living-donor transplants leaflet (amended final)

7/28/2019 Living-Donor Transplants Leaflet (Amended Final)

1/10

Human Tissue AuthorityInformation about living-donor transplants


2/10

Information about

living-donor transplants

Most organs for transplants are donated frompeople who have died, but every year, moreand more people receive organs from living

donors. This leaflet provides information ifyou are considering a living-donor transplant.It gives details about:

the law around living-donor transplants(the Human Tissue Act 2004 and theHuman Tissue (Scotland) Act 2006)and the role of the organisation whichregulates these transplants (the HumanTissue Authority);

the assessment process that the donorand the person who needs the transplant(the recipient) need to go through beforethey can go ahead with the transplant;

who can become a living donor; and

how to give valid consent (or permission)to donating or receiving a vital organ(for example, a kidney or part of a liver).

It is important that you read this leaflet,together with all of the other informationthat you receive. That way, you will be fullyinformed about what is involved for boththe living donor and the person who receivesthe organ.

1


3/10

What is the Human Tissue Authority?

After consulting the public, the Governmentupdated the law relating to transplants.The new law called the Human Tissue Act

(HT Act) reflects improvements in goodpractice and makes sure that people knowhow to give appropriate consent fortransplants.

We, the Human Tissue Authority, were set upto provide advice and guidance about the HTAct and to make sure that people follow it.We aim to support patients, families andprofessionals in this area by increasing

confidence in the systems we put in place.We are made up of both lay members(members without a professional interest)and professional members, including a seniortransplant specialist.

As part of the new law, we will need toapprove all transplant operations involvingliving donors following an independentassessment. This will be the case whetherthe donor is related or unrelated to theperson who receives it.

2


4/10

Why living-donor transplants?

Organ failure develops when vital organssuch as the kidneys, heart, lungs, liver orpancreas fail and cause life-threatening

illnesses. Many people with organ failurewould choose to have a transplant, and eachyear more and more people benefit fromtransplants from living donors.

Kidneys are often donated from livingdonors, and these transplants are usually verysuccessful. In kidney donation, the risks tothe donor are small and are reduced by fullyassessing the donor before they donate their

organ. However, donating a kidney involvesmajor surgery, and this must be fullyunderstood before the operation is planned.If a transplant from a kidney donor can beplanned beforehand, this offers the bestoutcome for both the donor and the recipient,who may be able to avoid dialysis treatment.In the long-term, there is no effect on thehealth of someone who is assessed as beinghealthy and suitable to donate a kidney.

Living people do not usually donate otherorgans, but occasionally people choose todonate parts of their liver, lungs or bowel fortransplants. Donating these organs is morecomplicated and the risks to the donor mustbe considered very carefully to make surethat they are acceptable. Your local transplantcentre will be able to give you more

information about this so that you knowexactly what is involved.

3


5/10

Who can become a living donor?

The outcome of transplants betweenunrelated living kidney donors and recipientsare as successful as transplants between

donors and recipients who are related byblood (genetically related). Previously, livingdonations were to genetic relatives and topeople with close personal relationships(people who were not genetically related

but had an emotional tie with one another).The HT Act allows more flexibility in whocan donate to whom, so that more peoplecan benefit from a living-donor transplant.

The new options for living-donor transplantsare as follows.

1 A donor and recipient whose bloodgroups or tissue types are mismatched(or incompatible) can be paired withanother donor and recipient in the samesituation. This is called paired donation.Sometimes, more than two donors andtwo recipients will be involved in theswap (called pooled donation) but eachrecipient will benefit from a transplantthat they would otherwise not have had.

Paired or pooled donations have onlybeen used for kidney transplants. Donorand recipient operations are planned tohappen at the same time so that organscan be exchanged at the same time.

4


6/10

Your local transplant centre will be ableto give you more information and assesswhether you are suitable to be put

forward for paired or pooled donation.If so, your details will be put on to anational register where they can bematched to a compatible pair.

2 A living person who has never met thepossible recipient may be considered tobecome a donor. This is called non-directed altruistic donation.

