(Press-News.org) EMBARGOED: Not for Release Until 00:01 AM (UK Time) on Friday 3 November 2023
New research highlights the need for routine discussions about eye donation in end-of-life care clinical settings
Less than four per cent of eligible patients in end-of-life care settings were asked to consider eye donation
Patients had positive views about eye donation, but most did not know it could be an option for them
Staff need training and guidance to support discussing eye donation with patients
A new study has found there is significant scope to increase the number of eye donations from patients cared for in hospice and palliative care settings - donations which are desperately needed for sight-restoring surgeries.
Researchers from the University of Southampton and clinical partners, including NHS Blood and Transplant, carried out the study, which has been funded by the National Institute for Health and Care Research (NIHR). It found just a small fraction of eligible patients in hospice and palliative care settings are being approached to consider the option of eye donation. This is despite both healthcare professionals and patients having favourable views towards it.
The researchers say practice needs to change so that patients who wish to donate are being offered the opportunity as a part of routine end-of-life care.
Demand for eye tissue
Over two million people in the UK are living with sight loss, taking a huge toll on their lives and costing the economy a reported £4.34 billion each year. Some conditions, such as Keratoconus and Fuchs’ Corneal Dystrophy, can be treated with surgery which removes all or part of a damaged cornea and replaces it with healthy donor tissue (corneal transplant). But there is a shortfall in the supply of donor tissue needed for operations.
NHS Blood and Transplant aims to achieve a weekly stock of 350 eyes for use in surgery or research. But from April 2021 to March 2022, only 88 eyes on average were donated per week.
The RNIB predicts that by 2050, the number of people with sight loss will double to nearly four million (mainly due to the ageing population), further increasing the demand for eye tissue. Each donor can help restore or improve the sight of up to 10 people.
‘Many potential donors’
Clinical partners across England reviewed the case notes of 1,199 deceased patients in three hospice care and three hospital-based palliative care services.
Although 46 per cent of patients were eligible to donate their eyes, less than 4 per cent of potential donors had been approached or referred for eye donation.
Views on donation
To understand attitudes and potential barriers to eye donation, the researchers interviewed over 100 healthcare professionals and over 60 patients and carers receiving palliative care. They also conducted a national survey of 156 service providers.
Dr Tracy Long-Sutehall, Associate Professor at the University of Southampton and lead author of the research which has been published today [3 November] in the Health and Social Care Delivery Research Journal, says:
“Many patients and carers were not aware of eye donation being an option for themselves or their relative. Those we spoke to generally had positive views about eye donation and were open to being asked about their preferences. This suggests there could be many potential donors in hospice and palliative care settings who are willing to donate their eyes after their death so that others might see.”
Knowledge gap
Healthcare professionals were in favour of eye donation being discussed as part of end-of-life care planning but had gaps in their knowledge around eligibility criteria and processes for referral; more than half had received no formal training regarding eye donation. As such, the majority had never, or hardly ever, initiated a discussion about eye donation with patients or family members.
Dr Long-Sutehall added: “Conversations around eye donation need to be sensitively managed, so it’s understandable that healthcare professionals would be reluctant to raise it if they haven’t had suitable training and education.”
Future opportunities
The study demonstrates that there is significant potential for more patients to be given the opportunity to donate their eyes in the future, and for eye donation to be embedded in routine end-of-life care clinical practice.
Emma Winstanley, Lead Nurse for Tissue and Eye Services at NHS Blood and Transplant who was a co-applicant on the study, says:
“This research provides crucial new insight to better understand both patient and healthcare staff views on eye donation. With more patients dying outside of traditional hospital settings, either at home or in hospices, it is essential that patients have the opportunity to donate whenever donation is possible. Eye donation is particularly special as donation can even be possible for patients who have cancer. We know that many patients and families take great comfort and pride from donation. By working closely with hospice colleagues, we can enable more patients to donate and more life-transforming surgeries to take place.”
The researchers highlight several implications for service development, healthcare practice and recommendations for further research, including the evaluation of a Support Toolkit for Eye donation in Palliative care Settings (STEPS) developed by the research team.
Eye Donation from Palliative and Hospice care contexts: the EDiPPPP mixed methods study was funded by the NIHR Health and Social Care Delivery Research programme.
Ends
Contact
Steve Williams, Media Relations, University of Southampton press@soton.ac.uk or 023 8059 3212.
Notes for editors
Eye Donation from Palliative and Hospice care contexts: the EDiPPPP mixed methods study is published in the Health and Social Care Delivery Research Journal and is available to download here: Eye donation from palliative and hospice care contexts: the EDiPPPP mixed-methods study (nihr.ac.uk)
Interview opportunities
Dr Tracy Long-Sutehall, Associate Professor at the University of Southampton and lead investigator on the EDiPPPP study. (Southampton)
Dr Sarah Mollart Consultant in Palliative Medicine at St Nicholas Hospice and clinical investigator on the EDiPPPP study. (Bury St Edmunds, Suffolk)
Laura – Mum of two who has had two corneal transplants for an undiagnosed illness. This has allowed her to see her children grow up. Her mother has also had a corneal transplant. (London)
Angie – Hospice nurse who made the decision (along with her mum and sister) to donate her father William’s corneas, kidneys and heart valves. The hospice she works at promotes discussion about organ donation (including corneas). (Wolverhampton)
Images available to download here: https://safesend.soton.ac.uk/pickup?claimID=ANs4m4SFgmFFfuBh&claimPasscode=a9JAjbHmcAcnCzcC
Placido disk reflected off eye with keratoconus - Credit National Keratoconus Foundation
Eye after cornea transplant - Credit NHS Blood and Transplant
Additional information
The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2023). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 22,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 200,000 alumni. www.southampton.ac.uk
www.southampton.ac.uk/news/contact-press-team.page
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About the National Institute for Health and Care Research (NIHR)
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
Funding high quality, timely research that benefits the NHS, public health and social care;
Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low-and-middle-income countries is principally funded through UK Aid from the UK government.
END
Study reveals untapped potential to increase eye donations needed for sight-restoring surgeries
2023-11-03
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