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Cobos M, Lausada N, Tanús R, Raimondi JC. Undergraduate Education in Transplantation. Transplant Proc 2023; 55:1466-1468. [PMID: 37183067 DOI: 10.1016/j.transproceed.2023.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Training in the transplants of organs, tissues, and cells as a therapeutic modality of multiple pathologies is essential in undergraduate education. The medical aspects typical of the theme are associated with ethical, legal, religious, and philosophical concerns, giving a holistic view of the process. We present a teaching model of the donation-transplant process with 15 years of experience. METHODS The subject of Organ, Tissue, and Cell Transplants began its activities in 2008. It is an elective, annual subject included in the last year of the medical career. Since its inception, it has established a continuous teaching methodology with a global approach to the donation and transplantation process. RESULTS During the last 15 years and until the moment of the presentation, 1057 students have registered for the subject, 80.6% (852) completed the requirements of approval of the course, 79.9% of the students presented for the final evaluation (681), and 96.4% (654) of the students passed the final assessment. The average final grade calculated was equal to 6.53 ± 2.9 points out of 10; 205 students (19.4%) still need to comply with the final evaluative instance. CONCLUSION The available literature has different training modalities, but none resembles the model presented. It is concluded that, during these 15 years, the pedagogic expectations in the training of human resources have been exceeded.
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Affiliation(s)
- Marisa Cobos
- Cátedra de Transplantes, Facultad de Ciencias Médicas-UNLP, La Plata, Argentina.
| | - Natalia Lausada
- Cátedra de Transplantes, Facultad de Ciencias Médicas-UNLP, La Plata, Argentina
| | - Roberto Tanús
- Cátedra de Transplantes, Facultad de Ciencias Médicas-UNLP, La Plata, Argentina
| | - J Clemente Raimondi
- Cátedra de Transplantes, Facultad de Ciencias Médicas-UNLP, La Plata, Argentina
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Johnston-Webber C, Mah J, Streit S, Prionas A, Wharton G, Mossialos E, Papalois V. A Conceptual Framework for Evaluating National Organ Donation and Transplantation Programs. Transpl Int 2023; 36:11006. [PMID: 37334013 PMCID: PMC10273098 DOI: 10.3389/ti.2023.11006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/14/2023] [Indexed: 06/20/2023]
Abstract
Conceptual frameworks are valuable resources that can be used to guide the planning, evaluation, and development of healthcare services. However, there are currently no comprehensive frameworks focused on organ donation and transplantation that identify the critical factors underlying a successful national program. To address this knowledge gap, we developed a conceptual framework that takes into account all major domains of influence, including political and societal aspects as well as clinical implementation. The framework was initially constructed based on a targeted review of the relevant medical literature. Feedback provided by a panel of international experts was incorporated into the framework via an iterative process. The final framework features 16 essential domains that are critical for initiating and maintaining a successful program and improving the health of patients with organ failure. Of particular note, these domains are subject to three overarching health system principles: responsiveness, efficiency, and equity. This framework represents a first attempt to develop a whole-system view of the various factors that contribute to the success of a national program. These findings provide a useful tool that can be adapted to any jurisdiction and used to plan, evaluate, and improve organ donation and transplantation programs.
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Affiliation(s)
- Charlotte Johnston-Webber
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Jasmine Mah
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Simon Streit
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Apostolos Prionas
- Department of Surgery, Imperial College, London, United Kingdom
- Department of General Surgery, Whipps Cross Hospital, Barts Health NHS Trust, London, United Kingdom
| | - George Wharton
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College, London, United Kingdom
| | - Vassilios Papalois
- Department of Surgery, Imperial College, London, United Kingdom
- Renal and Transplant Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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Streit S, Johnston-Webber C, Mah J, Prionas A, Wharton G, Casanova D, Mossialos E, Papalois V. Ten Lessons From the Spanish Model of Organ Donation and Transplantation. Transpl Int 2023; 36:11009. [PMID: 37305337 PMCID: PMC10249502 DOI: 10.3389/ti.2023.11009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/14/2023] [Indexed: 06/13/2023]
Abstract
The organ donation and transplantation program in Spain has long been considered the gold standard worldwide. An in-depth understanding of the Spanish program may promote the development and reform of transplant programs in other countries. Here, we present a narrative literature review of the Spanish organ donation and transplantation program supplemented by expert feedback and presented according to a conceptual framework of best practices in the field. Core features of the Spanish program include its three-tiered governing structure, close and collaborative relationships with the media, dedicated professional roles, a comprehensive reimbursement strategy, and intensive tailored training programs for all personnel. Several more sophisticated measures have also been implemented, including those focused on advanced donation after circulatory death (DCD) and expanded criteria for organ donation. The overall program is driven by a culture of research, innovation, and continuous commitment and complemented by successful strategies in prevention of end-stage liver and renal disease. Countries seeking ways to reform their current transplant systems might adopt core features and may ultimately aspire to include the aforementioned sophisticated measures. Countries intent on reforming their transplant system should also introduce programs that support living donation, an area of the Spanish program with potential for further improvement.
