Misinformation around novel transplants

Dear colleagues,

We understand there have been some misunderstandings around the process of organ donation in the current system and once the new change in the law comes in to play in spring 2020.

A lot of this misinformation is around the novel and rare transplants, so here are some facts to help clarify any misunderstanding there may be in this area.

At the moment in the UK, there is a limb transplant programme, but the face and uterus transplant programmes have not yet been introduced. 

The current system of ‘opting in’ to donate does not cover rare or novel transplants such as limb, face or uterus donation.  A person’s family would have to give explicit permission before their loved one’s limb, face or uterus could be donated.  

It is the Government’s intention to maintain the status quo for novel transplants even after the opt-out system is introduced, so express consent will be required for donation of that organ or tissue to go ahead.  

It has always been the Government’s intention that the opt-out system will only include routine transplants. 

Below is a step by step clarification on the rules around the donation of each of the organs or tissues that are often discussed when talking about novel transplants:

• Arm/Leg; There is an established limb transplant programme in the UK. Due to the very low number of transplants required, donors are from a limited number of hospitals in the north of England. The family of potential limb donors are approached to express consent before any donation can go ahead.

• Uterus; This form of donation already occurs in other countries, and the UK is being thoroughly evaluated to explore whether this form of donation and transplantation could be established here. This would be a novel form of donation and express consent from the family would be required before any donation could go ahead. The criteria for uterus donation would mean the recipients of any donated uterus would be biologically female. There are no plans for transplantation of reproductive organs into transsexuals.

• Face; We are in the process of establishing a face transplant programme in the UK. Similarly, with uterus transplantation, this is building on successful programmes elsewhere in the world. If this was to be implemented in the UK, as it is in other countries, express consent from the family would be required before any donation could go ahead.

• Brain; There are no plans for any form of brain transplantation in the UK and there is no evidence anywhere in the world that this form of transplantation is even possible for successful transplantation. Should this ever be a possibility, express consent would be required from the family.

• Testicles, Penis or spinal cord: There are no plans for any form of donation or transplantation involving the penis, testicles or spinal cord in the UK. Should such programmes ever be considered, it would need to be thoroughly evaluated to understand how effective it would be before considering if these types of the transplant would be successful and offered as a formal treatment option. Express consent from the family would then be required before any donation could go ahead.

During the family consent process, relatives are given full details of any potential use of any donated organ or tissue. This would include whether, for example, that organ or tissue might be stored, used in research involving animals/ commercial/ genetics or the type of recipient who may receive the donated organ or tissue.

If the family is unwilling to donate for certain research purposes, then this is noted, and the donated organ or tissue is only allocated to research studies that fall within the remit of what they have consented to.

Any organs and tissues donated for transplant must be consented to unconditionally and allocated by the NHS in line with nationally agreed criteria. If the family have any concerns or objections about the potential type of recipients of those organs or tissue, then the donation would not proceed.

 

Kind Regards