Introduction: Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. Over the last five years, very considerable gains have been made towards maximising organ donation from deceased donor in the United Arab Emirates . This has been the result of giving due attention to all parts of the donor pathway from initial identification and referral through to better donor management, and in particular is attributable to a family approach and authorization. Despite impressive improvements in some elements of the pathway, there is one crucial outcome that has proven stubbornly resistant to change, namely the proportion of families who give their consent/authorisation for organ retrieval to take place. Recent data from Emirates Organ Transplant Centre reveal that consent/authorisation rates for donation after brain-stem death (DBD) are increasing, but still family refusal represents the biggest ‘step down’ in loss of potential donors in the whole of the donation pathway.

Method: A retrospective analysis of patients referred to the Emirates Organ Transplant Centre for possible organ donation before 2022 and after 2022. Data regarding organ donation demographics and family consent rates have been compared before (2022 ) and after (2022). The conversion rate will be  calculated as the number of actual donors divided by the number of potential donors and is represented as a percentage.

Results: More than 200 nationalities living peacefully and successfully in the UAE, the UAE society has been an undisputed example of being a tolerant and inclusive country. The UAE organ donation and transplantation program has been helping patients from 48 different nationalities such us India, Philippines, Pakistan, Jordan, Kuwait, among others. The UAE brain death donor rate grows from 0.91 dpmp in 2020 to 5.4 dpmp in 2022. 41% increase in UAE dpmp rates was observed in 2022 compared to 2021. The 130 DBDs achieved up to to date have benefit 457 transplant recipients. The study of the differences between consent rates among UAE donor nationalities is currently ongoing, the results will allow us to understand the opportunities for system improvements.  

Conclusions: Deceased organ donation best practices should be adjusted according to the healthcare system, the cultural, political, and geographical local reality. The UAE’s diversity population will bring answers about how to tailor donor family approach.