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Affiliation(s)
- Simon Streit
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Charlotte Johnston-Webber
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Jasmine Mah
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Apostolos Prionas
- Department of Surgery, Imperial College, London, United Kingdom
- Department of General Surgery, Whipps Cross Hospital, Barts Health NHS Trust, London, United Kingdom
| | - George Wharton
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Daniel Casanova
- University Hospital Valdecilla, University of Cantabria, Santander, Spain
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College, London, United Kingdom
| | - Vassilios Papalois
- Department of Surgery, Imperial College, London, United Kingdom
- Renal and Transplant Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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4
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Xie Q, Lei L, Duan F, Luo Y, Luo C. Exploration of Profession Experience Among In-Hospital Organ Procurement Coordinators in China: A Qualitative Study. Transplant Proc 2022; 54:2082-2087. [PMID: 36127172 DOI: 10.1016/j.transproceed.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The gap between the supply and demand of organs is continuously increasing. The emergence of organ procurement coordinators (OPCs), to a certain extent, has decreased the gap. In China, a majority of OPCs work in hospitals that are qualified for transplants, namely in-hospital OPCs (Ih-OPCs). Their profession experiences are closely related to donation rates and indirectly reveal aspects that should be further improved. However, no data are available in China. We sought to explore Ih-OPCs' subjective feeling of the practice experience and provide targeted interventions for administrators. METHODS A project team was established and then interview outlines were listed by virtue of discussion and literature review. Furthermore, a total of 13 Ih-OPCs were selected as participants for interview. After that, the conversation was analyzed and encoded, and themes were finally identified according to phenomenology. RESULTS A total of 3 themes including positive emotions, negative emotions, and personal needs were identified, which were furthermore divided into 7 minor themes ranging from professional identity, competence improvement, recruitment methods, quality of life, workload evaluation, career prospects, and training courses. CONCLUSIONS Social support and public understanding play a pivotal role in strengthening positive emotions. Meanwhile, the administrators should put more emphasis on negative emotions and personal needs, and management system should be further optimized.
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Affiliation(s)
- Qin Xie
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China
| | - Lei Lei
- Xinqiao Hospital, Army Medical University (Third Military Medical University), No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, P.R. China
| | - Fangjian Duan
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China
| | - Yu Luo
- Xinqiao Hospital, Army Medical University (Third Military Medical University), No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, P.R. China.
| | - Chunmei Luo
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China.
