ORGAN DONATION AND ALLOCATION I

R. Deulofeu, J. Twose, M. Sanroma
Health Department Of Catalan Goverment, Catalan Organization of Transplants, Barcelone/SPAIN

Body: Introduction. We are used to comparing our activity using only donation or transplantation population rates between regions or countries, without further evaluation of the process. Rates, give us a general idea of the activity magnitude, but they are not enough. The aim of this study is to propose different quality indicators for evaluating the organ procurement process and to show Catalonia’s results during 2000-2009. Methods. Extraction index (EI) is defined as the number of organs extracted from valid donors. Transplantation index (TI) is the number of transplanted organs from valid donors and Utilization percentage (UP) the number of organs actually transplanted versus the number extracted. We studied the number of brain deaths (BD) detected, valid donors, organs retrieved and transplanted organs obtained in Catalan hospitals during 10 years (2000-2009). We defined as valid donors those who arrived to the extraction stage. 3311 cases (BD) were detected, but 30.5% were rejected mainly for medical contraindications and family refusal, so finally we obtained 2300 valid donors that provided 7659 organs, of which 6207 were transplanted. Results. Overall, the EI was 3.33 [3.22-3.56]: we retrieved a mean of 3.33 organs per valid donor; the TI was 2.70 [2.52-2.83]; and the UP was 81.04 [78.14-85.09]. Regarding organs, the EI of kidneys was 1.87, liver 0.88, heart 0.23, lung 0.26 and pancreas 0.10, whereas the UP was 79.22, 80.43, 92.02, 86.46 and 81.50 respectively. We observe also differences according to the age group of donors. Conclusions. We transplanted 81% of the total retrieved organs (3.3 organs retrieved per valid donor). Catalonia has one of the highest world rates of cadaveric donation; however, whilst the results of this study show high effectiveness in renal and liver transplantation, results in heart, pulmonary and pancreatic transplants are improvable. While we compare the donation and transplantation activity between regions and countries, the organ procurement process does not finish with the donation and it is also interesting to know the utilization of the organs obtained from these donors. We propose the use of these easily-obtainable indicators to more accurately measure and compare the effectiveness of the complete organ procurement process.

Disclosure: All authors have declared no conflicts of interest.