Review of deceased organ donation and transplantation

The Ministry of Health is leading a review of organ donation and transplantation.

Organ donation is a life-saving treatment and for people with organ failure it is the best, or only, option available. While New Zealand has made progress to increase organ donation and transplantation rates in recent years, we still have relatively low rates of deceased donation compared with many other countries.

This review aims to identify what can be done to increase deceased donation rates. The review is looking at current practices and trends in New Zealand, along with recent initiatives to increase deceased organ donation and transplantation rates. It has also considered features of higher performing organ donation systems overseas and identified issues within New Zealand that may be impacting donation rates. See the Terms of Reference (Word, 32 KB) of the review to find out more.

The Ministry has been supported by an expert advisory group with a range of knowledge and experience. These include clinical, ethical, behavioural change, public perspectives, and Māori views. See the Terms of Reference (Word, 27 KB) of the group to find out more.

The Ministry gave initial advice to the Minister in March 2016, and is now consulting more widely on the issues and options that the review has identified.

Consultation process

As part of the work to develop a deceased organ donation strategy, the Ministry completed a public consultation process on a set of preliminary proposals. One hundred written submissions were received from health professionals, health organisations and individuals. These submissions have been summarised and analysed in an internal report subsequently: Increasing Rates of Deceased Organ Donation: Summary of submissions.

The Ministry is now working with the sector to finalise the strategy, which looks to strengthen national coordinating arrangements, as well as looking at effective ways for hospitals to identify potential donors and discuss donation with families.

Background papers

As part of the Review, The Ministry of Health prepared draft working papers about different aspects of organ donation. These papers were developed as inputs into the initial advice that was provided to the Minister at the end of March 2016.

The papers were developed on the following topics:

  • Background information on organ donation and transplantation in New Zealand
  • Summary of international examples of organ donation reform programmes
  • Public and media awareness and promotion of organ donation
  • Registers for deceased organ donation
  • Ethnic, cultural and religious differences in relation to deceased organ donation
  • Incentives for deceased organ donation
  • Donation rates and trends in New Zealand and the potential scope to increase deceased donation.

In addition, the Ministry commissioned an independent report from consultancy firm Ernst and Young (EY), which looked at practices in clinical settings and institutional arrangements for deceased organ donation in New Zealand, to provide advice to the Ministry. EY’s analysis and recommendations have been incorporated into the wider Review.

The Ministry’s draft working papers and the EY report are attached for your information. The Ministry’s initial report to the Minister on the Review can be found on the Ministry’s Review consultation page.

Previous initiatives

The last significant review in New Zealand occurred between 2002 and 2008. This focused on overhauling the Human Tissue Act. Since then, the Government has invested in a number of initiatives to increase organ donation and transplantation rates.

To address live organ donation, Government provided $4 million in Budget 2014 over four years to establish a new National Renal Transplant Service to increase the number of live kidney donor transplantations. This includes continuation of the New Zealand Kidney Exchange programme, which enables incompatible live kidney donor/recipient pairs, to be listed for an exchange with other pairs in the same situation. New Zealand is now looking at the potential of a joint programme with Australia to increase the chance of bringing together suitable pairs.

In Budget 2012, Government provided $1.8 million for the Clinical Research and Effective Practice Foundation (now the Middlemore Clinical Trials) to trial a pilot in Counties Manukau District Health Board over three years to help overcome barriers to live donor kidney transplantation in Pasifika and Māori communities.

It is still too early to evaluate the success of these initiatives. However, there are some indications that live donation rates are improving.

To address deceased donations, Government allocated $2 million in Budget 2012 to Organ Donation New Zealand to increase support, coordination and education for staff in intensive care units. Between 2014 and 2015 the number of deceased donors increased from 46 to 53. 

To learn more about organ donation, becoming a donor, and the role of Organ Donation New Zealand, visit the Organ Donation New Zealand website.

Expert advisory group members

Full Name Organisation Role
Dr Don Mackie (chair) Ministry of Health Chief Medical Officer
Dr Nick Cross Canterbury DHB Clinical Director of National Renal Transplant Service and Nephrologist
Ms Joanne Gibbs Auckland DHB Director of Provider Services
Stephen James Capital and Coast DHB Charge Nurse Manager, Intensive Care Unit
Ms Eva Mehakovic Organ and Tissue Authority, Australia Director, Clinical Programs
Dr Helen Opdam Organ and Tissue Authority, Australia National Medical Director
Mr Max Reid Kidney Health NZ Chief Executive Officer
Dr Michael Roberts Northland DHB Chief Medical Officer
Sir Pita Sharples   KNZM CBE, Māori academic and politician, co-leader Māori Party 2004-2013, Minister outside Cabinet 2008-2014
Dr Catherine Simpson Auckland DHB Intensive Care Consultant
Dr Stephen Streat Auckland DHB Critical Care Medicine, Auckland City Hospital Clinical Director of Organ Donation NZ and Intensivist
Dr Louise Trent Hawke’s Bay DHB Intensive care consultant
Dr Catherine Trundle Victoria University of Wellington Senior Lecturer, School of Social and Cultural Studies
Mr Martin Wilkinson National Ethics Advisory Committee & University of Auckland Ethicist, Deputy Chair National Ethics Advisory Committee, Associate Professor of Political Studies
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