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5
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Effect of a multidisciplinary program to improve organ donation in the emergency department. Eur J Emerg Med 2021; 28:58-63. [PMID: 32976312 DOI: 10.1097/mej.0000000000000752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND IMPORTANCE As the emergency department (ED) is an important source of potential organ donors, it may play an important role in the organ donation process. OBJECTIVE To assess the effectiveness of the multidisciplinary organ donation improvement program (ODIP) on identifying potential donors and improving organ donation in South Korean EDs. DESIGN, SETTINGS, AND PARTICIPANTS This study was a retrospective, observational study of the ED-inclusive ODIP implemented in 55 tertiary teaching hospitals contracted with the Korea Organ Donation Agency (KODA) since 2014. The inclusion criteria were: patients in the ED with a serious brain injury and futile prognosis or expected death of the patient within a few days, no contraindications for organ donation, and no objections registered in the donor registry. INTERVENTION The ED-inclusive multidisciplinary approach was implemented to improve organ donation. It included regular meetings of the ODIP committee, hospital visits and staff education, improvement of notifications, and support of a coordination team. OUTCOMES MEASURE AND ANALYSIS We assessed the changes in the number of deceased organ donors per year and notifications of potential brain-dead donors by medical staff after the implementation of the new ED-inclusive ODIP. The entire organ donation process was monitored and measured. RESULTS There was a significant increase in deceased organ donors per million population after the implementation of the ED-inclusive multidisciplinary ODIP of KODA compared to the pre-intervention period: 5.21 vs. 9.72, difference 4.51 (95% confidence interval 2.11-6.91). During the study period, the proportion of deceased organ donors occurred from KODA-contracted hospitals increased from 25.3 to 50.3% in South Korea's total deceased organ donors. Emergency physicians of KODA-contracted hospitals notified increasingly more potential brain-dead donors each year throughout the study period (36 in 2014 vs. 135 in 2018). The longer the period contracted with KODA, the higher the potential brain-death identification rates (P < 0.001). CONCLUSION In this retrospective study, the implementation of multidisciplinary ODIP in the ED led to significantly higher deceased organ donors per million population and awareness of potential brain-dead donors in South Korea.
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Kazzaz YM, Da'ar OB. Assessing comfort level of organ donation competencies among pediatric intensivists in Saudi Arabia: a national survey. BMC MEDICAL EDUCATION 2020; 20:358. [PMID: 33046074 PMCID: PMC7552448 DOI: 10.1186/s12909-020-02262-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND As increasing the number of organ donations presents a global challenge, Saudi Arabia is no different. Intensivists can play a major role in maximizing the organ donation process and minimize the challenges. The purpose of this study was to investigate Saudi pediatric intensivists' comfort and importance levels of organ donation competencies. METHODS We conducted a cross-sectional survey whose sampling frame included 100 pediatric intensivists. The pediatrician intensivists were identified through an updated list provided by the Saudi Critical Care Society. We assessed 14 competencies categorized into four domains: the general donation, donation after brain death (DBD), neurological determination of death, and medicolegal, religious, and ethical domains. Then we investigated the association between these competencies and physicians' characteristics. RESULTS With a response rate of 76%, we found that 40-60% of the surveyed pediatric intensivists rated their comfort in 6 out of 14 competencies as high or very high. There was a statistically significant gap in the intensivists' rating of 10 competencies (i.e., high importance but low comfort levels). Ordinal regression showed that comfort levels with the general donation, neurological determination of death, and medicolegal, religious, and ethical domains were higher in intensivists who were frequently involved with DBD than those who had never been exposed. CONCLUSIONS Pediatric intensivists expressed low comfort levels to organ donation competencies that are essential for maximizing donation rates. Adapting mandatory comprehensive donation education programs and dedicated physician specialists may be beneficial in critical care units aiming to increase donation rates.
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Affiliation(s)
- Yasser M Kazzaz
- Department of Pediatrics, Ministry of National Guards - Health Affairs, Riyadh, Kingdom of Saudi Arabia.
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Omar B Da'ar
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Health Systems, College of Public Health and Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Dong H, Lin L, Xu X, He X, Yang Q, Zhang J, Lei L, Luo Y, Deng J, Yi D, Luo Y. Qualitative Analysis of Factors That Hinder Intensive Care Unit Nurses in Western China From Encouraging Patients to Donate Organs. Transplant Proc 2020; 52:20-25. [PMID: 32000939 DOI: 10.1016/j.transproceed.2019.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Organ transplantation is an important method to save the lives of patients suffering from organ failure. However, the low rate of organ donation is a common problem worldwide. Many potential organ donors in the intensive care unit (ICU) are not properly identified, which is one reason for the low donation rate. ICU nurses play a key role in organ donation but may be uncertain regarding some issues. In this study, an analysis of the reasons why ICU nurses in western China are reluctant to encourage patients and their families to donate organs is performed, providing a reference for promoting ICU nurse participation in organ donation work. METHODS From August to November of 2017, using a purposive sampling method, we conducted semi-structured, in-depth interviews using a phenomenological research method with 18 ICU nurses who were working in 4 large hospitals with organ transplant accreditation in Chongqing City, China, and analyzed the data with phenomenology. RESULTS Reasons for the reluctance of ICU nurses in encouraging patients to donate organs were categorized into the following 4 themes: limitation of the nurses' professional role, influence of the family's negative emotions, lack of training regarding organ donation in medical institutions, and impact of a conservative social attitude. CONCLUSION Chinese medical and health institutions need to attach importance to the duties and roles of ICU nurses in organ donation work, the creation of a good death culture, the implementation of training for organ donation specialist nurses, and the strengthening of advocacy efforts for organ donation so that ICU nurses' reluctance in engaging in organ donation coordination in China can be mitigated and the nurses can better participate in promoting organ donation to potential donors.
