‘Missed opportunities’ for organ donation identified in Irish hospitals

There were 10 cases of “potential missed opportunities” for organ donation in six Irish hospitals over a four month period, a new study has found.

On Thursday, the National Office of Clinical Audit published the Potential Donor Audit Development (PDA) project report.

This project was commissioned by Organ Donation Transplant Ireland to develop a national clinical audit of organ donation practices in Ireland.

During the development project, data was collected on a pilot basis in six hospital intensive care units between November 2022 and February 2023.

Your top stories on Thursday

---

Is there an alternative to banning children from social media?

---

Newton Emerson: Northern Ireland is already a ‘sanctuary city’ in the UK – it could yet become one in Europe

---

Karlin Lillington: Eurovision saw a collision of vintage operating systems and trashy Europop

---

The project found that 10 per cent of people who died in ICU during this period (23 of 231) died in circumstances where organ donation might have been possible.

Of these eligible organ donors, 13 went on to become organ donors. Three of patients could not donate their organs due to medical events.

For the 10 patients who did not become organ donors, there were a variety of reasons why donation did not occur.

These include the patient dying before an approach was made to the family or the patient was not expected to die within the timeframe required for organ donation; the patient did not want to become an organ donor; a reluctance to approach the family as well as the family being dissatisfied with patient care or being uncomfortable with the organ donation process.

The project makes four recommendations, including implementing the PDA in all acute hospitals with ICUs or emergency departments, provide an agreed list of contraindications that can support PDA, inform a set of national guidelines for organ donation and develop a quality improvement forum.

Dr Alan Gaffney, clinical lead for the Potential Donor Audit Development Project, said organ donation “happens because of the generosity of people who die in our ICUs”.

Within the study, Dr Gaffney said there were five cases where “ideal organ donation processes were not followed”.

“While there is no guarantee that following ideal processes would have resulted in more donors, two to three of these cases might have resulted in donation had ideal processes been followed,” he said.

“This audit shows how well the process is working in our ICUs but also identifies areas for improvement. Organ donation is such a rare event that any missed opportunity needs to be identified and learned from.”

Martina Goggin, public and patient interest representative, said: “As the parent of an organ donor, and knowing the consolation and comfort organ donation can give to a donor family, I feel it is so important that potential donors are always identified and given the opportunity to consider organ donation.”

“The implementation of the findings of this very comprehensive report should help minimise missed opportunities and increase the number of organ donors in our Irish hospitals,” she said.

Last November, the Government approved legislation which will see everyone regarded as organ donors unless they “opt out” of the system.

This legislation for the first time provides a statutory framework for organ donation and transplant services.