Efetividade do processo de doação de órgãos para transplantes

Abstract

Objective: to verify the effectiveness of the organ donation process in the State of Paraná. Methods: Cross-sectional study carried out with data provided by the Department of Transplantation of the State of Paraná referred to the organ donation process, from 2011 to 2016. Of the 3,872 notifications of potential donors with brain death, 2,600 were included in this study since they were eligible organ donors. The outcome of the protocols and variables related to eligible donors, notifying centers and notifications were evaluated. Data were analyzed descriptively by absolute and relative frequencies, and odds ratio was calculated through the Wald Chisquare test, with p<0.05 considered as statistically significant. Results: Out of the 2,600 eligible donors, 1,267 (48.7%) became effective organ donors. The main obstacles of the process were cardiopulmonary arrest, sepsis and family refusal. The odds of donation were significantly higher in the individuals younger than 60 years old (p<0.001), male (p=0.001) and in the East and West Macro-regions of the State (p<0.001). The percentage of organ donations increased from 38.8% to 66.5% in the period studied. Conclusion: The state of Parana presented a significant increase in the number of notifications and organ donations in the last six years. The weaknesses identified in the process refer to clinical and cultural issues, which indicate the need for interventions to train health professionals in the identification and maintenance of the potential donor, as well as in raising awareness of the importance of the consent to donation. ResumoObjetivo: Verificar a efetividade do processo de doação de órgãos para transplantes no Estado do Paraná. Métodos: Estudo transversal realizado com dados disponibilizados pelo Sistema Estadual de Transplantes do Paraná referentes ao processo de doação de órgãos, no período de 2011 a 2016. Das 3.872 notificações de potenciais doadores em morte encefálica, 2.600 foram incluídas neste estudo por se constituírem em doadores elegíveis de órgãos. Avaliou-se os desfechos dos protocolos e variáveis relacionadas aos doadores elegíveis, aos centros notificantes e às notificações. Os dados foram analisados descritivamente por frequências absolutas e relativas, e calculou-se odds ratio verificando-se a associação pelo teste de Qui-Quadrado de Wald, em que considerou-se p<0,05 como significância estatística. Resultados: Entre os 2.600 doadores elegíveis, 1.267 (48,7%) tornaram-se doadores efetivos de órgãos. Como principais obstáculos do processo destacaram-se a parada cardiorrespiratória, a sepse e a recusa familiar. As chances de efetivação da doação foram significativamente maiores nos indivíduos com menos de 60 anos (p<0,001), do sexo masculino (p=0,001) e notificados pelas Macrorregionais Leste e Oeste do Estado (p<0,001). O percentual de doações de órgãos aumentou de 38,8% para 66,5% no período estudado. Conclusão: O Paraná apresentou crescimento expressivo no número de notificações e doações de órgãos nos últimos seis anos. As fragilidad...

Trend of transplants and organ and tissue donations in Brazil: a time series analysis

“…In this perspective, the state governments of Santa Catarina and Paraná invested in the continuing education of professionals. The qualification of those involved is crucial for reducing the weaknesses of the process, by bringing on analytical, reflective and critical thinking health professionals, making them skilled and sensitive to deal with potential donors and their families (10,19) .…”

“…This way, the process of donating organs, tissues and cells proves to be complex, requiring the ability of the services to transform potential donors into effective donors (9) . The potential donor is the person with a confirmed brain death (BD) diagnosis and who has no clinical contraindication prescription to have the transplant done, becoming an effective donor only when there is a surgical incision, upon the family authorization (10) .…”

Organ and tissue donation: use of quality tool for process optimization

“…The number of effective donations has been increasing year by year, enabling patients who are awaiting for a transplant to stay a less waiting list time. [1][2][3][4][5] In our country, different improvement actions has been developed by governmental and non-governmental managers over the last ten years. These actions are directed towards the permancent education together with the health professionals, effectiveness strategies and agility in the logistics of the organs and tissues capture and implant, as well as in raising the awareness of the population for providing further clarifications to the society about the process of donation.…”

“…These actions are directed towards the permancent education together with the health professionals, effectiveness strategies and agility in the logistics of the organs and tissues capture and implant, as well as in raising the awareness of the population for providing further clarifications to the society about the process of donation. [1][2] All these improvements have been valuable, enabling Brazil to emerge from a rate of 7.2 effective donors per million population (pmp) in 2008 to 16.9 pmp in 2018, an increase of more than 150% over ten years. [1][2] The statistics show effective improvements in this process and reveal that, there is still space and opportunity for ongoing progress and advances in this thematic, since there was an improvement in the number of effective donors over the years.…”

“…[1][2] All these improvements have been valuable, enabling Brazil to emerge from a rate of 7.2 effective donors per million population (pmp) in 2008 to 16.9 pmp in 2018, an increase of more than 150% over ten years. [1][2] The statistics show effective improvements in this process and reveal that, there is still space and opportunity for ongoing progress and advances in this thematic, since there was an improvement in the number of effective donors over the years. However, losses related to underreporting of potential donors to the State Central Transplantation-SCTs and losses due to family refusals still persist with high rates.…”