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Affiliation(s)
- He Dong
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Li Lin
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Xia Xu
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Xiaochong He
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Qin Yang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Jiasi Zhang
- Department of Hematology, Southwest Hospital, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Lei Lei
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Yue Luo
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Jing Deng
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Dong Yi
- Department of Health Statistics, Third Military Medical University, Shapingba District, Chongqing, P.R. China
| | - Yu Luo
- School of Nursing, Third Military Medical University, Shapingba District, Chongqing, P.R. China.
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Evolution of Deceased Organ Donation Activity Versus Efficiency Over a 15-year Period: An International Comparison. Transplantation 2019; 102:1768-1778. [PMID: 29677069 DOI: 10.1097/tp.0000000000002226] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. METHODS This is a retrospective analysis of 2001 to 2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the United States. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons. RESULTS According to the DCI and of the countries included in the study, Spain, France, and the United States had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally. CONCLUSIONS Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues.
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Aikawa A. Current status and future aspects of kidney transplantation in Japan. RENAL REPLACEMENT THERAPY 2018. [DOI: 10.1186/s41100-018-0186-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Egea-Guerrero JJ, Martín-Villén L, Ruiz de Azúa-López Zaida Z, Bonilla-Quintero Francisco F, Pérez-López Enrique E, Marín-Andrés R, Correa-Chamorro E, Vilches-Arenas Á. Short-term Results From a Training Program to Improve Organ Donation in Uncontrolled Donation After Circulatory Death. Transplant Proc 2018; 50:530-532. [PMID: 29579843 DOI: 10.1016/j.transproceed.2017.09.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/21/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND In all organ transplantation programs, election of the proper protocol relies primarily on the professionals involved in the detection of potential donors. The objective of our study was to assess the impact of a series of prehospital training sessions, as well as to develop several positive feedback strategies within the uncontrolled organ donation after circulatory death (uDCD) program in our city. METHODS A before-after intervention study was carried out in 3 steps. First, professionals enrolled in the Emergency Health Services Agency-061 (EPES-061) program underwent specific training to identify potential donors. Second, a specific logotype was designed to alert emergency health care professionals that in cases where cardiopulmonary resuscitation was ineffective and after treatment of all potentially reversible causes, the "chain of survival" should be considered a "chain of opportunities." Third, a positive feedback strategy was put in place, whereby each time a donation was procured, the EPES-061 personnel that had identified the potential donor were notified by phone and in a personal letter. RESULTS The mean age for donors was 50.5 years of age (interquartile range 37-52.5), and 89.5% of all donations came from male subjects. Positive feedback letters and phone calls, including information on final outcome, were provided to the appropriate personnel in 100% of the cases. Postintervention information showed an increase in both eligible and utilized donors. CONCLUSIONS Interventions outside the hospital setting that facilitate optimal implementation of the uDCD program are an essential part of this strategy to increase the donor pool and make the wait shorter for transplant patients.
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Affiliation(s)
- J J Egea-Guerrero
- Donation and Transplantation Programs Department, H.U. Virgen del Rocío, Seville, Spain; Instituto de Biomedicina (IBiS)/CSIC/University of Seville, Seville, Spain.
