Evidence
Surveillance decision
We will not update the guideline at this time.
We will amend the guideline to include a footnote to recommendation 1.1.2 for early identification of patients who are potentially suitable donors. This footnote is to make reference to guidance on diagnosis of brain stem death in infants between 37 weeks' gestation and 2 months (post-term) published by the Royal College of Paediatrics and Child Health (RCPCH) in 2015. The footnote will also include a link to the guidance.
We will also include a footnote to recommendation 1.1.9 for seeking consent to organ donation when a patient lacks capacity to consent. This footnote is to make reference to the modification of the NHS Organ Donor Register which is now allowing anyone to register a decision to donate, not to donate or to nominate a representative to make a decision after their death. The footnote will also include a link to the NHS Organ Donor Register where these options can be seen.
Reason for the decision
We considered the impact of 38 new studies through surveillance of this guideline. We found 118 additional studies but these were conducted in other countries outside the UK and not used to inform the surveillance decision.
This included new evidence that supports current recommendations:
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Identifying patients who are potential donors.
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Patients who have capacity.
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Assessing best interests.
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Seeking consent to organ donation.
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Approach to those close to the patient.
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Discussions in all cases.
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Organisation of the identification, referral and consent processes.
We also identified evidence on potential of neonatal organ donation and guidance on diagnosis of brain stem death in infants between 37 weeks' gestation and 2 months (post-term). We asked topic experts whether this new evidence would affect current recommendations on organ donation for transplantation: improving donor identification and consent rates for deceased organ donation. Generally, the topic experts' opinion whether or not an update was needed was mixed. Two topic experts thought that an update of the guideline was needed, regarding the potential of neonatal donation, with the publication of the guidance on diagnosis of brain stem death in infants between 37 weeks' gestation and 2 months (post-term) by RCPCH.
None of the new evidence considered in surveillance of this guideline was thought to have an effect on current recommendations.
Overall decision
After considering all the new evidence and views of topic experts, we decided not to update this guideline.
See how we made the decision for further information.
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