Optimizing Organ Donation: Expert Opinion from Austria, Germany, Spain and the U.K

Ann Transplant. 2020 Mar 17;25:e921727 doi: 10.12659/AOT.921727.
Abstract

BACKGROUND Organ donation-rates using deceased donors and organizational approaches to organ donation differ drastically between countries at a similar level of health care as measured by the Euro Health Consumer Index (EHCI). MATERIAL AND METHODS Expert opinions from intensive care nurses, physicians, transplant coordinators and transplant surgeons from Austria, Germany, Spain, and the U.K. were obtained in semi-structured interviews followed by qualitative content analysis. Results were reported back to all interview partners to identify potential controversies and consensus recommendations. RESULTS No controversies could be detected. On a variety of beneficial factors an interprofessional consensus between interview partners could be reached: A) The relevance of standardization of the screening for potential donors, the family approach and training; B) standards and best-practice procedures should be regulated and supervised by state authorities; C) full transparency and the prevention of scandals is essential; D) overburdened intensive care unit (ICU) doctors need to be supported by full-time in-house special nurses who organize donor evaluation, transport logistics and pastoral care, if required; E) public awareness campaigns are helpful; F) a broad public consensus on the concept of donation after brain and cardiac death is essential; G) incentives for the reporting of potential organ donors are inappropriate; H) an opt-out system alone is not sufficient. CONCLUSIONS Expert opinions from different professional backgrounds from different European health care systems reach a broad consensus on the most relevant issues for the improvement of organ donation.

Metadata
Organisation: Becker, Fabian. Department of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany. Becker, Fabian. Management Team of the Transplant Center, Hannover Medical School, Hannover, Germany. Roberts, Keith J. Liver Unit, Queen Elizabeth Hospital, University of Birmingham, Birmingham, United Kingdom. Nadal, Miriam de. Department of Anesthesiology, Surgical Intensive Care Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain. Zink, Michael. Department of Anesthesiology and Intensive Care Medicine, General Public Hospital Brothers of Saint John of God, St. Veit/Glan and General Public Hospital of the Order of Saint Elisabeth in Klagenfurt, Head of the Transplantation Advisory Board, Klagenfurt, Austria. Stiegler, Philipp. Department of General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria. Pemberger, Sonja. Intensive Care Unit 2, KABEG Klinikum Klagenfurt am Worthersee, Klagenfurt, Austria. Castellana, Teresa Pont. Transplant Coordinator, Donation and Transplant Procurement and Management, University Hospital Vall d'Hebron, Barcelona, Spain. Kellner, Christian. Department of General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria. Murphy, Nick. Critical Care and Anaesthetics, Queen Elizabeth Hospital, University Hospitals, Birmingham, United Kingdom. Kaltenborn, Alexander. Management Team of the Transplant Center, Hannover Medical School, Hannover, Germany. Tuffs, Annette. Management Team of the Transplant Center, Hannover Medical School, Hannover, Germany. Amelung, Volker. Department of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany. Krauth, Christian. Department of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany. Bayliss, Janice. Midlands Organ Donation Services Team, NHS Blood and Transplant and Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom. Schrem, Harald H. Department of General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria.
Funding: Non-industry funding
Publication type: Guideline
Organ: Liver
Language: English
MeSH terms: Austria; Delivery of Health Care; Expert Testimony; Germany; Humans; Organ Transplantation; Qualitative Research; Spain; Tissue Donors; Tissue and Organ Procurement; United Kingdom; Liver Transplantation