Identifying and referring a potential organ donor

Deceased organ donation gives some patients the opportunity to give the gift of a life-saving organ after death.

The information provided on this page is intended to inform healthcare professionals how to identify and refer a potential organ donor. The guidance relates to both adult and paediatric patients.

It is best practice to have the Specialist Nurse in Organ Donation (SNOD) present for all family approaches regarding organ donation.

Organ donor referral line

To refer a potential organ donor, call the organ donor referral line at:

03000 203 040

How to identify a potential organ donor

Please refer patients if either of the following criteria apply.

Severe brain injury

Refer patients with a severe brain injury when either:

one or more cranial nerve reflexes are absent and a Glasgow Coma Score of 4 or less cannot be explained by sedation
a decision has been made to diagnose death using neurological criteria

Read more about donation after brainstem death.

Decision to withdraw life-sustaining treatment

Refer patients for whom a decision has been made to withdraw life-sustaining treatment.

Read more about donation after circulatory death.

Following timely referral, the SNOD will undertake a thorough assessment of the patient and confirm if they have the option of donation after death.

Before donation is raised with a family, the ICU consultant, bedside nurse and SNOD will meet to plan the best approach to discussing end of life care, the diagnosis of death and exploring organ donation.

Often, the consultant will lead on breaking bad news, supported by the bedside nurse. Only once a family have accepted the bad news imparted will a SNOD go on to explore donation.

How to refer an organ donor

You can refer an organ donor by following these steps.

Step 1: call the referral line

Step 2: provide patient information

A member of the organ donation specialist nursing team will contact you and ask a series of structured questions to determine the suitability of the patient to become an organ donor.

Providing the information they request will enable the team to undertake a robust assessment, provide a decision about suitability and plan next steps.

Having access to the following information will be useful:

patient demographics
NHS/CHI number
height and weight
admission details including; date, primary diagnosis, current clinical condition, anticipated cause of death
past medical history
GCS, sedation, presence of cranial nerve reflexes
ventilation settings and recent ABG result
current infections and blood results (including pre-admission creatinine)
haemodynamic stability including; vital signs, support and urine output
clinical plan

At this point, the Specialist Nurse will confirm whether your patient has the option of donation.

If so, the Specialist Nurse will arrange to assess the patient in person.

If the patient is deemed unsuitable for solid organ donation, the Specialist Nurse will advise if tissue donation should be considered.

For example, they may be suitable for corneal donation. For more information, find out how to refer an eye donor.

How to prepare for a Specialist Nurse attendance

In order for the Specialist Nurse to support family conversations and conduct a thorough potential donor assessment, they will require additional information when they arrive at the unit.

Please help them with access to:

current and historical medical notes
GP records
electronic patient records including ICU charts, scans, blood results and reports
details of next of kin and any prior communication since admission

The Specialist Nurse may request additional blood tests or non-invasive investigations such as urinalysis to aid assessment.

Following a detailed assessment to establish donation potential, the Specialist Nurse, bedside nurse and treating consultant should meet to plan a conversation and how to approach the next of kin to further explore organ and tissue donation.

The Specialist Nurse will be able to provide information on organ donor register status and potential for transplant. This is important to ensure that families are provided accurate information and to set out realistic expectations regarding the option of organ donation.

Benefits of early identification

Early identification and timely referral of potential donors can help ensure:

timely assessment of donor eligibility
timely Specialist Nurse in Organ Donation attendance
the Specialist Nurse in Organ Donation can access the Organ Donor Register, assist in assessing last known decision and application of appropriate law
access to expert clinical advice
where appropriate, stabilisation for neurological death testing
timely referral to a Medical Examiner and where appropriate Coroner or Procurator Fiscal
processing of blood tests required to support donation and transplantation
structured multi-disciplinary planning and approach for consent/authorisation

Further resources

Use the following resources for more guidance on identifying and referring a potential organ donor:

You may also be interested in

Consent and authorisation

Donation after brainstem death

Donation after circulatory death