Drivers get organ donor 'nudge'

31 July 2011 Last updated at 00:53 GMT Less than a third of people are registered as organ donors Drivers will have to state whether they want to be an organ donor when they apply for a new or replacement licence.

The move has been put forward by the government's "nudge unit", which has been set up to encourage changes in behaviour through gentle persuasion.

The Driver and Vehicle Licensing Agency already asks if applicants want to be donors - but from Monday an online form will require that the answer is stated.

Ministers hope it will help improve organ donation rates.

Less than a third of people are signed up to be organ donors - despite research suggesting that nine in 10 would he happy to be one.

Debate

The situation has prompted much debate in recent years about how best to improve rates.

Some have called for presumed consent, where it is assumed an individual wishes to be a donor unless he or she has opted out by registering their objection.

Continue reading the main story It is an idea based on a book by Richard Thaler and Cass Sunstein which advocates influencing behaviour by altering the context or environment in which people choose. It differs from traditional approaches to changing lifestyles which tend to be more overt.Conventional measures might include steps such as bans, using tax to increase price or promotional campaigns.But nudge tends to be more subtle, perhaps involving the provision of information about social norms or changing the environment, such as installing fewer lifts in a building to encourage people to use the stairs more.As well as working on organ donation, the Cabinet Office "nudge unit" will be looking at tax self-assessment and stop smoking services.The government has so far rejected presumed consent and instead the Cabinet Office's behavioural insight team has suggested the driving licence idea as part of its "nudge" drive.

The DVLA's existing scheme is already responsible for about half of the 1m new donor registrations each year.

As well as becoming compulsory to answer the question, the section will be moved from the end to the start of the DVLA process, so when applicants from England, Wales and Scotland apply for new or replacement licences they will have to say whether they want to become an organ donor or not.

When a similar scheme was introduced in the US state of Illinois, donor registration jumped from 38% to 60%.

Public health minister Anne Milton said the move was aimed at encouraging people to discuss the issue more and make it easier for them to sign up.

"Being an organ donor is a truly selfless act and a life-saving gift to someone in need," she added.

View the original article here

First synthetic organ transplant

7 July 2011 Last updated at 16:03 GMT By Michelle Roberts Health reporter, BBC News, in Stockholm The replacement windpipe was grown in the lab Surgeons in Sweden have carried out the world's first synthetic organ transplant.

Scientists in London created an artificial windpipe which was then coated in stem cells from the patient.

Crucially, the technique does not need a donor, and there is no risk of the organ being rejected. The surgeons stress a windpipe can also be made within days.

The 36-year-old cancer patient is doing well a month after the operation.

Professor Paolo Macchiarini from Italy led the pioneering surgery, which took place at the Karolinska University Hospital.

In an interview with the BBC, he said he now hopes to use the technique to treat a nine-month-old child in Korea who was born with a malformed windpipe or trachea.

Professor Macchiarini already has 10 other windpipe transplants under his belt - most notably the world's first tissue-engineered tracheal transplant in 2008 on 30-year-old Spanish woman Claudia Costillo - but all required a donor.

Indistinguishable

The key to the latest technique is modelling a structure or scaffold that is an exact replica of the patient's own windpipe, removing the need for a donor organ.

To do this he enlisted the help of UK experts who were given 3D scans of the 36-year-old African patient, Andemariam Teklesenbet Beyene. The geology student currently lives in Iceland where he is studying for a PhD.

Using these images, the scientists at University College London were able to craft a perfect copy of Mr Beyene's trachea and two main bronchi out of glass.

This was then flown to Sweden and soaked in a solution of stem cells taken from the patient's bone marrow.

After two days, the millions of holes in the porous windpipe had been seeded with the patient's own tissue.

Dr Alex Seifalian and his team used this fragile structure to create a replacement for the patient, whose own windpipe was ravaged by an inoperable tumour.

Despite aggressive chemotherapy and radiotherapy, the cancer had grown to the size of a golf ball and was blocking his breathing. Without a transplant he would have died.

During a 12-hour operation Professor Macchiarini removed all of the tumour and the diseased windpipe and replaced it with the tailor-made replica.

The bone marrow cells and lining cells taken from his nose, which were also implanted during the operation, were able to divide and grow, turning the inert windpipe scaffold into an organ indistinguishable from a normal healthy one.

