-suppression required by a patient with a transplant costs £5,000 per patient per year.
• Kidney transplantation leads to a cost benefit in the second and subsequent years of £25,800 pa.
• The cost benefit of kidney transplantation compared to dialysis over a period of ten years (the median graft survival time) is £241,000 or £24,100 per year for each year that the patient has a functioning transplanted kidney.
• Black people are three times as likely as the general population to develop kidney failure.
• The need for organs in the Asian community is three to four times higher than that of the white community. This is because conditions such as diabetes and heart disease – that can result in organ failure – occur more often in the Asian population.
• The number of living donor kidney transplants has more than quadrupled in the last 10 years and now account for one in nearly three of all kidney transplants.
• The oldest solid organ donor ever recorded in the UK was 84.
• The oldest recorded cornea donor was 104.
• The oldest recorded recipient of an organ in the UK was an 85-year-old kidney patient.
• The oldest recipient of a cornea transplant in the UK was 104.
• Surgical techniques, such as splitting livers, have meant that a donor can help more patients than ever before.
• Repeated surveys show that the majority of the public support organ donation. The last survey conducted in 2003 for UK Transplant showed that 90% of people support organ donation.
• All the major religions support organ donation and many actively promote it.
• 30% of people on the NHS Organ Donor Register are aged between 16 and 25 when they join. A further 24% are aged between 26 and 35. 9% are 65 or over when they join.
• More women (54%) than men (46%) have signed up on the NHS Organ Donor Register.

Transplantation milestones

1902

Alexis Carrel demonstrates method of joining blood vessels to make organ transplant feasible

1905

First reported cornea transplant takes place Olmutz, Moravia (now Czech Republic) in December 1905

1918

Blood transfusion becomes established

1948

Foundation of the National Health Service

1954

First successful kidney transplant operation performed in Boston, USA

1960

First UK living donor kidney transplant, performed at Edinburgh

1963

First liver transplant in Denver, USA

1965

First kidney transplant in UK using organ from a dead person*

1967

First heart transplant operation performed by Dr Christiaan Barnard in South Africa

1968

First heart transplant in UK

1968

First UK liver transplant, performed at Addenbrooke’s, Cambridge

1968

National Tissue Typing and Reference Laboratory (NTTRL) established at Southmead Hospital, Bristol

1971

Kidney donor card introduced in the UK

1972

National Organ Matching and Distribution Service (NOMDS) founded in Bristol

1979

NTTRL and NOMDS merge to become UK Transplant Service

1979

UK heart transplant programme begins

1980s

First transplant co-ordinators appointed

1981

UK kidney donor card changed to multi-organ card including kidneys, corneas, heart, liver, and pancreas

1983

UK liver transplant programme begins

1983

Launch of the UK Cornea Transplant Service (CTS)

1983

First combined heart and lung transplant in the UK

1985

Lungs added to the UK donor card

1986

First lung-only transplant in the UK

1986

Establishment of the Bristol Eye Bank

1987

First “domino” UK heart transplant, where a patient receiving a heart and lungs transplant donates their healthy heart to another

1989

Establishment of the Manchester Eye Bank

1991

UK Transplant Service becomes special health authority and is renamed United Kingdom Transplant Support Service Authority (UKTSSA)

1993

UKTSSA moves to purpose-built accommodation at Stoke Gifford, Bristol

1994

NHS Organ Donor Register established

1994

First living donor liver transplant in UK

1995

First living donor lung lobe transplant in UK

2000

UK Transplant takes over from UKTSSA with new, extended remit

2001

First lung transplant from a non-heartbeating donor

2005

UK Transplant merges with National Blood Service to form NHS Blood & Transplant

2005

First partial face transplant carried out in France on 27 November

2006

Introduction of the Human Tissue Acts 2004 in England Wales and Northern Ireland, and the Human Tissue (Scotland) Act 2006.

2007

July – UK’s first living donor paired kidney transplants and first altruistic non-directed living donor transplant.

2008

January – The Organ Donation Taskforce report was published containing 14 recommendations for increasing the UK’s rate of organ donation by 50% within five years, resulting in an additional 1,200 transplants a year.

November – The Organ Donation Taskforce’s report into the issue of presumed consent, recommends against adoption of an opt out system.

* Earliest recorded by UK Transplant

 

Transplants save lives

• Professor Sir Magdi Yacoub described transplantation as “one of the great success stories of the latter half of the 20th century”.
• Surgeons have been saving the lives of dying people through transplantation for more than 50 years.
• The first successful transplant was of a cornea on 7 December 1905 in what is now the Czech Republic.
• The first major organ transplant success involved the donation of a kidney between living twins in Boston, USA, on 23 December 1954.
• The first heart transplant was performed in South Africa in 1967, by Dr Christiaan Barnard.
• Transplants are vital operations and their success depends entirely on the generosity of donors and their families who make this life-saving gift.
• The UK’s NHS Organ Donor Register was launched in October 1994 and by April 2010 included the names of over 17.1 million people who had pledged to donate their organs for transplant after their death.

Waiting and hoping

• More than 10,500 people need an organ transplant in the UK.
• Last year (2009-10) a record 3,709 people’s lives were transformed by a transplant. More than one in four of all transplants are from living donors.
• Transplants are now so successful that many more patients can be considered for treatment in this way.
• Advances in surgical skills and better drugs mean that a year after surgery:
• 96% of kidneys in living donor transplants
• 93% of kidneys from people who have died
• 91% of liver transplants
• 83% of heart transplants
• 79% of lung transplants
• are still functioning well. These figures are improving all the time.
• The median (average) waiting time for an adult kidney transplant is 1,110 days. Children, who are prioritised in the matching sequence, wait on average 277 days.
• Adults wait an average of 184 days for a heart and 519 for a lung. Children wait an average of 93 days for a heart.
• Adults wait an average of 149 days for a liver transplant, while children wait an average of 86 days.
• About 1,000 people die every year in the UK while waiting for an organ transplant or because they become too ill to survive an operation and are removed from the list.

