The European experience

Roels, L; Rahmel, Axel

doi:10.1111/j.1432-2277.2011.01225.x

Cited by 80 publications

(39 citation statements)

References 139 publications

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“…These findings are in contrast with previous reports [5,[17][18][19][20][21][22]. For example, in 2001, Sundmacher and Reinhard reported in a local analysis a 30-50 % rate of acceptance regarding postmortem cornea donation in Germany [12].…”

Section: Discussioncontrasting

confidence: 82%

Attitudes toward postmortem cornea donation in Germany: a multicenter survey

Uhlig

Koch

Promesberger

et al. 2014

Graefes Arch Clin Exp Ophthalmol

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Section: Discussioncontrasting

confidence: 82%

Attitudes toward postmortem cornea donation in Germany: a multicenter survey

Uhlig

Koch

Promesberger

et al. 2014

Graefes Arch Clin Exp Ophthalmol

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“…Having an opt-out law, the number of donors per million inhabitants in Belgium is among the highest in the world (8)(9)(10). This results in shorter waiting times, for patients on the regular and the HU waitlist.…”

Section: Discussionmentioning

confidence: 99%

“…This has not only resulted in scientific output, but has also likely lowered the threshold for patients to contact the transplant nurses and physicians in case of questions or problems. It may have also assisted in creating a culture where patients and their families form a team together with Primary graft failure [16] Acute rejection [7] Late graft failure (HFrEF) [6] [Non] STEMI [4] Post-PCI/CABG [3] Technical problems during HTx [3] Stroke/intracranial bleeding [12] Aortic rupture [4] Intestinal ischemia [3] Malignancy 78 [32] Lung [35] GI tract [10] PTLD [9] Kidney-bladder [6] Pancreas [4] Blood [4] Prostate [3] Skin [3] Primary tumor unknown [3] Brain [1] Infection 43 [18] Pneumonia [22] Sepsis [15] Other [6] Other 27 [11] Old age [8] Dementia [5] Suicide [4] Therapy withdrawal [3] Trauma [3] Respiratory failure [1] Bleeding [1] ALS [1] Euthanasia [1] Finally, we pay a lot of attention to cardiovascular prevention and screening for malignancies. The significant and consistent decreases in age-adjusted cardiovascular mortality shown in European and US registries was attributed to better prevention and better treatment of cardiac disease (29).…”

Section: Discussionmentioning

confidence: 99%

How to obtain and maintain favorable results after heart transplantation: keys to success?

Cleemput

Verbelen²,

Aelst

et al. 2018

Ann. Cardiothorac. Surg.

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We compared survival in our heart recipients with survival rates reported by the International Society of Heart and Lung Transplantation (ISHLT) Registry. As recipient and donor characteristics are changing over time, we studied four different eras. In order to differentiate between short-and long-term survival, we analyzed both overall survival and survival at one year. Obviously, this exercise is only relevant when baseline donor and recipient characteristics are comparable, as these differences may affect the outcome in opposite directions. To overcome this potential bias as much as possible, we calculated the Index for Mortality Prediction After Cardiac Transplantation (IMPACT)-scores and the Donor Risk Index (DRI). Looking to our results, we found that our DRIs in the different eras are almost equal to those obtained from the United Network for Organ Sharing database in the very same eras. Our IMPACT-scores, on the other hand, seem higher than those reported by ISHLT. Survival after transplantation and conditional on 1-year survival was higher than the outcome reported by the ISHLT Registry. As our operation technique and post-transplant immunosuppressive schedule did not differ from most centers, we speculated on potential factors that might contribute to our positive results. Patient selection and a relatively short waiting time are important contributors to the overall survival benefit. Our centralized follow-up may also have played an important role. Finally, the indefinite compulsory health insurance coverage in our country and easy access to different screening programs might also have influenced our outcome in a positive way. We are well aware that with challenges like donor organ shortage, more and more patients on mechanical circulatory support (MCS) will affect outcomes in the future.Keywords: Heart transplantation; predictors; survival Submitted Sep 11, 2017. Accepted for publication Nov 25, 2017Nov 25, . doi: 10.21037/acs.2017 View this article at: http://dx.doi.org/10. 21037/acs.2017.12.03 Perspective IntroductionComparing the results of hip surgery performed by one surgeon with the results of his colleague working in the hospital next door, is asking for trouble. Comparing results of one heart transplant center with those of another or, even more challenging, those of a registry, is at least as daunting.Nevertheless, it is worthwhile to critically review one's results and compare them with those of peers. In case they differ manifestly, one has to speculate on why this is the case considering the importance our society currently attributes to cost effectiveness and transparency. Of course, this exercise only makes sense when you are comparing apples with apples. You should first examine that you are transplanting the same types of patients and that you are using the same types of donors.We compared our short-and long-term survival data with those of the ISHLT registry. To do so, we also compared our recipient and donor risk profiles with those of the UNOS database. Finally, we speculated...

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“…The European experience demonstrated that the most significant factor influencing the donation rate from deceased donors and the success rate of subsequent transplants is legislative measures [18]. Our lawmakers should pay more attention to streamline the donation process and to provide the people with more possibilities in making organ donation.…”

Section: Constrains and Solutionsmentioning

confidence: 99%

Transformation of organ donation in China

et al. 2015

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SummaryThe organ donation system in China has far lagged behind international levels. Transformation of this situation began in July 2005. A complete organ donation system that ensures fairness, impartiality, transparency, and respect for life has now been developed. This system is composed of regulations and policies, an organizational structure, operational guidelines, organ procurement organizations, registration of donors and recipients, and an organ allocation system. Since March 2010, pilot trials on donation after circulatory death (DCD) have been carried out. In 4 years, organ donation has started in 25 of 32 provinces in the country. From 2010 to 2013, the ratio of DCD liver transplantation to total case numbers in China rose from 1.38% to 26.1%, whereas for kidney, the ratio were 0.59% and 24.6%, respectively. The total number of DCD in China has accumulated to 1564 cases, and 4243 organs were transplanted. To alleviate the further difficulties of donation, establishment of professional organ procurement organizations in transplant hospitals, legislation of brain death, and promulgation of legal guidelines on DCD will be the main targets of organ donation development in China.

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The European experience

Cited by 80 publications

References 139 publications

Attitudes toward postmortem cornea donation in Germany: a multicenter survey

Attitudes toward postmortem cornea donation in Germany: a multicenter survey

How to obtain and maintain favorable results after heart transplantation: keys to success?

Transformation of organ donation in China

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