Monday, 20 October 2014

Research and Campaigns Officer, Gabrielle Bourke, discusses the WI’s recent visit to the NHS Blood and Transplant Tissue Centre in Speke.

The most dramatic moment of the NFWI Annual Meeting back in June was when WI member Jenny took the microphone, and implored members to pass the resolution on Organ Donation because she was only able to see the stage that day from receiving cornea donations, just weeks beforehand. Though 4,000 people singing along to Jerusalem is a closed second, to be fair!

Tweet from the AM debate

Each year thousands of people have their lives transformed through donations of tissue. Skin is used for burns victims. Heart valves and bones, tendons and cartilage can all be used.  Tissue donation also suffers some quirks: women are less likely to pledge to donate their eyes rather than their hearts, for example. People can give their consent to donate ‘any of my organs and tissue’ by ticking the first box of the registration form, but one kind of tissue donation – from eyes – is also listed alongside the organs.

A NHSBT Organ Donation Registration leaflet

The BBC ran a documentary about the Tissue Centre in Speke, just east of Liverpool, a few weeks ago. Information has power: there was a spike in Organ and Tissue Donor registrations after the show was aired.  Along with NFWI Public Affairs chair Marylyn-Haines Evans, I was privileged to visit the Tissue Centre in Speke recently, to get a better understanding about the centre, its work and how it helps donors and recipients alike. 

Speke Tissue Centre

We were met by Kyle Bennett, who’s worked for NHSBT in tissue services for 14 years, and he walked us through the stages of tissue donation, all the way from donation and consent to recipient. Other tissue banks only collect a few types of tissue, but the centre in Speke is unique. It’s the only multi tissue bank in the UK and the biggest in the EU.

Collecting tissue from recipients happens in a different way from organ donation. Many families who were asked to donate their loved ones’ organs were also asked about tissue, and most of them generously said yes.  But if someone is suitable to donate tissue only, consent for their tissue will be asked for over the phone. NHSBT has links to hospitals all over the country (and coroners, nurses and police), who inform bereaved families that tissue donation might be possible. NHSBT also has a presence in a dozen or so of the biggest hospitals throughout the UK. 13 specialist nurses make the calls to families to discuss the options. Because tissue can be kept for many years (10 years for heart valves, 5 for skin), the need for different tissues waxes and wanes. But the window for collecting tissue from a deceased person can be as short as 24 hours, and demand can spike with certain kinds of injuries (Kyle told us about the 7/7 attacks in London having an impact, for example). It’s up to NHSBT to manage the demand for tissue and make sure families are called when they are needed. The nurses who make these calls are specially trained, and consent from families is high.

It’s not all responding to accidents however. Sometime NHSBT staff are on the lookout for specific tissues to fit a particular patient. Sick children may need bones of a certain size, for example. The tissue centre also works with donations from living patients. One of the nicest aspects of hip replacements is how it goes on to help others: The bones removed from 3,000 hip-op patients last year made ‘cement’ used in the hip replacements for other people. It works better than a synthetic product! Donations of the amniotic membrane from women undergoing elective caesarean sections help with eye operations. The consent nurses must switch from asking bereaved families to these living donor cases frequently, so need to be well-trained and able to balance the different aspects of their role.

Once tissue has been donated from a patient, NHSBT gather up more information about the donor, screen the donation and make sure it’s safe to use. The information is then all independently checked and verified.  This process can take up to three months, so the tissue is stored in NHSBT’s facilities. Some tissue can’t wait three months to be processed for use, like skin and heart valves. These gets processed as soon as possible, stored in liquid nitrogen while the information gathering and verification go on.

Storing tissue in liquid nitrogen

Then the tissue itself is checked, processed and goes into freezer storage, ready for use. The site in Speke has a bank of freezers, all hooked up to two independent monitoring systems keeping them safe. Kyle’s phone alerts him to when any abnormal temperature is recorded.

Kyle walked us past the state-of-the-art labs where the tissue is processed, making guesses as to who was working as some staff are wearing scrubs and facemasks, making them all look alike! Each stage of the tissue processing has a different grade of cleanliness. The labs at the centre are sterile to a much higher standard than any operating theatre in Britain. Sterility must be strictly maintained, otherwise donors’ precious gifts are compromised. It’s the cleanest place in the country by far.

A lab

And then the donations are sent to hospitals to be used for the people who need them. Staff turnover at the centre is low, and you can understand why. Every day, they make a difference.

The lesson for WI members is that as well as finding the time to talk about organ donation, they should talk about tissue too! Families every day in Britain are asked about donating their loved ones’ tissue. The reality is that if you want to be a donor, it’s not up to you. Kyle’s team can only start their work when your family carry out your wishes. So let them know today!

More information about tissue donation is available here on the NHSBT Tissue site.  If you want to sign up to be an organ or tissue donor, click here. Once you’ve told your family about your decision, show us who you told through our Big Conversation craft project.

A big thank you to Kyle and his team for showing us around. 

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