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Organ donation FAQs

Frequently asked questions about organ donation.

 

Living organ donation

When did the HTA start regulating living organ donation?

The HTA has been responsible for regulating living organ donation since 1 September 2006. This is when the Human Tissue Act 2004 came into force.

What is the most common organ to donate whilst a person is alive?

The most common organ donated by living people is a kidney, as a healthy person can lead a completely normal life with only one functioning kidney. It is also possible for a living person to donate part of their liver. In very rare circumstances, it may also be possible to donate a segment of a lung and also part of the small bowel.

For all forms of living donor transplantation, the risk to the donor must be considered very carefully. Before a transplant can go ahead, there must have been a very thorough process of medical assessment. As with all surgery, there is an element of risk attached.

More information on living kidney donation can be found on the Living kidney donation: Questions and Answers page of the NHSBT website.

Further information can also be found in the NHSBT leaflet ‘Could I be a living kidney donor?’   

What is paired and pooled donation?

The term 'paired donation' relates to circumstances where a donor and recipient are incompatible (or mismatched), either by blood group or by tissue type. It is possible that pairs can be matched to another couple in a similar situation, so that both people in need of a transplant receive a matched organ or part organ.

Pooled donation is where more than two pairs of donors and recipients are involved in the swap.

The HTA’s code of practice on the Donation of solid organs for transplantation gives more information on the procedures involved. The HTA regulates this type of donation, but NHSBT is the body responsible for the system that facilitates this type of donation.

All cases of paired and pooled donation are referred to a HTA panel of Authority Members for decision.

What is non-directed altruistic donation? 

The term ‘non-directed altruistic donation’ is a form of donation whereby a healthy living person donates an organ or part organ, usually a kidney, to an unknown person. The donor does not have a relationship with the recipient. It is commonly known as ‘altruistic’ or ‘stranger’ donation.

If a person is interested in becoming an altruistic donor, they will need to contact the living donor coordinator (specialist nurse) at their nearest Transplant Centre.

Further information on altruistic donation can be found on the altruistic donation page of the NHSBT website.

All cases of non-directed altruistic donation are referred to a HTA panel of Authority Members for decision.

What safeguards are there to ensure donations are freely made and not undertaken for reward? 

The buying or selling of human material for transplantation is prohibited, subject to limited statutory exceptions. The Human Tissue Act 2004 makes it an offence to give or receive a reward for the supply or offer of human material for transplantation.

All living donors are assessed by an Independent Assessor (IA), who is required to conduct an interview and specifically look for evidence of coercion, payment or reward. The HTA must be satisfied that there is no evidence of payment or reward and that valid consent has been given before it can approve a donation.

Can donors be paid for donating an organ? 

It is unlawful for donors to be paid for donating an organ or part organ.

However, it is legal for a donor to receive reimbursement of expenses, such as travel costs and loss of earnings, that are reasonably attributable to, and directly result from, an organ donation.
 
All such payments must be made by a proper authority, e.g. an NHS Trust or foundation hospital, or, in the case of a private patient, the hospital. Details on the levels of reimbursement are available on the Department of Health website.

Donors should not be reimbursed directly by the recipient or by their family or friends. The HTA requires that checks are made to ensure that no other payment is made and that the donor does not make a profit from the donation.

What about the illegal trade of organs?

The buying or selling of organs or human tissue is illegal under the Human Tissue Act 2004. Penalties are up to three years imprisonment, a fine, or both.

Is commercial dealing in organs allowed?

No. The Human Tissue Act 2004 prohibits commercial dealing in all human material for transplants, subject to limited exceptions. Most importantly, it makes trafficking in tissue and cells for transplantation an offence and liable for a fine, imprisonment, or both. 

 Independent Assessors (IAs)

What is an Independent Assessor and what is their role?

IAs are trained professionals who are usually, but not exclusively, based in hospitals with transplant units. Once accredited by the HTA, they act as a representative of both the donor and the HTA. IAs interview potential donors and recipients to ensure the requirements of the Human Tissue Act 2004 have been met. IAs submit a report of their interview to the HTA and the HTA then make the decision on all cases. 

IAs do not have a role in determining the medical suitability of the potential donor or recipient and have no involvement in the living transplant programme of the hospital or Trust.

How do I apply to become an Independent Assessor?

There is a person specification for the role of Independent Assessor which can be found in the Guidance for transplant teams and Independent Assessors. Please see the Independent Assessors page for more information.

What is involved in becoming an Independent Assessor?

Once an application form has been received the HTA will request a reference. Once a reference has been received, all applicants are required to undergo training for the role.

How many cases will I be expected to undertake every year?

All IAs are expected to undertake a minimum of 2 cases every year. How many cases IAs undertake will depend on the size of the transplant unit and number of patients. The number of cases IAs assess range from 2-40.

 

Deceased organ donation

What is the HTA role in deceased organ donation?

The removal, storage and use of organs or part organs from a deceased person for transplantation is governed by the Human Tissue Act 2004. Before organs can be removed, stored or used for transplantation, appropriate consent must be obtained.

If there is no record of the deceased person’s wishes, consent can be obtained from the person nominated by the deceased person to act on his or her behalf; or if no one has been nominated, from a person in a ‘qualifying relationship’ to the deceased person.

The HTA is not required to approve deceased organ donations.

Does the Human Tissue Act 2004 prevent the import / export of organs for transplants?

No. Numbers are small but there is a regular exchange of organs between European countries that meet similar standards to ours. NHSBT facilitate this on the occasions when it occurs.

Does the HTA approve non-heart beating organ donation?

This is a form of deceased donation where the potential donor has died following cardio-respiratory arrest without being ventilated. The Human Tissue Act 2004 permits the taking of minimal steps, in order to preserve the organ’s viability for donation before consent has been obtained from the deceased person’s nominated representative or person in a qualifying relationship. The HTA is not required to approve these donations.

More information on minimal steps can be found in the HTA's code of practice on the Donation of solid organs for transplantation.

Is it possible to donate organs or tissue from infants born with anencephaly?

There are currently no active programmes, although advice should be sought from professionals if this situation occurs. It may be possible in some circumstances to donate organs or tissue, for example heart valves.

Further information on this can be found in the 1988 Conference of Medical Colleges Working Party document on Organ Transplantation in Neonates.

Further information on the diagnosis of brain stem death in infants and children can be found in the Academy of Medical Royal Colleges codef of practice for the diagnosis and confirmation of death (2008).

Can I direct an organ to a member of my family or a friend after I die?

Deceased donation in the UK is unconditional and subject to clinical priority. However, in some exceptional cases people can request that their organ/s are given to a family member or close friend. More information on this can be found on the Department of Health’s website.

 

 

Updated March 2012