Evolution of Deceased Organ Donation Activity Versus Efficiency Over a 15-year Period: An International Comparison

Weiss, Julius; Elmer, Andreas; Mahíllo, Beatriz; Domínguez‐Gil, Beatriz; Avsec, Danica; Costa, Alessandro Nanni; Haase‐Kromwijk, Bernadette; Laouabdia, Karim; Immer, Franz F.

doi:10.1097/tp.0000000000002226

Cited by 33 publications

(32 citation statements)

References 42 publications

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“…published a report on the situation of DCD in Europe . Since then, the scene has changed enormously, with more countries developing DCD programs and with practices evolving as new evidence becomes available . Through the present study, the CD‐P‐TO aims at providing an updated description of the situation of DCD in member states of the Council of Europe, with a focus on regulatory and organisational features, donation and transplantation activities, effectiveness of the process, and results obtained with DCD donor transplants.…”

Section: Introductionmentioning

confidence: 99%

Donation after circulatory death today: an updated overview of the European landscape

Lomero¹,

et al. 2019

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Summary Donation after circulatory death (DCD) has become an accepted practice in many countries and remains a focus of intense interest in the transplant community. The present study is aimed at providing a description of the current situation of DCD in European countries. Specific questionnaires were developed to compile information on DCD practices, activities and post‐transplant outcomes. Thirty‐five countries completed the survey. DCD is practiced in 18 countries: eight have both controlled DCD (cDCD) and uncontrolled DCD (uDCD) programs, 4 only cDCD and 6 only uDCD. All these countries have legally binding and/or nonbinding texts to regulate the practice of DCD. The no‐touch period ranges from 5 to 30 min. There are variations in ante and post mortem interventions used for the practice of cDCD. During 2008–2016, the highest DCD activity was described in the United Kingdom, Spain, Russia, the Netherlands, Belgium and France. Data on post‐transplant outcomes of patients who receive DCD donor kidneys show better results with grafts obtained from cDCD versus uDCD donors. In conclusion, DCD is becoming increasingly accepted and performed in Europe, importantly contributing to the number of organs available and providing acceptable post‐transplantation outcomes.

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Section: Introductionmentioning

confidence: 99%

Donation after circulatory death today: an updated overview of the European landscape

Lomero¹,

et al. 2019

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“…The international comparison of deceased donation program efficiency is based on the “donor conversion index” (DCI) methodology and data [ 14 ]. The DCI was developed in the framework of the Council of Europe’s European Committee on Organ Transplantation (CD-P-TO) by an international working group led by Swisstransplant.…”

Section: Methodsmentioning

confidence: 99%

“…The DCI was developed in the framework of the Council of Europe’s European Committee on Organ Transplantation (CD-P-TO) by an international working group led by Swisstransplant. The DCI indicates how many ADD resulted from 100 deaths from a selection of causes associated with brain death, such as cerebrovascular accidents, anoxic brain damage and trauma resulting from traffic accidents [ 14 , 17 ]. Mortality data was only available until 2015; therefore, 2016 and 2017 DCI values were calculated based on 2015 mortality data.…”

Section: Methodsmentioning

confidence: 99%

“…Mortality data was only available until 2015; therefore, 2016 and 2017 DCI values were calculated based on 2015 mortality data. The DCI is interpreted as follows: a DCI of 4% equals four ADD that resulted from 100 fatalities from the selected causes of death [ 14 ]. Some of the potential included in the DCI calculation may consist of patients who would not qualify for organ donation.…”

Section: Methodsmentioning

confidence: 99%

“…However, it seems that the federal action plan’s main goal, a donation rate of at least 20 donors after brain death (DBD) per million of population in 2018, may not be achieved [ 10 ]. This means that the Swiss DBD donation rate remains relatively low in international comparisons [ 14 , 15 ]. More importantly, it also means that organs donated for transplantation continue to be a scarce resource in Switzerland.…”

