INTERNATIONAL TRENDS IN ORGAN DONATION

L. Roels¹, J. Smits², B. Cohen^1
1, Donor Action Foundation, Linden/BELGIUM, ², Eurotransplant International Foundation, Leiden/NETHERLANDS

Body: Background: The conversion rate of potential into actual donors is accepted as being the gold standard to assess hospitals’, regions’ or countries’ performance in organ donation. Transplant centers increasingly tend to accept older donors to challenge their organ shortage problem. The study presented aimed at investigating on differences in conversion rates for heart-beating organ donation between 5 European countries in relation with donor age. Methods: A total of 49,130 Donor Action^® (DA) Medical Record Review (MRR) files were collected from Critical Care deaths between January 2006 and June 2009 in 5 European countries that have implemented DA’s methodology as a quality assurance tool (Belgium: n=17,663, Finland: n=2,447, France: n=20,821, Poland: n=1,163, and Switzerland: n=7,036). Data was entered to the DA System Database for further analysis. According to DA’s MRR algorithm, ‘potential donors’ are defined as medically suitable and ventilated patients meeting all criteria for brain death diagnosis. Donor age categories were < 30 yrs (potential: n=674), 30-49 yrs (potential: n=1,223), 50-69 yrs (potential: n=1,942) and 70+ yrs (potential: n=1,039). Results: Average total conversion rates were 39.5% in Finland, 39.4% in France, 35.4% in Belgium, 34.8% in Switzerland and 28.9% in Poland (P=.0007). Aggregated conversion rates were highest in the < 30 yrs group (41.3 ± 6.4%), and 30-49 yrs (41.6 ± 3.5), to decrease to 36.5 ± 9.5% (50-69 yrs) and only 18.4 ± 8.4% in the 70+ yrs group. In the age groups of < 30 and 30-49 yrs., conversion rates were highest in Belgium (48.5 and 46.5% respectively) and lowest in Poland (36.7%) and Switzerland (32%). In the age group 50-69, France scored highest (44.3%) and Poland lowest (20.1%, P<.0001). In the age group 70+, again France scored highest with 30% and Finland lowest (12%, P<.0001). Conclusions: DA’s MRR methodology is a powerful and standardized tool to assess countries’ conversion rates of potential into actual donors. Markedly different conversion rates between countries as shown in this study demonstrate a significant room for improvement of donation practices, particularly with regard to an obviously less than optimally exploited use of older donors.

Disclosure: All authors have declared no conflicts of interest.