Dr. Sumana Navin, Course Director, MOHAN Foundation was invited as an observer for the Deceased Donation Course for Intensive Care Medicine (ICM) trainees in Nottingham by Dr. Dale Gardiner, Deputy National Clinical Lead for Organ Donation, NHSBT, under the auspices of the Memorandum of Understanding (MoU) signed between NHS Blood and Transplant (NHSBT), UK and MOHAN Foundation in 2015. The course was held on 24th & 25th February 2016 at Jurys Inn and Trent Simulation & Clinical Skills Centre, QMC Campus, Nottingham University Hospitals.
The UK Organ Donation Taskforce (2008) recommended that all clinical staff likely to be involved in the treatment of potential organ donors should receive mandatory training in the principles of donation. The objective of this course was to give participants the knowledge and skills to be able to confidently include organ donation as part of their end of life care options for their patients in their future intensive care career. The recent amendment of the Transplantation of Human Organs Act in India has made intensivists an integral part of brain stem death certification. In addition, their role in donor optimisation cannot be overemphasised. This observership, therefore, offered great learning opportunities.
At the Deceased Donation Course
On Day 1, the lectures and patient stories set the stage perfectly for the simulations the next day. Bronwyn, a heart transplant recipient, shared her experience and the wonderful care and support that she received from the team at Freeman Hospital, Newcastle upon Tyne, England. It was a privilege to hear Mrs. Carol Donaldson, mother of deceased donor James. Her fighting spirit and generosity was inspiring.
On Day 2, the use of video vignettes, professional actors and manikins in the simulations gave the day a very 'real' feel. The scenarios involved both Donation after Brain Death (DBD) and Donation after Circulatory Death (DCD). There were tutorial-based workshops on Brain stem death and Objective ethics. There was also focus on how to work productively with others, particularly the Specialist Nurses in Organ Donation (Transplant Coordinators, in the Indian context).
Visit to NHSBT Tissue Services
Dr. Sumana Navin also visited the NHSBT Tissue Services in Speke, Liverpool on 29th February 2016 on the invitation of Dr. Akila Chandrasekar, Consultant in Transfusion Medicine. This sprawling facility started in 2005, is the hub for the coordination, retrieval, processing, banking and supply of human tissue grafts in the UK – bone, skin, cardiovascular, tendons and eyes.
They bank and supply tissue grafts from around 400 deceased tissue donors per year and respond on a 24-hour basis to over 6,000 donor referrals. Their key objectives are to provide high quality, safe and effective tissue grafts for the benefit of patients. They also work in collaboration with coroners, pathologists and NHS partners to provide families of tissue donors with access to a team of specially trained nurses. Their role is to discuss the donation options and help facilitate the donation process. Dr. Sumana Navin had the opportunity to interact with some of the personnel in the National Referral Centre – Anita Ambrose, Manager, Gill Sullivan, Shift Leader and Victoria Carroll, nurse. They gave her insights into the rigorous protocol and documentation that was followed.
Dr. Richard Lomas, Senior Clinical Development Scientist, took Dr. Navin on a tour of the state-of-the-art tissue bank facility. The Research & Development wing was fascinating, particularly the autologous serum eye drop system for the treatment of severe dry eye (e.g. Sjögren’s syndrome). The centre is a major step forward in the donation of human tissue. Historically, tissues have been obtained from deceased donors in mortuaries, however the donation process can now be carried out in a high grade facility built to the same standards as an operating theatre. The donated tissue is then transferred directly to clean rooms to be prepared for transplantation and stored pending clinical requirement.