Section: Introductionmentioning

confidence: 99%

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Deceased organ donation activity and efficiency in Switzerland between 2008 and 2017: achievements and future challenges

Weiss

Elmer

Béchir

et al. 2018

BMC Health Serv Res

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BackgroundVarious actions have been taken during the last decade to increase the number of organs from deceased donors available for transplantation in Switzerland. This study provides an overview on key figures of the Swiss deceased organ donation and transplant activity between 2008 and 2017. In addition, it puts the evolution of the Swiss donation program’s efficiency in relation to the situation in the neighboring countries.MethodsThis study is an analysis of prospective registry data, covering the period from 1 January 2008 to 31 December 2017. It includes all actual deceased organ donors (ADD) in Switzerland. Donor data were extracted from the Swiss Organ Allocation System. The “donor conversion index” (DCI) methodology and data was used for the comparison of donation program efficiency in Switzerland, Germany, Austria, Italy and France.ResultsDuring the study period there were 1116 ADD in Switzerland. The number of ADD per year increased from 91 in 2008 to 145 in 2017 (+ 59%). The reintroduction of the donation after cardiocirculatory death (DCD) program in 2011 resulted in the growth of annual percentages of DCD donors, reaching a maximum of 27% in 2017. The total number of organs transplanted from ADD was 3763 (3.4 ± 1.5 transplants per donor on average). Of these, 48% were kidneys (n = 1814), 24% livers (n = 903), 12% lungs (n = 445), 9% hearts (n = 352) and 7% pancreata or pancreatic islets (n = 249). The donation program efficiency assessment showed an increase of the Swiss DCI from 1.6% in 2008 to 2.7% in 2017 (+ 69%). The most prominent efficiency growth was observed between 2012 and 2017. Even though Swiss donation efficiency increased during the study period, it remained below the DCI of the French and Austrian donation programs.ConclusionSwiss donation activity and efficiency grew during the last decade. The increased donation efficiency suggests that measures implemented so far were effective. The lower efficiency of the Swiss donation program, compared to the French and Austrian programs, may likely be explained by the lower consent rate in Switzerland. This issue should be addressed in order to achieve the goal of more organs available for transplantation.

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Impact of the revision of the law on pancreatic transplants in Japan—An analysis of the Japanese Pancreas Transplants Registry

Ito

Kenmochi

Aida

et al. 2021

J Hepato Biliary Pancreat

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Background In Japan, it has been about 10 years since the revision of the law on donating brain‐dead organs. The present study compared the outcomes of pancreatic transplant before and after the revision of the law. Methods The 437 patients who had received pancreas transplantation were divided into two groups according to the time when pancreas transplantation was performed between era 1 (before the revision) and 2 (after the revision), and compared in the patient and pancreas graft survival. Results While the annual number of brain‐dead donors was <10 in era 1, and this number significantly increased in era 2 to >50. This resulted in an increased number of pancreas transplantations: >30 cases per year. The comparison data after a propensity score‐matched analysis revealed that the death‐censored pancreatic graft survival at 1, 3, and 5 years after pancreas transplantation in era 2 was 94.9%, 92.0%, and 92.0%, which, while lacking significance, tended to be better than the values of 90.5%, 83.1%, and 78.2%, respectively, in era 1. Conclusions The revision of the law on donating brain‐dead organs increased the number of pancreas transplantations. Technical improvements in surgery due to increased experience with performing pancreas transplants may help improve pancreatic graft survival.

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Evolution of Deceased Organ Donation Activity Versus Efficiency Over a 15-year Period: An International Comparison

Cited by 33 publications

References 42 publications

Donation after circulatory death today: an updated overview of the European landscape

Donation after circulatory death today: an updated overview of the European landscape

Deceased organ donation activity and efficiency in Switzerland between 2008 and 2017: achievements and future challenges

Impact of the revision of the law on pancreatic transplants in Japan—An analysis of the Japanese Pancreas Transplants Registry

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