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SAFEBOD – the SAFEty and Biovigilance in Organ Donation Public Health Register

The Safety and biovigilance in organ donation (SAFEBOD) Public Health Register draws together health records from all people considered as organ donors, all actual donors and all organs recipients in NSW. SAFEBOD was conceived by the CODE team and created as a Public Health Register, under the Public Health Act, NSW 2010, by the NSW Ministry of Health. The aim of SAFEBOD is to provide evidence to support an increase in donors that can be safely used for transplantation, so that more people waiting can receive a transplant.

Insights from the ORCHARD database showed the CODE team that the information available for decision-making at the time of making organ donor decisions was far from perfect. Full medical records are not always available, and next of kin are often unaware of the specifics of their family member’s past medical history. The CODE team also thought it was important to know if there had been any transmissions of infection of cancer from donors to recipients, that transplant services had not planned for. The SAFEBOD database has allowed the CODE team to check how accurate the medical history information was at the time the donation decision was made, by going back and checking all the medical history available for each potential donor from a range of other data sources. Using SAFEBOD, the CODE team has also produced reliable estimates of how likely infection or cancer transmission is from donor to recipient, over the past 10 years. The SAFEBOD register is being harnessed to provide insights into systems issues in the organ procurement pathway, establishes incidence of biovigilance transmission and non-transmission events from organ donors to recipients, and illuminates the potential for missed opportunities (potential donors who could have been safely used but were not) for donation.