| | - L Martín-Villén
- Donation and Transplantation Programs Department, H.U. Virgen del Rocío, Seville, Spain
| | - Z Ruiz de Azúa-López Zaida
- Donation and Transplantation Programs Department, H.U. Virgen del Rocío, Seville, Spain; Instituto de Biomedicina (IBiS)/CSIC/University of Seville, Seville, Spain
| | | | | | | | - E Correa-Chamorro
- Donation and Transplantation Programs Department, H.U. Virgen del Rocío, Seville, Spain
| | - Á Vilches-Arenas
- Instituto de Biomedicina (IBiS)/CSIC/University of Seville, Seville, Spain; Department of Public Health and Preventive Medicine, University of Seville, Seville, Spain
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11
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Yoshikawa M, Yoshinaga K, Imamura Y, Hayashi T, Osako T, Takahashi K, Kaneko M, Fujisawa M, Kamidono S. Transplant Procurement Management Model Training: Marked Improvement in the Mindset of In-Hospital Procurement Coordinators at Hyogo Prefecture, Japan. Transplant Proc 2017; 48:2437-2441. [PMID: 27742317 DOI: 10.1016/j.transproceed.2016.02.087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/02/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The organ donation rate in Japan is much lower than that in other developed countries for several reasons. An advanced educational program for in-hospital procurement coordinators is a possible solution for this. We introduced a Transplant Procurement Management (TPM) educational program at Hyogo Prefecture, Japan. METHODS Ten healthcare professionals at Hyogo Prefecture participated in the Advanced International TPM course to educate themselves on TPM and held 2 TPM Model Organ Procurement Training Workshops at Hyogo Prefecture for in-hospital procurement coordinators. Furthermore, we held 2 workshops outside Hyogo Prefecture and at the same time undertook a pre-workshop questionnaire survey to evaluate the ability and motivation with respect to organ donation. To evaluate the effectiveness of the workshops, we conducted post-workshop and 3-months-after workshop questionnaire surveys. RESULTS The results of the pre-workshop survey revealed that in-hospital procurement coordinators lacked the knowledge regarding the entire organ donation process, the current status of organ donation in Japan, and the definition of brain death. Moreover, they did not completely understand the meaning of "organ donation." The results of the post-workshop questionnaire survey showed that the educational program was effective to improve the knowledge and skills of organ donation and motivated behavioral changes among the participants. CONCLUSIONS The survey results showed that our TPM model educational program offered sufficient knowledge and skills to increase organ donation at Hyogo Prefecture. We will continue this program and make an effort to further contribute to the Japanese organ donation activities.
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Affiliation(s)
- M Yoshikawa
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Hyogo, Japan.
| | | | - Y Imamura
- Hyogo Prefecture Procurement, Hyogo College of Medicine, Hyogo, Japan
| | - T Hayashi
- Division of Emergency Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - T Osako
- Department of Emergency, Disaster, and Critical Care Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - K Takahashi
- Toyama Prefecture Procurement, Department of Crisis Medicine, University of Toyama, Toyama, Japan
| | - M Kaneko
- Nara Prefecture Procurement, Nara Medical University Hospital, Nara, Japan
| | | | - S Kamidono
- Hyogo Association of Countermeasure for Kidney Disease, Hyogo, Japan
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12
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de Moraes EL, dos Santos MJ, Merighi MAB, Massarollo MCKB. Experience of nurses in the process of donation of organs and tissues for transplant. Rev Lat Am Enfermagem 2016; 22:226-33. [PMID: 26107829 PMCID: PMC4292609 DOI: 10.1590/0104-1169.3276.2406] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 10/30/2013] [Indexed: 11/25/2022] Open
Abstract
Objective to investigate the meaning of the action of nurses in the donation process
to maintain the viability of organs and tissues for transplantation. Method this qualitative study with a social phenomenological approach was conducted
through individual interviews with ten nurses of three Organ and Tissue
Procurement Services of the city of São Paulo. Results the experience of the nurses in the donation process was represented by the
categories: obstacles experienced in the donation process, and interventions
performed. The meaning of the action to maintain the viability of organs and
tissues for transplantation was described by the categories: to change
paradigms, to humanize the donation process, to expand the donation, and to
save lives. Final considerations knowledge of the experience of the nurses in this process is important for
healthcare professionals who work in different realities, indicating
strategies to optimize the procurement of organs and tissues for
transplantation.