Between 1 April 2009 and 31 March 2010:

• 3,709 organ transplants were carried out, thanks to the generosity of 2,021 donors.
• 2,739 patients’ lives were dramatically improved by a kidney or pancreas transplant, 160 of whom received a combined kidney/pancreas transplant.
• 978 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney, liver/pancreas or heart/kidney transplant.
• A further 3,099 people had their sight restored through a cornea transplant.
• Organs from 959 deceased donors were used in the UK to provide 2,647 transplants.
• A record number of 552 non-heartbeating donor kidney transplants took place and accounted for one in five of all kidney transplants.
• A record number of 99 non-heartbeating donor liver transplants took place, a 24% increase on 2008-09.
• Nearly one in four (more than 24%) of liver transplant recipients were aged 60 or over, while patients aged under six received over 8% of liver transplants.
• 33% of heart transplants were given to patients under 18, while patients over 60 received 6% of all heart transplants.
• Patients with cystic fibrosis or fibrosing lung disease received 40% of combined heart/lung and lung-only transplants.
• More than one in six kidney transplants, including living donor transplants, were received by people of minority ethnic origin in the UK.
• Living donor kidney transplants are increasing – 475 in 2004-05, 589 in 2005-06, 690 in 2006-07, 831 in 2007-08, 927 in 2008-09 and 1,038 in 2009-10 – and now represent more than one in three of all kidney transplants.
• 16 living donors gave a kidney altruistically to unknown recipients.
• 32 living donors gave kidneys that were used in ‘paired’ transplants.
• 23% of living kidney donations in the UK were parent to child and 27% were sibling to sibling.

Last updated September 2010

 

Cost-effectiveness of transplantation

• Kidney transplantation is highly cost-effective, particularly in relation to NHS spend, and is the treatment of choice for many patients with end-stage renal failure.
• The indicative cost of maintaining a patient with end-stage renal failure on renal replacement therapy (dialysis) is £17,500 per patient per year for a patient on peritoneal dialysis and £35,000 per patient per year for a patient on hospital haemodialysis.
• There are over 37,800 patients with end-stage renal failure in the UK. Nearly 21,000 are on dialysis, whilst the remainder have a transplant. Of those on dialysis, 76% are on haemodialysis and 24% on peritoneal dialysis.
• The average cost of dialysis is £30,800 per patient per year.
• 3% of the NHS budget is spent on kidney failure services.
• The indicative cost of a kidney transplant (including induction therapy but excluding NHSBT costs) is £17,000 per patient per transplant.
• The immuno-suppression required by a patient with a transplant costs £5,000 per patient per year.
• Kidney transplantation leads to a cost benefit in the second and subsequent years of £25,800 pa.
• The cost benefit of kidney transplantation compared to dialysis over a period of ten years (the median transplant survival time) is £241,000 or £24,100 per year for each year that the patient has a functioning transplanted kidney.
• In 2008-09, 2,497 people received a kidney transplant. These transplants are now saving the NHS £50.3m in dialysis costs each year for every year that the kidney functions.
• In 2008-09, 215 more kidney transplants were provided than in the previous year. These transplants are now saving the NHS £4.5m every year until graft failure.
• At the end of March 2009, the UK Transplant Registry had records of over 23,000 people in the United Kingdom with a functioning kidney transplant. In this year, these patients will save the NHS over £512m in the dialysis costs that they would need if they did not have a functioning kidney transplant.
• On 1 April 2009 there were 6,920 patients waiting for a transplant of which the majority will be on dialysis, costing around £193m per year. If all of these patients received a transplant, the approximate cost would be £41m per year, which represents a saving to the NHS of £152m per year.

You can find out more about organ donation and join the NHS Organ Donor Register by calling 0300 123 23 23 or visiting the NHSBT website www.organdonation.nhs.uk

References and notes: many figures are approximate. In particular, data on the costs of dialysis, transplantation and immuno-suppression can differ quite markedly between patients.

1. Economic evaluation of end-stage renal disease treatment. G Ardine de Wit, P Ramsteijn and F de Charro, Health Policy 44, 1998, pp215-232.
2. UK Renal Registry.
3. UK Renal Registry, Eighth Annual Report December 2005.
4. A weighted average of the cost of dialysis based on 76% of patients receiving haemodialysis.
5. Estimated tariff for renal transplantation in England (to be updated later in 2009)
6. Based on NICE assessment of the clinical and cost effectiveness of home and    hospital haemodialysis for patients with end stage renal failure, 2004.
7. NHSBT – Organ Donation & Transplantation, based on adult cadaveric kidney-only graft recipients of    transplants carried out in 1992-1994.
8. NHSBT – Organ Donation & Transplantation, Activity Report 2008-2009.
9. NHSBT – Organ Donation & Transplantation.
10. NHSBT – Organ Donation & Transplantation, based on number of patients in the UK with a functioning kidney transplant, who have not been lost to follow-up or have died, and whose last assessment date was after January 2005.
11. Based on the cost of a transplant and ten years of immuno-suppression, averaged over ten years.