The national Organ and Tissue Authority works alongside all Australian states and territories to improve organ and tissue donation and organ transplant outcomes.
In Victoria a number of organisations - including the Australian Red Cross Blood Service and DonateLife Victoria - work alongside specialised health professionals and hospitals to implement the reform agenda. Protocols have also been developed to ensure equitable and transparent transplant criteria.
The Organ and Tissue Authority
In 2009 the Commonwealth Government created the Organ and Tissue Authority to develop, implement and monitor national programs to increase the rate of organ and tissue donation across Australia. The authority was allocated $151 million over an initial four-year period to develop and implement a national reform program. This funding has enabled:
- the employment of DonateLife Network health professionals in public and private hospitals
- organ donation activities at hospitals
- organisations to provide essential support services to health services.
Since the implementation of the reform program in 2009 the national and Victorian donation rates have increased significantly.
- The Australian donation rate per million population increased from 11.4 in 2009 to 22.2 in 2018.
- The Victorian donation rate per million population increased from 12.1 in 2009 to 29.9 in 2018.
This indicated that the Victorian donation rate is significantly above the national average.
Following the initial success of the national reform program, the Australian Government will continue to fund organ donation and transplantation services.
Paired Kidney Exchange program
The Australian Paired Kidney Exchange program (AKX) is part of the Organ and Tissue Authority’s efforts to increase the number of living kidney donors. The AKX program uses the computerised national Organ Match system to find compatible donors among other registered pairs who might be suitable. This can enable two or more simultaneous living donor transplants to occur. The AKX program is coordinated from Victoria by the Royal Melbourne Hospital.
The national reform agenda also includes strategies to encourage the donation of tissues from committed organ donors.
Victorian implementation of the national reform agenda
Victorian implementation of the federal scheme involves a multidisciplinary approach with the Department of Health and Human Services working alongside specialist programs and health professionals, the Australian Red Cross Blood Service, DonateLife Victoria and hospitals.
Department of Health and Human Services
The department plays a major direct and indirect funding support role in every phase of the process of organ donation and transplantation. It provides:
- funding for the costs of transporting the organ retrieval team to the donor’s hospital, surgery at the donor’s hospital, and transporting the team with the donated organs back to the transplant hospital
- additional funds to health services to employ organ donation specialists
- contributions to the nationally funded centres for paediatric transplant patients
- funding for tissue typing costs.
Organ donation specialist doctors and nurses
Private and public hospitals participate in organ and tissue donation and transplantation programs by employing experienced doctors and nurses whose specialised role is to facilitate organ and tissue donation opportunities.
In Victoria, medical and nursing organ and tissue donation specialists are based in a number of metropolitan and regional health services. The network of Victorian hospitals and staff dedicated to donation activities ensure that a state wide service is provided for all Victorians. The authority reimburses these hospitals for carrying out organ donation activities. Hospital costs include pathology and imaging, staff time in the emergency department and intensive care unit, and the costs of transferring a potential donor from a regional hospital to a larger, more specialised hospital.
There are six primary Victorian hospitals that provide the transplantation services: The Alfred Hospital, Austin Health, Melbourne Health, Monash Medical Centre, Royal Children's Hospital and St Vincent’s Health.
DonateLife Victoria is the organ donation agency for Victoria. DonateLife Victoria’s team of health professionals provides a range of support services to participating health services and hospital-based organ donation specialists. The team coordinates donation services, encourages best practice, and helps raise community awareness and understanding.
DonateLife Victoria trains and supports DonateLife Tasmania’s organ donation specialist nursing coordinators. Organ donation and transplantation specialists from Victoria work with Tasmanian doctors, nurses and hospitals to facilitate donation and transplantation activities.
Australian Red Cross Blood Service
The department funds the Blood Service to coordinate Victorian organ donation activities. The Blood Service currently provides support to DonateLife Victoria and DonateLife Tasmania, and tissue typing services through the Victorian Transplantation and Immunogenetics Service.
Lions Eye Donation Service
The Lions Eye Donation Service (LEDS) operates as part of the Department of Ophthalmology of Melbourne University at the Royal Eye and Ear Hospital. LEDS staff members collect and distribute human eye tissue for vision restoration, research and education.
Donor Tissue Bank of Victoria
The Donor Tissue Bank of Victoria (DTBV) is a multi-tissue bank, processing skin, bone, cartilage, tendons, connective tissue and heart valves for transplantation. The DTBV provides surgeons with safe and effective tissue grafts for orthopaedic, cardiothoracic, reconstructive surgery and burn care. The microbiology laboratory is licensed by the Therapeutic Goods Administration to carry out testing on cadaveric tissues for transplantation.
DTBV, LEDS and DonateLife Victoria are working collaboratively to increase tissue donation from hospital sources.
National protocols for organ recipient priority
The Transplantation Society of Australia and New Zealand has developed equitable and transparent national criteria and protocols for selecting recipients for donated organs. Organs from deceased donors are allocated to transplant recipients in a process that takes no account of race, religion, gender, social status, disability or age, unless age is relevant to the organ-matching criteria.