Successful Example of How to Implement and Develop a Deceased Organ Donation System in the Caribbean Region: Five-Year Experience of the SEUSA Program in Trinidad and Tobago

Ballesté, Chloë; Arredondo, Estephan; Gómez, María Paula; Fernández, Ángel; Wolf, Maximilian; Gunderson, Susan; Roberts, LA; Elcock, B.; Bradshaw, Pamela J.; Gardiner, Chris; Byam, J.; Harnanan, Dave; García-Buitron, J.M.; Manyalich, M.

doi:10.1016/j.transproceed.2015.08.037

Cited by 5 publications

(10 citation statements)

References 6 publications

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“…However, kidney transplantation has increased in the country since the implementation of the Spain-Europe-USA program aimed at improving organ donation and transplant systems, with support from the National Organ Transplant Unit and the Ministry of Health. 47 Similar initiatives that are backed by government support could help transform kidney transplantation in other Caribbean countries. In the United States and Canada, transplantation referral practices need to be standardized.…”

Section: Discussionmentioning

confidence: 99%

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean

Bello

McIsaac

Okpechi

et al. 2021

Kidney International Supplements

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The International Society of Nephrology established the Global Kidney Health Atlas project to define the global capacity for kidney replacement therapy and conservative kidney care, and this second iteration was to describe the availability, accessibility, quality, and affordability of kidney failure (KF) care worldwide. This report presents results for the International Society of Nephrology North America and the Caribbean region. Relative to other regions, the North America and Caribbean region had better infrastructure and funding for health care and more health care workers relative to the population. Various essential medicines were also more available and accessible. There was substantial variation in the prevalence of treated KF in the region, ranging from 137.4 per million population (pmp) in Jamaica to 2196 pmp in the United States. A mix of public and private funding systems cover costs for nondialysis chronic kidney disease care in 60% of countries and for dialysis in 70% of countries. Although the median number of nephrologists is 18.1 (interquartile range, 15.3-29.5) pmp, which is approximately twice the global median of 9.9 (interquartile range, 1.2-22.7) pmp, some countries reported shortages of other health care workers. Dialysis was available in all countries, but peritoneal dialysis was underutilized and unavailable in Barbados, Cayman Islands, and Turks and Caicos. Kidney transplantation was primarily available in Canada and the United States. Economic factors were the major barriers to optimal KF care in the Caribbean countries, and few countries in the region have chronic kidney disease-specific national health care policies. To address regional gaps in KF care delivery, efforts should be directed toward augmenting the workforce, improving the monitoring and reporting of kidney replacement therapy indicators, and implementing noncommunicable disease and chronic kidney disease-specific policies in all countries.

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Section: Discussionmentioning

confidence: 99%

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean

Bello

McIsaac

Okpechi

et al. 2021

Kidney International Supplements

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“…The paucity of data in peer-reviewed journals does not mean that there is no evidence for successful initiatives to increase the number of organ donors. Although not the focus of our review, there have been successful donor programs (with combined best practices) that have improved and sustained organ donation [50, 51]. The focus on potential organ donors outside the ICU, e.g., ED, could be an area where a collaborative effort between the ICUs and ED can increase the number of organ donors and more data is needed from successful collaborative efforts [6, 37–39].…”

Section: Discussionmentioning

confidence: 99%

Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review

Witjes¹,

Jansen²,

Hoeven³

et al. 2019

Crit Care

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Background The last decade, there have been many initiatives worldwide to increase the number of organ donors. However, it is not clear which initiatives are most effective. The aim of this study is to provide an overview of interventions aimed at healthcare professionals in order to increase the number of organ donors. Methods We systematically searched PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library for English language studies published until April 24, 2019. We included studies describing interventions in hospitals aimed at healthcare professionals who are involved in the identification, referral, and care of a family of potential organ donors. After the title abstract and full-text selection, two reviewers independently assessed each study’s quality and extracted data. Results From the 18,854 records initially extracted from five databases, we included 22 studies in our review. Of these 22 studies, 14 showed statistically significant effects on identification rate, family consent rate, and/or donation rate. Interventions that positively influenced one or more of these outcomes were training of emergency personnel in organ donation, an electronic support system to identify and/or refer potential donors, a collaborative care pathway, donation request by a trained professional, and additional family support in the ICU by a trained nurse. The methodological quality of the studies was relatively low, mainly because of the study designs. Conclusions Although there is paucity of data, collaborative care pathways, training of healthcare professionals and additional support for relatives of potential donors seem to be promising interventions to increase the number of organ donors. Trial registration PROSPERO, CRD42018068185 Electronic supplementary material The online version of this article (10.1186/s13054-019-2509-3) contains supplementary material, which is available to authorized users.

