Organ and tissue donation
Organ and tissue donation gives the gift of life to others. If you become an organ or tissue donor after your death, you could help save or improve the lives of up to nine people.
Organ donation opt-out system
Northern Ireland has an opt-out system for organ donation.
The law is known as Dáithí’s Law in recognition of Dáithí Mac Gabhann who has been on the waiting list for a heart transplant since 2018.
Under the opt-out system, if organ donation is a possibility, it is considered that you agree to being an organ donor when you die, unless you have registered a decision not to donate, or are in an excluded group.
Excluded groups include:
- those under the age of 18
- people who lack the mental capacity to understand the change in law
- visitors to Northern Ireland
- temporary residents
You have the right to choose whether to donate your organs and can register or amend your decision at any time.
Organ Donor Register
If you do not want to donate your organs when you die, you should record your decision to opt-out, preferably on the NHS Organ Donor Register.
The Organ Donor Register gives you the choice at any time to:
- register to donate (opt-in)
- register not to donate (opt-out)
- withdraw your registration
- amend your decision
When you register as a donor, you also have the option to specify which organs and tissues you wish to donate, either:
- all organs and tissues
- only those you select
To add your name to the NHS Organ Donor Register, you can:
- register online
- telephone: 0300 123 23 23
You can also register details of a representative or representatives if you want someone to make the decision for you after death.
Children aged 14 and over in Northern Ireland can sign the NHS register and parents/ guardians can register their children before the age of 14 if it is something the child has expressed a wish to do.
Share your decision
Your family will be consulted if organ donation is a possibility, so it's very important to talk to loved ones about your decision, so they know your wishes.
By signing the register and talking to your family about your decision, you are removing the burden from them to make that decision for you.
Advice on sharing your decision with your family is available at the following link:
Whatever you decide, it is very important to talk to your family or those important to you about your organ donation decision.
After your death, your family will continue to be consulted before organ donation would go ahead and any decision they make will be respected.
So, it's very important to talk to loved ones about your decision, so they will know what you would have wanted.
When families or friends know the decision of their loved ones it can make the situation less stressful and can give them the confidence to fulfil your wish of being an organ donor or not.
Only around half of families agree to organ donation going ahead if they do not know their loved ones’ wishes, however this rises to nine out of 10 when families have had a conversation.
Find out more at the following link:
People who can donate an organ
Being of an older age or having a medical condition will not automatically stop you from being an organ donor.
The transplant team will decide if all or part of your organs are suitable for transplant at the time of your death.
The important thing is that you are registered and have spoken to your family about your wishes.
For children, consent would be sought from their parent or the person in the closest qualifying relationship to them at the time of their death.
Organs and tissue you can donate
Advances in transplant medicine mean more patients can now be saved, or their quality of life improved through organ donation.
You can record a decision to donate or not to donate on the NHS Organ Donor Register.
If you decide to record a decision to donate, you can choose which organs and tissue you would like to donate.
The organs and tissue which can be donated are:
- heart
- lungs
- kidneys
- liver
- pancreas
- small bowel
- tissue
Further information is below.
Heart
Blood being pumped around your body by your heart carries oxygen and nutrients.
Without the heart, your body wouldn’t get oxygen.
For conditions such as heart disease, sometimes medicine or conventional surgeries no longer work. A transplant is sometimes the only option.
Your heart can be transplanted whole or in some cases the valves (pulmonary and aortic) can be transplanted.
Lungs
Your lungs supply oxygen to your blood and clear carbon dioxide from your body.
Without healthy lungs you couldn’t breathe properly.
Many patients needing a transplant have chronic infection of the lungs from cystic fibrosis and other conditions such as bronchiectasis.
Kidneys
Your kidneys filter wastes from your blood and convert them to urine.
When your kidneys stop working you can develop kidney failure.
Harmful wastes and fluids build up in your body and your blood pressure may rise.
When kidneys fail, people suffer tiredness, swelling, breathlessness, anaemia, anxiety and nausea.
A kidney transplant frees patients from the burden of dialysis.
You can live healthily with one kidney.
Liver
Your liver produces bile to clean out your body.
If your liver isn’t working right, you will begin to feel tired, experience nausea, vomiting, decreased appetite, brown urine, or even jaundice (yellowing in the whites of your eyes).
Transplantation can:
- treat the symptoms of a disease such as primary biliary cirrhosis
- save the life of a patient dying from liver failure
Your liver can be transplanted whole or in some cases the cells (hepatocytes) can be transplanted.
Pancreas
Your pancreas is in your abdomen.
It produces insulin to control your blood sugar levels. If your pancreas is not working correctly your blood sugar level rises, which can lead to diabetes.
A pancreas transplant is the only treatment which restores insulin independence for people with Type 1 diabetes and can prevent, or slow, diabetic complications like blindness or kidney failure.
Your pancreas can be transplanted whole or in some cases the cells (islet cells) can be transplanted.
Small bowel
The small bowel (also small intestine) absorbs nutrients and minerals from food you eat.
If your small intestine fails, you can't digest food. You would need to get nutrition from an alternative method, such as through a drip into your vein.
Small bowel transplantation can help adults and children with intestinal failure, to avoid life-threatening infections and other complications.
Tissue
Tissue is a group of cells that carry out a particular job in your body.
It can include heart valves and parts of the eye, such as the corneas and sclera, and can save the lives of children born with malformed hearts or help to restore sight for people with eye disease or injuries.
Tissue donations save hundreds of lives every year. One tissue donor can enhance the lives of more than 50 people.
Corneas
The cornea lets light into your eyes. Without them, you can't see.
The gift of sight is precious.
Your donation can help someone regain their sight.
Living donation
It is possible to be a living donor.
The most common type is kidney donation, when one kidney is removed from a healthy individual and transplanted into someone else, often a relative.
It is also possible to donate part of a liver.
Living donation is obviously a major decision and every person who comes forward undergoes a thorough assessment.
All live donors and recipients are reviewed by an independent assessor, who is responsible for making sure:
- there is no pressure or coercion involved
- all parties understand the risk of complications
The NHS Organ Donor Register is only for those who wish to donate after death.
To be a living donor, you must contact a transplant centre directly.
Contact details for living kidney donation at the Transplant Unit, Belfast City Hospital are below:
- Email: donatelife@belfasttrust.hscni.net
- Website: Donate Life
There are no liver transplant centres in Northern Ireland, but you can still enquire about living liver donations at enquiries@nhsbt.nhs.uk.
What happens after donation
Families are given the opportunity to spend time with their loved one after the operation if they wish, and this is facilitated by the specialist nurse.
Arrangements for viewing the body after donation are the same as after any death.
Organs and tissue are always removed with the greatest of care and respect.
The patient’s wounds are closed and dressed the same as after any other operation.
The organ donation operation is performed as soon as possible after death.
To allow the process to be organised and successful donation to take place, it can cause a short delay to funeral arrangements, possibly up to 24 hours.
After this, however, funeral arrangements can be made as normal, including the option to have an open coffin.