Organ donation audit found 'missed opportunities for donation' 

Dr Catherine Motherway, clinical lead for Organ Donation Transplant Ireland. Picture: Ray Ryan

An audit of organ donation in Irish hospitals found “missed opportunities” to carry out the life-saving act and has recommended changes to increase the number of donations in hospitals.

The audit, carried out over five months between November 2022 and February of this year, found 10% of the 231 people who died in intensive care units in that time were eligible to donate organs. This percentage is in line with international experience.

However, among those 23 eligible donors, they found only 13 organs were donated and 10 failed to opt for donation.

This audit was carried out to support the move to an opt-out organ donation system. This will mean people will be assumed to be potential organ donors unless they have registered their wish not to do so.

Legislation for this change and related issues around organ storage, the Human Tissue Bill 2022, is at report stage in the Dáil, having recently been discussed by the Oireachtas health committee.

The ‘potential donor audit’ was carried out at the request of the HSE Organ Donation Transplant Ireland (ODTI) by the National Office of Clinical Audit (NOCA).

The audit identified a number of reasons why patients did not opt for donation, including a reluctance among staff to discuss this with families and families being uncomfortable with the process.

Dr Alan Gaffney, clinical lead for the project said: “Organ donation happens because of the generosity of people who die in our ICUs.” 

However, he said the audit also identified times when donation did not happen, possibly linked to processes in hospitals.

After accounting for all medical reasons why someone did not become an organ donor, 10 cases were considered as potential missed opportunities for donation."

Among those 10, they identified “five cases where ideal organ donation processes were not followed” on-site.

“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.

NOCA recommended this audit to be implemented across all hospitals, with emergency departments and intensive care units to boost awareness of where changes could be made at individual sites.

Dr Catherine Motherway, clinical lead for the ODTI, previously told the Irish Examiner this audit was vital to preparing for the opt-out approach to donations.

“It’s an absolute key in telling us how much potential there is and how much we can improve,” she said.