The role of medical examiners in organ donation

Medical examiners (ME) are senior doctors providing independent scrutiny of non-coronial deaths in England and Wales only. This role has been a statutory requirement since 9 September 2024.

In the context of organ and tissue donation, MEs can advise the senior clinician responsible for care whether there are any requirements to refer the death to the HM Coroner under the Notification of Deaths Regulations (2019).

The treating clinician should discuss the potential donor’s cause of death with an ME early in the organ or tissue donation process, to help identify if the death is coronial and avoid unexpected coroner referrals after retrieval.

The National Medical Examiner has issued guidance to MEs acknowledging the value of these discussions prior to death, even though full scrutiny cannot occur until after death. This can be found on the Royal College of Pathologists website under 'Good Practice Series No. 4':

National Medical Examiner's Good Practice Series – The Royal College of Pathologists

Tissue donation

In contrast to deceased organ donation, tissue donation can be considered after any death. Tissue donation can take place in a mortuary, hospice or funeral home.

Timely ME scrutiny is essential, as delays can reduce the already short window for tissue retrieval. Tissue donation services can advise on necessary timeframes to identify any requirement of coroner referral.

NHS Blood and Transplant care of tissue donors operates seven days a week, between 8am and 8pm. The retrieval of corneal tissue must take place within 24 hours, with other tissues needing be retrieved within 48 hours of death.

Other pages in this section