Wednesday, 8 January 2014

Human Tissue Authority – emergency out of hours....

I have been sleeping with my mobile phone next to my bed the past two weeks – it also hasn’t left my side through all the holidays.  I wasn’t waiting for either good or bad personal news but was on the emergency out-of-hours rota for the Human Tissue Authority (HTA) where I am a non-executive member.  This is something that all non-executive members and senior staff do once or twice a year. Calls are very rare but when they do happen it could be a life or death situation.

You probably know that you can sign an organ donor card which means that if you die in circumstances where your organs can be used, they will be – opt in.  I did this several years ago.  In Wales the situation will change on December 1, 2015 when The Human Transplantation (Wales) Act becomes effective which will mean that you will need to opt out.

However, when it comes to donations of solid organs from living people, this is regulated by the HTA (see Organ Donations - frequently asked questions). The Human Tissue Act 2004, and associated regulations, requires the HTA to assess all proposed transplants from living donors and to decide whether the transplant should be approved, based on criteria set by Parliament. These are most often kidneys – you have two and can manage with one, or part of the liver – it can regenerate.

All donors and recipients are required to see a local Independent Assessor who is trained and accredited by the HTA. The Independent Assessor interviews the donor and recipient (both separately and together) and is independent of the healthcare teams who are involved with the transplant. The purpose of the interview is to ensure that no reward has been or will be given for the donation and the donor has given consent to the removal of their organ.

The donor must have the mental capacity to give consent and they must demonstrate an understanding of the medical procedure and the risks involved. We have to be satisfied that the donor has not been coerced into agreeing and is not under any duress. The Independent Assessor will then submit a report to the HTA; this report will be used to make a decision on the case.

Every week certain living donation cases are referred to a panel of non-executive members who assess the information and then make a decision on whether the transplant can go ahead, on the basis that the requirements of the Human Tissue Act 2004 have been met.

Very occasionally this will happen as an emergency out of hours, this might be when a person goes into sudden liver failure and has a potential living donor available. As the HTA is still responsible for ensuring that the requirements of the Human Tissue Act 2004 have been met, even in emergency cases, this responsibility is delegated to the individual on duty at the time.  We have all received training and have strict guidelines to follow. 

It is rare and unlikely but you can’t take chances so the processes are in place, just in case.

It is a criminal offence to carry out a transplant operation between two living people if the conditions of the Human Tissue Act 2004 are not met. This means valid consent must have been given.

It is also an offence to buy or sell organs or human tissue. If convicted, the penalty for these offences can be a prison sentence of up to three years, a fine, or both.

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