Ireland ‘well below’ peer countries in older organ donation rate

Ireland’s performance is “well below” peer countries in the rate of deceased organ donation in the over-60 age group, a meeting of the national organ donation and transplantation advisory group (NODTAG) heard.

The minutes noted the importance of families being offered an opportunity to donate and that age alone should not be a factor. “This will require a focus and cultural change across the [healthcare] system,” stated minutes of the NODTAG’s meeting in November.

The medical complexities associated with older organ donors and recipients were recognised during the discussion. The meeting also heard that, based on data of organ offers in 2024, “transplant teams are accepting donors if medically appropriate.”

“Important [that] organs offered to UK and Europe if teams here not accepting offer for any reason. Overall, a clear picture is required.”

The minutes stated that HSE Organ Donation and Transplant Ireland (ODTI) would convene a group focusing on improving the rate of donation in the population over 60 years.

In 2023, Ireland ranked 22nd out of 27 EU countries for the rate of organ donation per million population in the over-60 age group, according to data from the International Registry in Organ Donation and Transplantation.

A HSE spokesperson said the reference in the NODTAG minutes to the need for “cultural change” in the system related to the area of donation after circulatory death (DCD).

“DCD occurs when a patient donates organs following the determination of death by cardio-respiratory criteria. A strict protocol is followed before this is considered. The rate of DCD in Ireland has increased in recent years and ODTI is exploring ways to increase the scope of the DCD programme.”

In 2024, ODTI published a guideline to support staff who are facilitating the end of life care pathway for potential organ donors. This document seeks to provide clarity as to which patients would not be eligible to become organ donors and includes guidance on age-related parameters for DCD.

The HSE added that the DCD rate in the over-60 age group is the focus of discussion in many forums. A formal programme is being drafted through discussion at the NODTAG. A subgroup of the NODTAG “may be required to address this nationally”.