In-house coordination for organ donation – single center experience in a pilot project in Germany

Gernot M. Kaiser¹, Claas Baier², Sonia Radunz¹, Holger Krauss³, Andreas Paul¹

¹General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany, ²Administration, University Hospital Essen, Essen, Germany, ³NRW, DSO, Essen, Germany

The most urgent challenge for solid organ transplantation in Germany is the shortage of organs. Recent data demonstrate a consistently low donation rate in Germany (less than 15 organ donors per million) compared to the rest of the world . In an effort to increase donation rates, some federal states mandated that hospitals install transplantation officers to coordinate, evaluate, and enhance the donation and transplant processes.

In 2009 the German foundation for Organ Transplantation (DSO) implemented the so called “In-house coordination project,” which includes retrospective, quarterly, IT-based case analyses of all deceased patients with primary or secondary brain injury in regard to the organ donation process. From 2006 to 2008 an analysis of potential organ donors was performed in our hospital using a time consuming, complex method that of questionnaires, hand-written patient files, and the hospital IT documentation system (standard method). Analyses in the In-house Coordination project are instead carried out by a proprietary semi-automated IT Tool called Transplant Check, which uses easily accessible standard data records of the hospital controlling and accounting unit. The aim of our study is to compare the results of the standard method and Transplant Check in detecting and evaluating potential donors. To do so, the same period of time (2006 to 2008) was re-evaluated using the IT Tool.

In the comparison of both investigation methods during the same time period, Transplant Check was able to record significantly more patients who fulfilled the criteria for inclusion (641 vs. 424). The methods displayed a wide overlap, apart from 22 patients who were only recorded by the standard method (see figure 1). In these cases, the accompanying brain injury diagnosis was not recorded in the controlling and accounting unit data records due to little relative clinical significance. None of the 22 patients fulfilled the criteria for brain death.

The IT Tool detected a greater number of death, which included those who eventually became organ donors and who qualified as potential donors. Therefore, Transplant Check is an easy to use, reliable, and valid tool for evaluating donor potential in a maximum care hospital. Therefore from 2010 on, analyses were performed exclusively with Transplant Check.