The organ donation and transplantation system is complex and involves many health professionals working across the end-to-end organ donation, retrieval and transplantation system. All of those involved are dedicated to achieving the best possible outcomes for patients and their families who generously donate and those who are fortunate enough to receive a transplant.

Collaboration across the whole system is critical and necessary to continue Australia’s growth in organ donation and transplantation outcomes. Our strong relationship with the transplantation sector continued in 2018–19 and included close collaboration with the key professional organisations that represent the Australian organ transplantation sector.

Australian donation, retrieval and transplantation system (June 2019)

The OTA’s Transplant Liaison Reference Group (TLRG) is the key group that facilitates collaboration between the donation and transplantation sectors. It includes representatives from the Transplantation Society of Australia and New Zealand (TSANZ) and their Advisory Committees, the Transplant Nurses Association, the DonateLife Network, the Australasian Transplant Coordinators Association, Transplant Australia, and the Australian and New Zealand Intensive Care Society. The TLRG meets three times a year to discuss common areas of interest and discuss strategies to continually drive improvements in the donation and transplantation system.

We continued to provide funding support to TSANZ for key projects which in 2018–19 included:

• updating the TSANZ Clinical guidelines for organ transplantation from deceased donors to include evidence-based guidance on donor assessment for the risk of infectious disease transmission
• developing best-practice guidelines for eligibility and allocation of paediatric donor organs
• establishing a working group to conduct a national review of paediatric kidney transplantation
• considering an immunosuppressant protocol tailored to the needs of Aboriginal and Torres Strait Islander kidney transplant recipients.

In June 2019 TSANZ, with our support, began new projects to review organ allocation systems and perfusion requirements in Australia. These projects are being conducted to review current arrangements with a view to optimising transplantation outcomes for patients while ensuring fairness and equity. Specific work is being undertaken through targeted working groups and consultative workshops led by subject matter experts in renal allocation, non-renal allocation and perfusion technology.

The TSANZ review of renal and non-renal allocation processes will be further supported by the technology available in the OrganMatch system, which enables simulation and rapid updates to the allocation process as determined through these projects. The reporting functionality and clinician portal delivered in OrganMatch will also provide significantly enhanced transparency and accountability of practice in the offer, allocation and acceptance process through security-controlled functionality for viewing and reporting by clinicians.

In 2018–19 the Commonwealth Department of Health, with COAG Health Council agreement, commissioned a review of the Australian organ donation, retrieval and transplantation system. This followed increasing concerns that the growth in donation activity was placing significant pressure on retrieval and transplantation services provided by state and territory governments.

We worked with transplant and donation clinicians, as well as state and territory government representatives, to inform the review and provide information on current processes and practices across the system. This involved documenting eight elements of the system: the initial assessment and wait-listing management of potential recipients, deceased donation, organ allocation, offering, acceptance, retrieval, transplantation and post-transplantation.

The findings from the review will inform the development of a future national strategy for organ donation, retrieval and transplantation.

Mr Robert Larbalestier AO