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Affiliation(s)
- Edvaldo Leal de Moraes
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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13
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Hoste P, Vanhaecht K, Ferdinande P, Rogiers X, Eeckloo K, Blot S, Hoste E, Vogelaers D, Vandewoude K. Care pathways for organ donation after brain death: guidance from available literature? J Adv Nurs 2016; 72:2369-80. [PMID: 27328738 DOI: 10.1111/jan.13051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 01/10/2023]
Abstract
AIMS A discussion of the literature concerning the impact of care pathways in the complex and by definition multidisciplinary process of organ donation following brain death. BACKGROUND Enhancing the quality and safety of organs for transplantation has become a central concern for governmental and professional organizations. At the local hospital level, a donor coordinator can use a range of interventions to improve the donation and procurement process. Care pathways have been proven to represent an effective intervention in several settings for optimizing processes and outcomes. DESIGN A discussion paper. DATA SOURCES A systematic review of the Medline, CINAHL, EMBASE and The Cochrane Library databases was conducted for articles published until June 2015, using the keywords donation after brain death and care pathways. Each paper was reviewed to investigate the effects of existing care pathways for donation after brain death. An additional search for unpublished information was conducted. DISCUSSION Although literature supports care pathways as an effective intervention in several settings, few studies have explored its use and effectiveness for complex care processes such as donation after brain death. IMPLICATIONS FOR NURSING Nurses should be aware of their role in the donation process. Care pathways have the potential to support them, but their effectiveness has been insufficiently explored. CONCLUSION Further research should focus on the development and standardization of the clinical content of a care pathway for donation after brain death and the identification of quality indicators. These should be used in a prospective effectiveness assessment of the proposed pathway.
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Affiliation(s)
- Pieter Hoste
- Department of General Internal Medicine, Ghent University Hospital, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Department of Intensive Care, General Hospital Sint-Lucas, Ghent, Belgium
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium.,Department of Quality Management, University Hospitals Leuven, Belgium.,European Pathway Association, Kapucijnenvoer, Leuven, Belgium
| | | | - Xavier Rogiers
- Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Department of Transplant Surgery, Ghent University Hospital, Belgium
| | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Stijn Blot
- Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Department of Internal Medicine, Ghent University, Belgium.,Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Eric Hoste
- Department of Intensive Care Medicine, Ghent University Hospital, Belgium.,Research Foundation - Flanders (FWO), Egmontstraat, Brussels, Belgium
| | - Dirk Vogelaers
- Department of General Internal Medicine, Ghent University Hospital, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Department of Internal Medicine, Ghent University, Belgium
| | - Koenraad Vandewoude
- Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Department of Internal Medicine, Ghent University, Belgium
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14
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The current status and future perspectives of organ donation in Japan: learning from the systems in other countries. Surg Today 2015; 46:387-92. [PMID: 26126653 DOI: 10.1007/s00595-015-1211-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
The revised Organ Transplant Law came into effect in Japan in July 2010. The law allows for organ procurement from brain-dead individuals, including children, with family consent from subjects who had not previously rejected organ donation. Nevertheless, the number of cadaveric organ donations has not increased as expected. The Spanish Model is widely known as the most successful system in the field of organ donation. The system includes an earlier referral of possible donors to the transplant coordination teams, a new family-based approach and care methods, and the development of additional training courses aimed at specific groups of professionals, which are supported by their corresponding societies. South Korea, a country which neighbors Japan, has recently succeeded in increasing the rates of organ donation by introducing several systems, such as incentive programs, an organ procurement organization, a donor registry, and a system to facilitate potential donor referral. In this review, we present the current status of organ donation in Japan and also explore various factors that may help to improve the country's low donation rate based on the experiences of other developed countries.