If you want to donate an organ, usually akidney, to an unknown recipient, you needto contact your local transplant centre soyou can be assessed. If you are assessedas a suitable donor and are still willing togo ahead, your name will be put forwardto a national allocation scheme and thenmatched to a suitable person. This worksin the same way that organs from peoplewho have died are matched to patients onthe waiting list.

There are special considerations to be takeninto account for paired or pooled donationand non-directed altruistic donation, as theseare very different from the usual living-donortransplants, where the donor and recipientknow each other. It is important that thedonor and recipient stay anonymous, and

that confidentiality is respected.

5


7/10

Assessment and consent:

what is involved?

Before a living-donor transplant can takeplace, the donor and recipient must bethoroughly assessed to make sure that it is

safe and suitable for both people. This includesmedical testing, compatibility checks anddiscussions about the risks and benefits of theprocedure. The assessment makes sure thatthe donor and recipient can give full consent,

on the basis of the best information available.

Wherever possible, the donor and recipientwill have their own consultant who isresponsible for their welfare. Other members

of the healthcare team will also be involvedin assessing the donor and the recipient. Boththe donor and the recipient are completelyfree to withdraw from the procedure at anytime during the assessment period, and upuntil the time of surgery.

All donors and recipients need to see a localIndependent Assessor (IA) who can recommendthat we give our approval for the transplantoperation to go ahead. The IA acts as ourrepresentative and is independent of thehealthcare teams who have responsibilityfor the donor and recipient.

The IA will interview the donor and recipientboth together and separately, and then write

What is the independentassessment process?

6


8/10

a report. This is to make sure that the donorand recipient have been thoroughly assessedand understand what is involved in giving

and receiving an organ. The IA must besatisfied that the donor is not under anypressure to donate and can give theirconsent freely and voluntarily. In particular,the IA will make a judgement about the

nature of the relationship between the donorand the recipient, and the motivation for thedonation. The IA must make sure that it is alegitimate relationship and that there is nofinancial or other incentive. When a child is

the potential recipient, the adult who agreesto the transplant on behalf of the child willaccompany them at the interviews.

The IA will ask both the donor and therecipient to provide documents that supportthe nature of their relationship. The type ofevidence that is needed will vary accordingto the nature of the relationship, and thetransplant centre will advise on this.

For transplants where the donor and recipientknow one another, the IA can recommendthat we give our approval for the transplantto go ahead once we are satisfied that theconditions for donation have been met. In theunlikely event that the IA cannot recommendwe give our approval for a transplant to goahead, the case will be referred to a panel

of our members for consideration. In theextremely rare case that a child is considered

7


9/10

as a possible living donor, this will also bereferred to us.

In the case of paired or pooled donation andnon-directed altruistic donation, once the IAhas made a local assessment they will applyto a panel of our members for approval forthe transplant to go ahead.

The independent assessment process is notneeded when an organ is removed as part ofmedical treatment and the patient is willingto become a living donor. An example of this

is when a heart is removed so the patient canreceive a heart and lung transplant, and theremoved heart is then used for a transplant.In this situation, the person who receives thedonated heart will be identified once it hasbeen removed. This is called non-directeddomino donation.

Note

It is a criminal offence to carry out atransplant operation between two livingpeople if the conditions of the HT Act arenot met. This includes valid consent beinggiven by the donor and recipient. It is also anoffence to be involved in any buying or sellingof human organs, or in advertising the buyingor selling of human organs. The penalty for

these offences is a prison sentence of up tothree years, or a fine, or both.

8


10/10

More information

This leaflet is a guide only. For moreinformation about us or the HT Act,visit www.hta.gov.uk or contact:

Human Tissue AuthorityFinlaison House1517 Furnival Street

London EC4A 1AB

Tel 020 7211 3400Fax 020 7211 3430Email [email protected]

This leaflet is available on our website in Welsh,Urdu, Gujarati, Punjabi, Hindi and Bengali.

Published in June 2006.Copyright: Human Tissue Authority

living-donor transplants leaflet (amended final)

Documents