NICE guidance on organ donation

 NICE’s first guideline on organ donation seeks to address the shortage of organs by improving the rate of potential donors identified. It also aims to increase organs available by improving consent rates from people close to patients that are potential donors, and who have been declared dead after the brainstem has stopped functioning, or whose death has been confirmed after cardiac death. The guideline recommends that organ donation should be considered as a usual part of end-life-care planning. Furthermore, each hospital should have systems in place, consistent with the recommendations, to identify potential donors and manage the process for consent. Patients who are potentially suitable donors should be identified as early as possible based on two possible criteria. The first is defined clinical trigger factors, which indicate a high likelihood of brainstem death, in patients who have had a catastrophic brain injury. The second is the intention to withdraw lifesustaining treatment in patients with a lifethreatening or limiting condition which will, or is expected to, result in circulatory death. If the patient is able to make their own decisions, the healthcare team should seek their views on organ donation and consent. If the patient is close to death and unable to make their own decisions on consent, the healthcare team should determine whether taking steps before death to help organ donation would be in the patient’s best interests. This can be done by considering the patient’s known wishes and feelings, asking people close to the patient what their thoughts and wishes are, checking whether the patient is on the organ register, and whether they left an advance statement. Those close to the patient should be approached in a setting suitable for private and compassionate discussion, and they should be given sufficient time to consider the information.