Vol. 13 No. 1 (2020): The Gift of Life

Organ Donation Law & Its Impact on BAME Communities

Professor Nithya Krishnan MD FRCP
University Hospital Coventry & Warwickshire NHS Trust, UK
Kirit Modi
National Kidney Federation UK
portrait of nithya krishnan

Published 2020-04-17


  • organ donation,
  • transplantation,
  • BAME Communities,
  • Opt-in,
  • Opt-out

How to Cite

Krishnan, N., & Modi, K. (2020). Organ Donation Law & Its Impact on BAME Communities. Sushruta Journal of Health Policy & Opinion, 13(1), 13–15. https://doi.org/10.38192/13.1.4


Opt out will be introduced in England and Scotland in 2020; building on its success in Wales. BAME issues have moved higher up the agenda and will feature in the new post 2020 Strategy on organ donation and transplantation. BAME communities are taking greater leadership roles in in engaging with their communities with the establishment of the Community Investment Scheme and the Living Transplant Initiative. Organisation such as the NBTA and BAPIO are involved in influencing future strategies and policies.


  1. Suthanthiran M, Strom TB. Renal transplantation. N Engl J Med. 1994; 331:365–76.
  2. The Madrid Resolution on Organ Donation and Transplantation. National Responsibility in Meeting the Needs of Patients, Guided by the WHO Principles. http://www.transplant-observatory.org/download/the-madrid-resolution-on-organ-donation-and-transplantation/ (last accessed 24/2/2020).
  3. World Health Organization. WHO guiding principles on human cell, tissue and organ transplantation. Transplantation. 2010 Aug 15;90(3):229-33.
  4. United Nations. Universal Declaration of Human Rights, 1948.
  5. Department of Health. The potential impact of an opt out system for organ donation in the UK: an independent report from the Organ Donation Taskforce. (2008).
  6. http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_090303.pdf (last accessed 24/2/2020).
  7. Transplant activity in the U.K. https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/1291/transplant_activity_uk_2007-2008.pdf (last accessed 24/2/2020).
  8. Rithalia, Mcdaid, Ridgers et al. A Systematic Review of Presumed Consent Systems for Deceased Organ Donation. Health technology assessment (Winchester, England) June 2009; 13(26):iii, ix-xi, 1-95. DOI: 10.3310/hta13260
  9. Taking Organ Transplantation to 2020: A detailed strategy.
  10. https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/1395/nhsbt_organ_donor_strategy.pdf (last accessed 24/02/2020)
  11. What is opt out system in England? ODT, NHSBT, U.K
  12. https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/faq/what-is-the-opt-out-system/ (last accessed 24/2/2020)
  13. Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities. Report for 2018/2019. ODT, NHSBT, U.K
  14. https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/16918/organ-donation-and-transplantation-bame-activity-report-2018-2019.pdf (last accessed 24/2/2020).
  15. Policies and guidance. ODT, NHSBT, U.K
  16. https://www.odt.nhs.uk/transplantation/tools-policies-and-guidance/policies-and-guidance/ (last accessed 24/2/2020).
  17. Yacoub R, Nadkarni GN, Cravedi P, et al. Analysis of OPTN/UNOS registry suggests the number of HLA matches and not mismatches is a stronger independent predictor of kidney transplant survival. Kidney Int 2018; 93:482.
  18. Williams RC, Opelz G, McGarvey CJ, et al. The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts From Deceased Donors. Transplantation 2016; 100:1094.
  19. Lim WH, Chadban SJ, Clayton P, et al. Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients. Clin Transplant 2012; 26: E428.
  20. Noyes, McLaughlin, Morgan et al. Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study. BMJ Open; Vol 9, issue 4. 2018. http://dx.doi.org/10.1136/bmjopen-2018-025159 (last accessed 24/2/2020).
  21. Chris J Rudge Organ donation: opting in or opting out? British Journal of General Practice 2018; 68 (667): 62-63. DOI: https://doi.org/10.3399/bjgp18X694445
  22. Rithalia A, McDaid C, Suekarran S, et al. Impact of presumed consent for organ donation on donation rates: a systematic review. BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.a3162
  23. Morgan , Kenten , Deedat et al. Attitudes to deceased organ donation and registration as a donor among minority ethnic groups in North America and the UK: a synthesis of quantitative and qualitative research. Ethnicity & Health, Volume 18, 2013 - Issue 4 Pages 367-390
  24. Lin, Y., Osman, M., Harris, A. J. L., & Read, D. (2018). Underlying wishes and nudged choices. Journal of Experimental Psychology: Applied, 24(4), 459–475. https://doi.org/10.1037/xap0000183
  25. Final report of Living Transplant INITIATIVE. Increasing living kidney donations among some BAME communities. https://www.nbta-uk.org.uk/wp-content/uploads/2020/01/LTI-FINAL-REPORT-Nov-2019-1.pdf (last accessed 24/2/2020)
  26. NHSBT press release on Community Investment Schemes: https://www.organdonation.nhs.uk/get-involved/news/projects-in-england-and-wales-win-funding-to-promote-organ-donation-among-bame-communities/ (last accessed 24/2/2020)