Soaring obesity rates fuel doubling in the number of organs which cannot be transplanted

NHS transplants are declining because soaring obesity rates have fuelled a doubling in the number of unusable organs in the last decade, a stark report shows.

Official statistics reveal that for every 10 donors, there was one fewer transplantable organ than last year.

In total, 849 organs – more than one in six of those retrieved – were rejected because they were clinically unsuitable in 2018/19, because donors were too overweight, old or suffering from medical problems. The figure is almost double the 460 such cases in 2009/10.

Health officials warned that rates of obesity among deceased donors rose from 24 per cent to 29 per cent in less than a decade.

Experts said the disclosures reflected a tragic worsening of Britain’s lifestyles, with many of those willing to donate organs after their death unaware their weight problem could make this impossible.

Britain has the highest rates of obesity in Western Europe, with rates rising even more quickly than those of the United States.

The report from NHS Blood and Transplant also show an increasing reliance on older donors, whose organs are less likely to be suitable, with 15 per cent of donors aged 70 and over – a rise from eight per cent in 2008/9.

The total number of transplants fell to 3,951, down from 4,038 in 2017/18 – the first drop for five years. Meanwhile, the number of eligible donors saw the first significant fall in a decade, with 5,815 cases, down from 6,038 the previous year. Despite the fact the number of donors reached a record high, with 1,600 such cases, up from 1,574 in a year, the worsening quality of organs meant the number of transplantable organs slumped.

The number of lung or heart and lung transplants fell by a fifth in a year, with just 344 carried out in 2017/18, while 646 people were on the transplant list.

Tam Fry, from the National Obesity Forum, said the figures reflected a spiralling health crisis in Britain.

He said: “There may well be many thousands of people wishing to donate their organs on death who are oblivious to the fact that their obesity renders that impossible.

“Most people think of fat as being visible but it’s the invisible viscous fat that envelopes and crushes vital internal organs that does the damage and renders transplant improbable.

“The greater tragedy is that, as morbid obesity increases, so, too will successful donorship reduce.”

In total there were 5,147 usable organs, down from 5,260 the year before. This equates to around 27 organs for every 10 donors, down from 28 in 2017/18 .

It comes as England and Scotland prepare to follow Wales in introducing a system of presumed consent, requiring those who do not wish to donate to opt out.

The changes, to be introduced next spring, aim to boost rates of organ donation, and encourage more public debate about the issue.

The report warns that the rising proportion of older and obese donors, who are more likely to suffer from medical problems which affect their organ quality is likely to be affecting the numbers of successful transplants.

It warns: “All of these changes may have an adverse impact on the quality and utilisation of the organs, and the subsequent transplant outcome for the recipient.”

Prof John Forsythe, NHSBT medical director of organ donation and transplant, said: “Every potential donor is very precious to us. But what we are seeing reflects the changing demographics of the population”.

“It isn’t surprising that someone with obesity is more likely to have heart disease, which would affect heart transplants. But it has an impact on other organs too – so if the liver is affected by obesity fat is laid around it and it becomes more vulnerable to the process of transplantation; bigger and more fragile. Similarly the capacity of the pancreas is affected if fat is laid around it.”

“In addition, when you have got older or obese donors, there is a higher risk of other conditions – for example diabetes.”