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“…We identified this attribute, which included any recommendations or actions within the context of the role of OTDCs in acute care settings in any part or the whole deceased organ donation process, in 8 papers. 23,61,63,66,67,73,74,83,84,94,99,100 One action, to implement Note. There is no single path to success in organ donation programs.…”

Section: Table 3 (Continued)mentioning

confidence: 99%

“…We identified the attribute of either formal academic or professional training for OTDCs or healthcare professional involved in the organ donation processes in 35 papers. 23,25,35,[40][41][42][43]47,52,57,61,62,64,65,69,73,74,77,78,[82][83][84][85]93,99,[102][103][104][105][106][107][108][109] Successful outcomes in organ donation programs depend on ensuring that involved individuals are well-informed. Training programs are cost-effective 109 and have positive perceived effects on healthcare professionals' practices.…”

Section: Table 3 (Continued)mentioning

confidence: 99%

“…110 While educating employees allows them to recognize and refer possible donors earlier in the process 45,52,74 and facilitate steps, 52 training programs should be adapted to each level, that is, basic knowledge to hospital staff, in-depth training to donation coordinators. 23,25,57,62,64,73,78,[83][84][85]99,103,104,108 Furthermore, specific training (ie, on effective and empathetic communication with donor relatives) boosts the number of consent rates and organ donors, 61,77,82,93,102,105,106,109 donor relatives' satisfaction with the donation process, 82 and is recommended as one key strategy to improve donation numbers. 40,68,69 Specific training inspires hospital staff to become committed to the organ donation cause and increase conversion rates.…”

Section: Table 3 (Continued)mentioning

confidence: 99%

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Defining Quality Criteria for Success in Organ Donation Programs: A Scoping Review

Silva

Schirmer

Roza

et al. 2021

Can J Kidney Health Dis

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Background: Well-established performance measures for organ donation programs do not fully address the complexity and multifactorial nature of organ donation programs such as the influence of relationships and organizational attributes. Objective: To synthesize the current evidence on key organizational attributes and processes of international organ donation programs associated with successful outcomes and to generate a framework to categorize those attributes. Design: Scoping Review using a mixed methods approach for data extraction. Setting: Databases included PubMed, CINAHL, Embase, LILACS, ABI Business ProQuest, Business Source Premier, and gray literature (organ donation association websites, Google Scholar—first 8 pages), and searches for gray literature were performed, and relevant websites were perused. Sample: Organ donation programs or processes. Methods: We systematically searched the literature to identify any research design, including text and opinion papers and unpublished material (research data, reports, institutional protocols, government documents, etc). Searches were completed on January 2018, updated it in May 2019, and lastly in March 2020. Title, abstracts, and full texts were screened independently by 2 reviewers with disagreements resolved by a third. Data extraction followed a mixed method approach in which we extracted specific details about study characteristics such as type of research, year of publication, origin/country of study, type of journal published, and key findings. Studies included considered definitions and descriptions of success in organ donation programs in any country by considering studies that described (1) attributes associated with success or effectiveness, (2) organ donation processes, (3) quality improvement initiatives, (4) definitions of organ donation program effectiveness, (5) evidence-based practices in organ donation, and (6) improvements or success in such programs. We tabulated the type and frequency of the presence or absence of reported improvement quality indicators and used a qualitative thematic analysis approach to synthesize results. Results: A total of 84 articles were included. Quantitative analysis identified that most of the included articles originated from the United States (n = 32, 38%), used quantitative approaches (n = 46, 55%), and were published in transplant journals (n = 34, 40.5%). Qualitative analysis revealed 16 categories that were described as positively influencing success/effectiveness of organ donation programs. Our thematic analysis identified 16 attributes across the 84 articles, which were grouped into 3 categories influencing organ donation programs’ success: context (n = 39, 46%), process (n = 48, 57%), and structural (n = 59, 70%). Limitations: Consistent with scoping review methodology, the methodological quality of included studies was not assessed. Conclusions: This scoping review identified a number of factors that led to successful outcomes. However, those factors were rarely studied in combination representing a gap in the literature. Therefore, we suggest the development and reporting of primary research investigating and measuring those attributes associated with the performance of organ donation programs holistically. Trial Registration: Not applicable.

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Successful Example of How to Implement and Develop a Deceased Organ Donation System in the Caribbean Region: Five-Year Experience of the SEUSA Program in Trinidad and Tobago

Cited by 5 publications

References 6 publications

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in North America and the Caribbean

Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review

Defining Quality Criteria for Success in Organ Donation Programs: A Scoping Review

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