saving and improving lives

Saving lives togetherAn Overview

Saving and improving LiveS

www.nhsbt.nhs.uk

2 Saving and Improving LivesAn Overview 3

Contents Welcome ....................................................................................... 3

Blood donation .............................................................................. 4

Safe blood for patients ................................................................... 6

Organ donation and transplantation .............................................. 8

Tissues ...........................................................................................10

Stem cells ......................................................................................12

Research ........................................................................................14

How you can help ..........................................................................16

WelcomeNHS Blood and Transplant (NHSBT) is a Special Health Authority, dedicated to saving and improving lives through the wide range of services we provide to the NHS.

Our challenge is to supply enough safe blood to hospitals in England and North Wales and provide tissues and solid organs to hospitals across the UK. And we can’t do it alone. Each year our donors give around two million donations of blood and 3,500 organs, saving and transforming countless lives.

Our remit also extends beyond the vital task of safeguarding the blood supply and increasing the number of donated organs. The following pages provide a glimpse of the scope of our work, our donors, the patients we serve, and how you can be a part of saving lives through donation. For more information, please visit www.nhsbt.nhs.uk.

Lynda Hamlyn Chief Executive

Bill FullagarChairman

FRONT COVER IMAGE

Nisa Karia, was diagnosed with thalassaemia major when she was just five months old. This rare blood disorder means that she cannot produce normal haemoglobin for her red blood cells and so she relies on donated blood to survive.

Shohanna was born in 1998 without a bile duct, a condition called biliary atresia, which meant her liver couldn’t work properly and poisons were building up in her system. When Shohanna was two-and-a-half, her health deteriorated and she joined the transplant waiting list. She was lucky enough to receive the smaller lobe of a liver through a split liver transplant about a week later. She is now happy and healthy.

4 Saving and Improving LivesAn Overview 5For more information about becoming a blood donor, please visit www.blood.co.uk

Blood donation

We need to collect around two million donations of blood a year to help save the lives of patients in England and North Wales.

At present, we have around 1.4 million registered blood donors. Our aim is to provide them with an efficient service, allowing them to give blood as part of a busy life. To help achieve this, we have 24 blood donation centres across the country, and more than 100 blood collection teams running sessions in the community.

Platelet donor who finds time to give blood in a busy working life

Our challenge:

• Collect two million blood donations every year

• Organise 29,000 blood donation sessions a year

• Recruit 250,000 new blood donors each year

Donor and donor carer in a donor centre.

6 Saving and Improving LivesAn Overview 7For more information about becoming a blood donor, please visit www.blood.co.uk

Once donated blood has been processed and tested, it is distributed to the NHS through a network of 15 stock holding units throughout England and North Wales. These units supply hospitals with blood when it is needed.

Red cells last only 35 days, and platelets just five days, so a regular supply of blood is vital.

Safe blood for patients

Our challenge:

• Ensure a sufficient supply of red cells, blood components and specialist services to 300 hospitals across England and North Wales

• Provide hospitals with expert scientific support, making blood transfusions safer for patients

• Help hospitals to use donated blood as effectively as possible

Over 99% of the blood we collect is processed into components: red cells, platelets and plasma. Donated blood is also checked for blood group, and tested for infectious diseases such as HIV, hepatitis B and C, Human t-cell lymphotrophic virus (HTLV), and syphilis.

Year

0

10000

20000

30000

40000

50000

60000

70000

20092008200720062005

53795

3938437372

43444

52296

Daily Stock Average – 1 April 2005-31 March 2009

Daily Stock Average

In 2009 we opened the world’s largest blood centre in Filton, near Bristol. The centre processes and distributes 600,000 units of donated blood every year for patients in 90 hospitals across the Midlands and the South-West. Operating 24 hours a day, seven days a week, it uses cutting-edge technology in blood filtration, conveyor and storage systems. The testing laboratory, which is the largest in the UK, tests close to 1,000,000 donations every year.

We aim to have five to seven days blood stock available for hospitals. Thanks to the support of our donors, blood stocks have been stable and sufficient for many years.

8 Saving and Improving LivesAn Overview 9For more information about joining the nHS organ donor register, please visit www.organdonation.nhs.uk

We are involved in delivering a number of critical areas of work to increase the number of organs available for patients, including:

• Expanding and strengthening the network of donor transplant co-ordinators, working with hospitals to guide and support bereaved families through the donation process.

