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Issue 43 / March 2015

Welcome to this issue of the HTA's Independent Assessor bulletin.

Contents

Revised guidance to Transplant Teams and Independent Assessors


As you are aware our Guidance to transplant teams and Independent Assessors was revised in June of last year, primarily to address the ‘quick wins’ that came as a result of the IA survey, discussions and feedback at the IA Conference in March 2014. The Living Donation Assessment Team has now undertaken a more detailed review and we would like to draw your attention to the more substantive changes below.   
This new guidance contains key updates and new information on the following areas:
  • Information on trafficking and guidance for units (Pages 22–23): We remain aware of the need to offer advice and guidance to IAs and clinical teams on this issue. This includes a definition of trafficking and the signs the clinical community should look out for. Please be reminded that it is crucial that you inform the HTA when cases fall away during the work up process (prior to referral to the IA) due to concerns about issues including duress, coercion, and reward.
  • Evidence of relationship (Pages 25-27): Clarity has been provided in terms of the evidence of relationship that donors and recipients could and should provide in each type of case.
  • Inconsistency in donor and recipient interviews (Para 147): Advice for IAs on how to explore further when faced with situations where donor and recipient accounts of relevant facts do not match.  
  • General guidance annex (Pages 54-57): An annex has been added specifically to advise IAs on interview techniques and to provide report writing guidance. This includes an explanation about why we require the information that we ask for, alongside some helpful examples.
Please read the new Guidance to transplant teams and Independent Assessors here and disregard any previous versions you may have.

The Council of Europe convention against trafficking in human organs


This Convention was adopted by the Committee of Ministers on 9 July 2014 and was opened for signature on 25 March 2015 at the Conference on the fight against Trafficking in Human Organs, held in Santiago de Compestela, Spain. The aims of the Convention are to:
  • prevent and combat the trafficking in human organs by providing for the criminalisation of certain acts;
  • protect the rights of victims of the offences established in accordance with this Convention;  
  • facilitate co-operation at national and international levels on action against the trafficking in human organs.
The UK has signed the convention along with countries such as Poland, Belgium, Norway, Moldova, Albania and Greece. 
Daniel Pruce, Deputy Head of Mission at the British Embassy Madrid signs the Convention Against Human Organ Trafficking.

Referral letters and donor declarations


Please ensure all referral letters and donor declaration forms are sent to the HTA as soon as possible after the Independent Assessment has taken place. Ideally these should be scanned and uploaded at the same time as the report is submitted online, as this is the most secure method available and means the HTA has as much information as possible when considering each case. This is particularly important for cases which need to be referred to Panel as Panel Members have confirmed that they will require these documents before making a decision on each case.

Duress, coercion and reward


Please ensure you include full details of your discussions with both the donor and recipient on duress, coercion and reward. We are unable to provide statutory approval if this information is not provided and also means that we need to seek more information from IAs. As always, please feel free to contact the Living Donation Assessment Team at if you have any questions.

Social media advertising for donors


There continues to be a number of patients sharing their stories or seeking donors using social media sites. We are aware this presents a number of logistical difficulties for units, not least how to manage large volumes of calls. Lisa Burnapp, Lead Nurse for Living Donation at NHS Blood and Transplant (NHSBT), has agreed to work with units and look at extending the existing guidance to agree and share best practice for these circumstances. In the meantime please continue to refer to the British Transplant Society social media guidance for information.

Transplantation Advisory Group meeting


This meeting takes place twice a year and is used as a forum for the discussion of issues arising in living and deceased organ donation, including new policy issues and emerging novel areas in transplantation, identification of revisions required to current HTA policies and  discussion on the complex ethical issues in transplantation.

This month the meeting took place on the 17 March and the minutes will soon be available here

National Living Donor Kidney Sharing Schemes (NLDKSS)


As you may be aware NHS Blood and Transplant (NHSBT) have recently made changes to the NLDKSS to increase the number of recipients benefiting altruistic donor chains. The following changes will be put in place for the next (April) matching run:
  • An increase in the length of Altruistic donor chains to include 2 pairs.
  • A more flexible approach to the simultaneous nature of the surgeries within the defined period summarised below. However, the aim is to only stagger surgeries that can’t take place simultaneously in order to prevent unnecessary delays for matched donors and recipients
  • A 2 week period within 8 weeks of the matching run where all identified transplants will take place. This will help to encourage more non-directed altruistic donors to enter a chain by ensuring a more defined time period for their donation.
The above changes do not create any differences to how IAs submit reports to the HTA. Please do not hesitate to contact the LDAT for more information 

HTA's new website and newsletter


In 2014 the HTA invested in a newly designed website as part of our ongoing commitment to enhance the quality, accessibility and transparency of the information we provide. We launched the new website in February alongside a redesigned e-newsletter. Read more about the features of the website here

HTA annual review event


Registration is now open for the HTA’s annual review event 2015. Please find more information, including the registration form here. It is 10 years since the HTA was established and this year's annual review will be a chance to look back at some of the work we have done to ensure tissue and organs are used safely, ethically and with proper consent. We will also look ahead to the next 10 years and discuss some of the upcoming challenges we face. We are looking for thoughts, stories, quotes, pictures etc from people that have worked with us over the years, sharing some of your experiences of the HTA and our work. Please share your thoughts here.

Stats and facts

 
Month   Directed kidney   Directed altruistic kidney   Non-directed altruistic kidney   Paired or pooled kidney   Directed liver lobe
Jan 15   82   0   12   3   4
Feb 15   74   1   7   10   1
Total   156   1   17   13   5

 

Month   Number of cases considered   Approvals by the Living Donation Assessment Team   Approvals by Authority panels
Jan 15   101   86   15
Feb 15   92   76   16
Total   193   162   31

Living Donor Assessment Team members and HTA contact details


We have two new team members, Catherine Cullen and Amy Gelsthorpe-Hill, who will be assessing cases as part of the Living Donation Assessment Team. 

HTA team members

Katy Tinker, Living Donation Officer,
Handles enquiries from IAs and Transplant Coordinators and the management of cases and assessment of cases that can be considered by the LDAT Jessica Porter, Living Donation Manager
Responsibility for the day to day management of the living donation system and the LDAT

Allan Marriott-Smith, Director of Strategy and Quality
Senior lead on the HTA’s statutory role in living organ donation across the UK

Courtney Pires, Living Donation Officer
Overseeing HTA panel cases and assisting the team with the assessment of cases.

Betty Lamport, Amy Gelsthorpe-Hill, Catherine Cullen    
Assist the team with the assessment of cases that can be considered by the LDAT.
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