On behalf of the Board of the Organ and Tissue Authority (OTA) I am pleased to present the OTA’s Annual Report 2020–21.

Since 2017, I have had the privilege to reflect and report on the efforts and vital outcomes of the national program for improving opportunities for transplantation through increased organ and tissue donation.

We have a very important remit every year to increase organ and tissue donation for transplantation, and this year has been the most challenging with the COVID-19 pandemic remaining prevalent in Australia.

Despite difficult circumstances and ongoing challenges for our national program, the lives of 1,270 Australians were saved through an organ transplant due to the generosity of 463 deceased organ donors and their families. There were a further 182 recipients of organs from living donors, including 29 recipients of kidneys through the Australian and New Zealand Paired Kidney Exchange Program.

Our key focus areas in 2020–21

Throughout the course of the year we’ve had to remain vigilant in continuing to monitor the prevalence of COVID-19 nationally and globally, and to take a leadership role in identifying and responding to current, emerging and potential impacts on the national program. Both the OTA CEO and National Medical Director remained key participants in the COVID-19 – Australian Transplantation and Donation Rapid Response Taskforce fortnightly meetings on the current situation with donation and transplantation in Australia and New Zealand, and looking at national and international COVID-19 data, as well as a monthly international COVID-19 forum for sharing learnings and experiences.

Against the backdrop of a COVID-19 environment, we focussed our efforts on continuing the national program with donation being offered where possible and with safe delivery of donation services, and working closely with the transplant sector so people on the waitlist could still receive a transplant. It has been a worrying time for anyone waiting for a transplant and for their families. Minimising the risks to transplantation and patients on the waiting list has been the priority for everyone involved including our DonateLife Agencies and specialist donation doctors and nurses, along with the transplantation sector, who have worked incredibly hard to minimise any impacts on people needing a transplant.

Our ongoing success is only possible through the collaborative efforts of those involved in delivering our national program, extending across state and territory governments, the donation and transplantation clinical sectors and eye and tissue banks. A key function of the OTA is to support organ and tissue donation services by the states and territories through the administration of funding. This crucial funding is used by the states and territories to employ staff – the DonateLife Network (DLN) who deliver a nationally consistent organ and tissue donation service in each jurisdiction.

Through our DonateLife Network, across 95 hospitals, we have continued to deliver innovative best practice education and training of donation specialists, intensive care, and other clinical staff in a COVID-safe environment. This has included evolving the core Family Donation Conversation workshop in line with best practice and delivery of web-based coaching for donation specialists. Our focus has been, and will continue going forward, to ensure all patients and their families receive excellent care throughout the donation process that meets their physical, psychosocial and spiritual needs. This care is delivered with a focus on dignity and comfort, while patient care is simultaneously managed to support donation and transplantation outcomes.

The OTA also focussed on organ and tissue donation being considered for all patients when end-of-life care is planned in the intensive care unit (ICU) or emergency department (ED). Organ and tissue donation best practice occurs in a hospital setting where high quality end-of life care is a priority. Our ongoing collaboration with ICUs and EDs will continue to embed organ and tissue donation in end-of-life care.

States and territories continued to implement agreed clinical best practice processes through the Clinical Practice Improvement Program (CPIP) and will contribute to the ongoing review of CPIP and other agreed clinical practice improvement initiatives to optimise every opportunity for donation.

Our objectives over the year have been focussed on increasing consent rates, with an emphasis on increasing the number of Australians registered on the Australian Organ Donor Register (AODR) and promoting family discussion about donation. Families who know that their family member wanted to be a donor generally try to honour their wishes. Although the majority of Australians report a willingness to donate, only 34% of Australians were registered on the AODR at the end of 2020. We have continued to explore options and approaches to facilitate increased AODR registrations, including through increased community engagement and through the use of state and territory driver’s licence systems. We also continued to collect and analyse registration data, including key registration demographics and the effectiveness of registration channels, to inform future initiatives.​​

​​The wider community has once again been fundamental to our progress over the last 12 months. Donation is only possible through the generosity of donors and their families, who save and transform the lives of others through the gift of donation. This act of generosity has a profound impact on those who receive a transplant, as well as their families, friends and the community and continuing to acknowledge the generosity and gift of donation is an important way to recognise the contribution made by donors and their families.

Financial performance

The OTA’s operating result for 2020–21 was a deficit of $0.114 million against a budget deficit of $0.512 million. The OTA is committed to delivering the program and that resources are appropriately allocated to optimise our performance. The OTA remains in a net asset position at 30 June 2021. Administered expenditure for 2020–21 was $46.970 million towards the delivery of the national reform program, including $45.357 million grants expenditure, the majority of which was provided towards dedicated organ and tissue donation specialists in hospitals and organ and tissue donation agencies.

Acknowledgements

In what has been another tumultuous year, on behalf of the Board I would like to take this opportunity to acknowledge and extend my sincerest gratitude to all of the dedicated people who deliver our national program and who work tirelessly to drive change and progress in the donation and transplantation sectors – our OTA staff, the DonateLife team, partners, community groups, and all of those who are actively supporting donation and transplantation across Australia.

Our program would not exist without the generosity of every donor and their family who make the selfless decision to save the life of another. This generosity has a profound impact on those Australians who receive a transplant, as well as on their families and communities.

Awareness and ongoing community conversation about the importance of organ and tissue donation and transplantation is also not possible without the contribution from individuals and organisations in our community who generously volunteer their time and expertise.

We also acknowledge the dedication and commitment of our donation and transplantation specialists who through extraordinary passion and commitment have navigated the most difficult of circumstances in a COVID-19 environment.

Looking forward

Looking forward to 2021–22 and beyond, the OTA Board will transition from the Accountable Authority for the OTA to an Advisory Board, with a dedicated focus on the provision of strategic advice and direction for the Australian Government’s national program to improve opportunities for transplantation through increased organ and tissue donation.

We will continue to work in partnership with the OTA CEO and team, the Commonwealth Department of Health and state and territory governments to progress the recommendations from the Review of the Organ Donation, Retrieval and Transplantation System and on the National Eye and Tissue Sector Framework.

I would like to thank the OTA CEO and team for their professionalism and dedication to the national program, they have made a significant contribution during 2020–21.

As we emerge from the full impacts of the COVID-19 pandemic, we will also turn our attention to not only striving to bring donation and transplantation rates back to pre-pandemic levels but to further increase these levels to help as many Australians as possible access the benefits of transplantation.

On behalf of the Board I am very pleased to present the OTA’s 2020-2021 Annual Report.

Signed by

Dr Mal Washer

Chair, OTA Board