• Commissioning a UK-wide network of dedicated organ retrieval teams available 24 hours a day, working with critical care teams in hospitals to retrieve organs for transplant across the UK.

We launched a major public awareness campaign in November 2009 to encourage more people to join the Organ Donor Register and discuss their donation wishes with their families.

• Training hospital clinical leads for organ donation.

• Improving and streamlining the process of organ allocation by introducing an electronic (web-based) system.

• A UK-wide public awareness campaign, to promote organ donation to the general public.

Organ donation and transplantation

Our challenge:

• Increase the number of organs available for the 10,000 patients who currently need a transplant

• Increase the number of people on the NHS Organ Donor Register

We are responsible for matching and allocating donated organs throughout the UK. A key part of this work involves managing the NHS Organ Donor Register (ODR), a confidential database used to identify those who have indicated that they wish to donate organs or tissue after their death.

Year

0

1000

2000

3000

4000

5000

6000

7000

8000

2009-20102008-20092007-20082006-20072005-2006

764

2196

793

2385

809

2381

899

2552

958

2645

6698

72197655

7877 7980

Donors

Transplants

Transplant list

Number of deceased donors and transplants in the UK, 1 April 2005-31 March 2010, and patients on the active transplant lists at 31 March

As a result of specific and targeted action, the number of organs donated and transplants is beginning to increase.

10 Saving and Improving LivesAn Overview 11For more information about the work of our Tissue Services department, please visit http://www.nhsbt.nhs.uk/tissueservices/

We collect tissue from around 400 living and deceased donors each year. Living donors can donate tissue such as bone, which is no longer needed during surgery such as a hip replacement. People who have died can also donate tissue. Our specially trained nurses work with bereaved families to explain the process of tissue donation and how it can help patients, and gain their consent for donation.

Tissues

Our challenge:

• Issue 8,500 donations of tissue every year which meet the highest standards of quality and safety, enabling patients to have life-saving and life-enhancing surgery

We are the largest non-for-profit organisation supplying the NHS with human tissue. Tissue includes bone, skin, heart valves, arteries, tendons, and amniotic membranes. It is used to provide lifesaving and life-enhancing transplant surgery for patients.

All our donated tissue is banked in a state-of-the-art centre in Speke, near Liverpool. The site, which opened in 2005, is a purpose-built tissue bank, one of the largest in Europe, and also a major centre for research.

Nicky sustained extensive burns to his hands and face when he was electrocuted at work. He needed to be covered immediately with donated skin to help the healing process begin, and preserve as much of his own skin as possible. He says, “I cannot express the amount of gratitute I have for the families who made it possible for me to receive the donated skin, it has helped me to return to a normal life.”

12 Saving and Improving LivesAn Overview 13For more information on the work of the nHS Cord Blood Bank, please visit: http://www.nhsbt.nhs.uk/cordblood/

We also provide expert support to ensure patients receive closely matched stem cells, which can come from siblings, unrelated donors, or the patient themselves.

Our aim is to increase the number of donors available for patients, particularly those who have a lower chance of finding a matched unrelated donor. If a patient needs a stem cell transplant, 25 to 35% are lucky enough to have a brother or sister who is a match for them. If a suitable donor is not available within the family, the international stem cell registers are searched for a suitable donor.

There are around 13 million donors on the international registers, but they are mostly white Caucasian. A white patient has around a 90% chance of finding a match, whereas a patient from an ethnic minority background only has a 30 to 40% chance. For this reason, we are working to ensure all patients have the best possible chance of finding a match, regardless of their ethnic background.

We are taking action in two main areas:

• Increasing the diversity of the British Bone Marrow Registry by encouraging more people from Black and Minority Ethnic backgrounds to give blood and join the register.

• Collecting cord blood at hospitals with a high number of births in the BME population.

Stem cells Our challenge:

• Provide over 1,000 lifesaving stem cell transplants a year, for patients with diseases such as leukaemia

• Provide hospitals with expert scientific support for around 50% of stem cell transplants which take place in England

The British Bone Marrow Registry• The British Bone Marrow Registry (BBMR) holds details of around 300,000

blood donors who have volunteered to donate stem cells for patients. To do this they give a small extra sample of blood with their donation, which is ‘tissue typed’ and added to the register.

NHS Cord Blood Bank• The NHS Cord Blood Bank collects stem cells from umbilical cord blood at

five NHS hospitals. We currently have around 15,000 donations banked, which are available to any patient who needs a stem cell transplant in the UK or abroad. It is the fourth largest internationally accredited cord blood bank in the world, with the second highest percentage of rare tissue types.

