October 15 2013 The Current State of Organ Donation and Transplantation Thomas A Nakagawa MD FAAP FCCM Professor and Section Head Pediatric Critical Care Medicine Director Pediatric Critical Care ID: 684298
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Slide1
The Donation & Transplantation SymposiumOctober 15, 2013Slide2
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 CarolinaSlide3
We have achieved and sustained a 75% conversion rate nationallyWe continue to transplant
more organs annually
We continue to engage more partners to save more livesWe have continued to increase organ recovery from donors following circulatory determination of death CELEBRATING OUR SUSTAINED SUCCESS Slide4
(OPTN Data, September 2013)Slide5
Conversion Rate
2009 – 2012 (
Jan-Dec)Slide6
Organs Transplanted
P
er Donor
Adults
3.09
Pediatrics
4.06
All donors
3.08
-DCDD donors-Slide7
Organ Donors, Organs Transplanted &
OTPD
2006 vs. 2013 (Jan-Aug)Slide8
C
ontinued
Growth of DCDD
UNOS. OPTN data. 2013, Pediatrics patients < 18 years of age
Adult DCDD donors
Pediatric DCDD donors
2006 645 adult 77 pediatric
2007
793 adult
66 pediatric
2008 847
adult
73 pediatric
2009
747 adult
81 pediatric
2010 939 adult 72 pediatric
2011 1053 adult 115 pediatric
2012 1102 adult 124 pediatricSlide9
(OPTN Data, September 2013)Slide10
DCD
Donors
2009 – 2012 (Jan-Dec)Slide11
G
rowing
National Organ Transplant WaitlistSlide12
120,188 people are currently on the national waiting list. 16, 669 organ transplants have been performed from 8,215 donors*
through July 20133,450 people have died waiting for a needed organ*2,973 people were removed from the waiting list because they became too sick to transplant*
Current State of
Organ
D
onation & Transplantation
www.UNOS.org
. Data obtained October 14, 2013
*
Data through July 2013Slide13
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 20133,450 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
Facts About the Current State of
Organ Donation and Transplantation
www.UNOS.org
. Data obtained October 14, 2013
*
Data through July 2013Slide14Slide15
A National
I
ssue That C
ontinues to Escalate
October 23, 2012
G
rowing 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
*
OPTN data accessed October 14, 2013
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 childrenSlide16
An average of 18 people die every day in the US waiting for a needed organAlthough 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 transplantIn California, an average of 3 people die everyday waiting for a needed organ
Waiting for an Organ
That Never CameSlide17
*
OPTN data. Accessed
October 14, 2013
www.OPTN.org
575
deaths through
June 2013
2012: 1,109
people died waiting for a needed
organ transplant
California DataSlide18
The Solution:
Recover more organs
for transplantationSlide19
Reducing the Number of Deaths
Among Those
Waiting for a TransplantTransplant 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
M
ore time on the waiting list
Education programs to help keep people off the waitlistSlide20
Ensure we never miss opportunities for donationPreserve the option of donation for every person and their family facing end-of-life issuesEducation
Healthcare professionals
PublicDonor registriesRecovering More Organs for TransplantSlide21
Donor Designation in the
U.S.
108,963,103
as of 12/31/12Slide22
108,963,103 designated donors nationwide24 states have signed up more than 2 million designated donors
In
31 states, donor designation share is at least 50% of the adult populationThe number of donor designations increased 7.5% over the last 12 monthsSummary: Donor Designations,
Q4 2012Slide23
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 registriesDonor designation rate increased year-over-year
in 16 of 28 states reporting
Donor Designation Highlights – Q4 2012Slide24
Impact on Donation, 2007-2012
Designated
Donors Among Recovered Donors Slide25
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 populationThis process of donation relies on collaboration between the critical care team and the OPO to optimize organ recovery for transplantationDonation is a ProcessSlide26
Donation is more than
just a question
Donation is a conversationSlide27
Identification of the potential donorDeclaration of death in a timely mannerConsent from the family
Management of the donor
Recovery of organs and tissuesSuccess in Maximizing O
rgan
R
ecoverySlide28
Tissue Donors
2009 compared to 2013
(Jan-Aug) Slide29
Be openListen, learn, and teach othersBe bold: Share your thoughts and experiences
Focus on what we can do, not what we can
’t doDetermine what we as a community of health care professionals can do to decrease and eventually eliminate deaths on the waiting listBold RequestSlide30
"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