And, importantly, Mr Beyene's body will accept it as its own, meaning he will not need to take the strong anti-rejection drugs that other transplant patients have to.

Professor Macchiarini said this was the real breakthrough.

"Thanks to nanotechnology, this new branch of regenerative medicine, we are now able to produce a custom-made windpipe within two days or one week.

"This is a synthetic windpipe. The beauty of this is you can have it immediately. There is no delay. This technique does not rely on a human donation."

He said many other organs could be repaired or replaced in the same way.

A month on from his operation, Mr Beyene is still looking weak, but well.

Sitting up in his hospital bed, he said: "I was very scared, very scared about the operation. But it was live or die."

He says he is looking forward to getting back to Iceland to finish his studies and then returning to his home in Eritrea where he will be reunited with his wife and young family, and meet his new three-month-old child.

He says he is eternally grateful to the medical team that has saved his life.

View the original article here

Organ donor challenge over-ruled

28 June 2011 Last updated at 10:47 GMT By Nick Triggle Health correspondent, BBC News, in Cardiff More than 3,700 donations took place last year - a 5% increase on the previous year Doctors have reiterated their support for overhauling the organ donation system.

The British Medical Association has been campaigning for presumed consent - where all people are assumed to be willing to donate organs unless they opt out - since 1999.

But some medics at the union's annual conference challenged the stance on grounds it could damage patient trust.

Delegates rejected the challenge, arguing it would save lives.

No part of the UK has introduced a system of presumed consent yet, although Wales has said it intends to.

Those in favour believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.

More than 3,700 donations took place last year - a 5% rise on the previous year - but there are still about 8,000 people on the waiting list.

Over the last three years, the NHS has invested in specialist nurses and transplant co-ordinators to identify potential donors and allow for approaches to families when death becomes likely.

Dr Sharon Blackford, a dermatologist from Swansea, who proposed the motion challenging the BMA's support for presumed consent, said: "If we move to presumed consent in could damage trust in doctors. If someone is ill in intensive care, families may feel doctors just want to harvest the organs.

"It also goes against the whole idea of the moment - putting patients in charge. People may start thinking about it differently and it could turn people off."

Dr Blackford cited the experience of Spain, where organ donation hardly changed following the introduction of presumed consent in 1979.

But others argued presumed consent would be beneficial.

Laura Turkenburg, a medical student from Durham, cited research which showed three people a day die waiting for an organ transplant.

"We have a significant problem in this country. That means the system has to change."

Former Lib Dem MP Dr Evan Harris, who originally proposed the motion in favour of presumed consent 12 years ago, said: "It [presumed consent] does work. It saves lives."

Under the BMA's suggestion - dubbed soft presumed consent - families would still be able to object to organ donation even if their relative had not opted out.

A spokesperson for NHS Blood and Transplant (NHSBT) said:

"We welcome debate that raises the value and importance of organ donation as a way of encouraging discussion about this important subject.

"NHSBT is neither for nor against a change to presumed consent legislation and will work within whatever legislative framework is introduced in any of the four health administrations in the United Kingdom.

"Next week is Transplant Week (4 - 10 July) which focuses on the wait patients experience when on the organ waiting list. With three people dying every day in the UK whilst waiting for an organ transplant, we urge people to join the NHS Organ Donor Register and discuss their wishes with their family."

View the original article here

Organ donor register passes 18m

23 June 2011 Last updated at 06:43 GMT In 2010, 2,700 organs were transplanted in the UK The number of people registered as organ donors in the UK has reached "staggering" levels, according to NHS Blood and Transplant.

A record 18 million - nearly one out of every three - people now say they are willing to donate their organs.

But the organisation said even more people needed to register.

It added Black and Asian people had to wait three times longer for a transplant, because of a shortage of donors in those communities.

Sally Johnson, director of organ donation and transplantation, said the number of people on the register represented "a fantastic achievement".

But she added: "Getting people to sign up to the register is only half the battle.

"In order to see that their wishes are carried out in the event of their deaths, it is essential that those who want to become donors discuss donation with family and friends."

People in Scotland are the most likely to donate, 37% are on the register.

In 2010, more than 1,000 people donated their organs, and 2,700 organs were transplanted, across the UK.

However, 10,000 people are still on a waiting list for transplants.

View the original article here