I am delighted to reflect on our year at the Organ and Tissue Authority, highlight our achievements, and also the challenges amidst the COVID-19 pandemic.
It is a privilege to be leading the Australian Government’s national organ and tissue donation program. I am very proud of our incredible teams at the OTA and DonateLife Network who, in very challenging times, have remained dedicated to supporting donation to give as many people as possible the chance of receiving a life-saving transplant.
In 2019 more families said yes to donation than ever before. Due to this, the lives of 1,444 Australians were saved through organ transplantation from a deceased organ donor. Families are faced with this decision in the hospital at such an emotional time, as they are dealing with the news that their loved one will not survive. I want to personally thank them for saying yes and giving someone else a second chance at life.
For the 239 living organ donors who unselfishly gave an organ in 2019 – usually a kidney to their family member or close friend – I thank you, too.
There are also many people who generously made eye or tissue donations to improve the lives of others. In 2019 over 12,000 Australians benefited from eye and tissue donation.
Much has been achieved in the past 11 years as a result of having a nationally coordinated program in Australia. The organ donation rate has more than doubled, resulting in more than 13,000 people receiving a life-saving transplant. We will continue to strive to increase this further.
Our clinical system
A key focus for us is the nationally consistent approach to donation being delivered across more than 95 hospitals by our funded DonateLife network. This consists of 265 donation specialist medical, nursing and support staff.
It is critical that the donation Clinical Practice Improvement Program is well understood and fully embedded across all DonateLife hospitals. National, jurisdictional and individual hospital dashboard reporting clearly demonstrates the positive outcomes of the program, performance against best practice elements, and key areas of focus.
Building on the enhanced reporting and analysis of DonateLife hospital performance and data from 2018, this past year the OTA – with DonateLife – has focused on increasing engagement with hospital executives and intensive care units (ICUs). In addition to quarterly reporting, outcomes were presented to all Health Ministers, and meetings occurred with a number of hospital executives, ICU Directors and peak clinical associations.
One of our key strategies is to increase community awareness of, and support for, donation and transplantation. The call to action over the past year has been to encourage people to talk to their families and, importantly, if they support donation, to register on the Australian Organ Donor Register. The OTA’s streamlined channel at donatelife.gov.au means it takes less than a minute to register.
We worked with our Community Engagement Group to plan the messaging for our annual DonateLife Week campaign, which commenced on the last Sunday of July. Our agreed social media messaging for the campaign was 'Who’s your plus one?'. This recognised that if every person on the register encouraged just one more person to also register, we would automatically double the number of Australians with a registered wish to be an organ donor.
DonateLife Week 2019 was launched by Minister Mark Coulton MP on the steps of the iconic Sydney Opera House which was lit up in our DonateLife colour, magenta, for the first time. Community organisations and partners participated in the week, and sporting events were held across the nation. Highlights included our first partnership with the Melbourne Storm as well as ongoing partnerships with the AFL, the Football Federation Australia and Tonic Health Media. In addition, the many local community events resulted in an 18.4% increase on registrations over the campaign period compared to the previous year.
The new state-of-the art organ wait-listing, matching and allocation system is running well and already making a difference to practice. In September 2019 we rolled out the OrganMatch Clinical Portal to all transplant units, enabling over 650 clinical staff from 46 transplant units to access the Clinical Portal for real-time patient results and reports, as well as matching and transplant information for their patients. This was the first time the clinical units in Australia have had direct access to the organ matching system.
Australian and New Zealand Paired Kidney Exchange
A highlight for the year was the successful expansion of the Australian Paired Kidney Exchange Program to include New Zealand. The Australian and New Zealand Paired Kidney Exchange (ANZKX) Program, which began on 1 July 2019, increases the potential number of living donor kidney transplants. This is achieved by identifying matches for patients who are eligible for a kidney transplant and who have a living donor who is willing but unable to donate because of an incompatible blood type or tissue type. The successful expansion of the program has resulted in a larger combined pool of donor/recipient pairs from which compatible matches can be identified. The first round of surgeries following the expansion has resulted in four successful trans-Tasman exchanges since October 2019.
I acknowledge the enormous amount of work by the very dedicated team of people involved in this collaboration.
The impact of COVID-19
The 2020 calendar year has seen unprecedented challenges for all Australians in the face of the COVID-19 health pandemic, including impacts on the national program. During the initial outbreak of the pandemic in Australia, the OTA played a key role in facilitating national coordination and communications across the donation and transplantation sector.
The establishment of the National Transplantation and Donation Rapid Response Taskforce has been instrumental in providing an effective forum for key clinical stakeholders across the end-to-end donation, retrieval and transplantation sector. The taskforce reviews and discusses critical information in relation to national approaches to managing impacts on the program and provides clear and regular communications to the sector.
The emergence of COVID-19 saw the suspension of adult kidney transplant programs, including the ANZKX, in March 2020. While a gradual recommencement occurred from May 2020, the complexities of the ANZKX program, and international travel restrictions, have delayed the recommencement of the program. Both Australia and New Zealand are looking to conduct their paired kidney exchange programs within each country separately, and we continue to monitor the situation with a view to recommencing trans- Tasman exchanges as soon as possible.
We have also been regularly sharing the COVID-19 experience and impacts on donation and transplantation with our international colleagues, including the United Kingdom, Canada, USA, Spain and Italy. This information exchange has been invaluable.
Our National Medical Director’s reflection provides details of the impacts of COVID-19 on our clinical donation and transplantation system, and we continue to navigate this challenging time.
Thank you OTA team
I am very proud of the efforts of the OTA team during the initial outbreak of the pandemic. We quickly and successfully adapted to working-from-home arrangements and continued to deliver in this challenging environment. Our team were also very willing to contribute to the wider COVID-19 response across the Australian Public Service and in the health system. Our registered nurses were on stand-by for a call-up from hospitals if needed, and we had staff re-deployed, including to the Department of Health.
As part of the Government’s pandemic response, I was also seconded to the Department of the Prime Minister and Cabinet as the Executive Coordinator for the COVID-19 Health Taskforce for more than two months, returning to the OTA in June. I want to say a big thank you to Judy Harrison for acting as CEO, the OTA Executive Team and staff for your commitment and positivity during this period.
Our future areas of focus
It is critical that learnings from the current health situation inform our future planning. Recognising the current environment, our key areas of focus for 2020–21 must afford us the agility and flexibility to respond to changing priorities. Our national strategic focus areas will support our DonateLife Network and the retrieval and transplantation sector to continue delivery of our national program in the uncertainty of the next 12 months. Over this period, it is also critical that we focus on enhancing data analytics and system capability to continue to drive improvements in clinical practice.
I am looking forward to the year ahead and the challenges and opportunities it may bring for the OTA.