We provide stem cell donors for patients having treatment for conditions such as leukaemia. Donors come from the British Bone Marrow Registry and the NHS Cord Blood Bank, which we run.

Rebecca Khan donated her cord blood following the birth of daughter Leah. Rebecca and husband Kyle’s diverse ethnic heritage of Greek and English; and Trinidadian and Scottish parents meant her donation was unique. The NHS Cord Blood Bank has the world’s second highest number of rare tissue types.

A cord blood pack.


• Generate new knowledge about blood transfusion and organ and stem cell transplantation.

• Improve the health of patients and donors.

• Improve the quality, safety and appropriate use of our products and services.

• Develop new products and services for the NHS.

• Assess new technologies developed by industry, to ensure improvements in quality and safety for patients.

Research

Using bar code technology to make blood transfusions saferWe worked with Oxford John Radcliffe Hospital to develop an award-winning bar code technology for blood transfusions. This helps identify patients, ensure they are given the right blood, and improve blood traceability in hospitals.

Finding out a baby’s blood group whilst still in the wombWe have successfully completed a research project which means a baby’s blood group can be identified whilst it is still in the womb. During pregnancy, women who are Rh D negative currently receive two injections of anti-D, an antibody derived from plasma. This prevents the baby’s red cells being destroyed by the mother’s immune system. However, anti-D injections are only needed if the baby is Rh D positive. Knowing the baby’s blood group before it is born will eventually mean only those mothers who really need anti-D actually receive it.

Using stem cells to ‘grow’ red cellsWe are examining how red blood cells develop in the bone marrow, and whether it is possible to ‘grow’ red cells in a laboratory using stem cells. If successful, this work could mean that blood could be produced in the laboratory. This would help patients for whom it is difficult to find matched donor blood, and develop new treatments for blood disorders such as sickle cell anaemia.

We run an £18.2 million national research programme, with the majority of the work conducted in partnership with universities. Our aim is to:

Our challenge:

• To invest in research, and deliver even safer and more effective treatments for patients in the future


How you can help

“The need for more donors has never been greater, with 7,000 blood donations needed daily and more than 10,000 people across the UK now needing a donated organ.” Lynda Hamlyn, Chief Executive, NHSBT.

Although the need for donors is constant, the good news is nearly everyone could do something to help. It could be a long-term commitment, like giving blood, or helping promote donation through your work. Or it could be picking up the phone, joining the NHS Organ Donor Register, and discussing your wishes with your family.

Donation is a gift – and the great thing is every single gift makes a huge difference to the patient who receives it.

For more information and to sign up to become a blood or organ donor, visit www.blood.co.uk orwww.organdonation.nhs.uk, or call the Donor Line on 0300 123 23 23. Lines are open 24 hours a day, seven days a week, every week of the year.

If you are able to help by promoting blood and organ donation through your regular contacts, such as employees, customers, or suppliers, please email [email protected]

Louisa McGregor-Smith was diagnosed with an acute heart condition at three months old. She received a heart transplant two months later and is now happy and healthy.

www.nhsbt.nhs.uk

NHS Blood and Transplant Oak House Reeds Crescent Watford Hertfordshire WD24 4QN

Tel: 01923 366829

Photo Credits

P234/0058

SGS

Foetal blood stem cells, SEM - Page 17

Foetal blood stem cells, coloured scanning electron micrograph (SEM). These cells are said to be pluripotent as they are able to differentiate into the precursor cells of any type of blood cell. The process, known as haemopoiesis, leads to the formation of red blood cells, or one of the several types of white blood cells.

STEVE GSCHMEISSNER/SCIENCE PHOTO LIBRARY

P680/0743

HTU

Ultrasound of foetus at 20 weeks - Page 17

Ultrasound scan of a human foetus at 20 weeks showing head (centre right) and abdomen (centre). At this stage the foetus measures about 20 centimetres and weighs around 500 grams and has fully developed organs, limbs, fingers and toes. This image has been taken using ultrasound scanning. This technique involves the passing of high frequency sounds through the mother’s abdomen using a transducer. The echoes are recorded to build up a picture of the foetus. It is a useful way to monitor and examine the health and growth of the foetus.

GUSTOIMAGES/SCIENCE PHOTO LIBRARY