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15
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EXP CLIN TRANSPLANTExp Clin Transplant 2015; 13. [DOI: 10.6002/ect.mesot2014.o128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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16
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Weiss J, Coslovsky M, Keel I, Immer FF, Jüni P. Organ donation in Switzerland--an analysis of factors associated with consent rate. PLoS One 2014; 9:e106845. [PMID: 25208215 PMCID: PMC4160222 DOI: 10.1371/journal.pone.0106845] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/09/2014] [Indexed: 11/18/2022] Open
Abstract
Background and Aim Switzerland has a low post mortem organ donation rate. Here we examine variables that are associated with the consent of the deceased’s next of kin (NOK) for organ donation, which is a prerequisite for donation in Switzerland. Methods and Analysis During one year, we registered information from NOK of all deceased patients in Swiss intensive care units, who were approached for consent to organ donation. We collected data on patient demographics, characteristics of NOK, factors related to the request process and to the clinical setting. We analyzed the association of collected predictors with consent rate using univariable logistic regression models; predictors with p-values <0.2 were selected for a multivariable logistic regression. Results Of 266 NOK approached for consent, consent was given in 137 (51.5%) cases. In multivariable analysis, we found associations of consent rates with Swiss nationality (OR 3.09, 95% CI: 1.46–6.54) and German language area (OR 0.31, 95% CI: 0.14–0.73). Consent rates tended to be higher if a parent was present during the request (OR 1.76, 95% CI: 0.93–3.33) and if the request was done before brain death was formally declared (OR 1.87, 95% CI: 0.90–3.87). Conclusion Establishing an atmosphere of trust between the medical staff putting forward a request and the NOK, allowing sufficient time for the NOK to consider donation, and respecting personal values and cultural differences, could be of importance for increasing donation rates. Additional measures are needed to address the pronounced differences in consent rates between language regions.
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Affiliation(s)
- Julius Weiss
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Michael Coslovsky
- CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Isabelle Keel
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Franz F. Immer
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
- * E-mail:
| | - Peter Jüni
- CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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17
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Teixeira J, Maio R, Immer F, Dominguez J, Papalois V, Mihály S, Paredes D. The Certification of Transplant Coordinators in Europe. Transplant Proc 2014; 46:1265-73. [DOI: 10.1016/j.transproceed.2013.12.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 12/19/2013] [Indexed: 11/25/2022]
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18
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Khalaf H, Derballa M, Elmasry M, Khalil A, Yakoob R, Almohannadi M, Almaslamani M, Fadhil R, Al-Kaabi S, Al-Ansari A, Almaslamani Y. First Liver Transplant in Qatar: An Evolving Program Facing Many Challenges. EXP CLIN TRANSPLANT 2013; 11:423-5. [DOI: 10.6002/ect.2013.0194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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19
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Manyalich M, Guasch X, Paez G, Valero R, Istrate M. ETPOD (European Training Program on Organ Donation): a successful training program to improve organ donation. Transpl Int 2012; 26:373-84. [DOI: 10.1111/tri.12047] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/08/2012] [Accepted: 12/02/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Gloria Paez
- Transplant Procurement Management (TPM); Donation and Transplantation Institute (DTI); Barcelona; Spain
| | | | - Melania Istrate
- Transplant Procurement Management (TPM); Donation and Transplantation Institute (DTI); Barcelona; Spain
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20
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Manyalich M, Mestres CA, Ballesté C, Páez G, Valero R, Gómez MP. Organ procurement: Spanish transplant procurement management. Asian Cardiovasc Thorac Ann 2012; 19:268-78. [PMID: 21885556 DOI: 10.1177/0218492311411590] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Transplantation is an accepted therapeutic option to save or improve the quality of life when organ failure occurs or tissue replacements are needed. However, the lack of organs is the major limitation. The deceased organ procurement organization and professionals provide the solution to this international problem. In this review, we identify the elements involved in the organ procurement management process to analyze the possibility of implementation of deceased organ procurement for a transplantation program. While the donation rates are subject to several negative factors including religious, economic, cultural, and legal issues, the existence of well-trained professionals may considerably increase them. Professional training in organ donation along with the establishment of a solid organizational system has been identified as the crucial factor in developing efficient organ donation and transplantation programs.
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Affiliation(s)
- Martí Manyalich
- Transplant Coordination Service, Hospital Clinic, University of Barcelona, Spain.
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21
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Lee S, Ahn C, Kim SI, Han DJ, Cho WH. Analysis of the Potential Deceased Donors in the Neurosurgical Intensive Care Units of Korea. KOREAN JOURNAL OF TRANSPLANTATION 2011. [DOI: 10.4285/jkstn.2011.25.2.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Samuel Lee
- Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Duck Jong Han
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Hyun Cho
- Department of Surgery, Keimyung University College of Medicine, Daegu, Korea
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22
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Abstract
This mini-review on European experiences with tackling the problem of organ shortage for transplantation was based on a literature review of predominantly European publications dealing with the issue of organ donation from deceased donors. The authors tried to identify the most significant factors that have demonstrated to impact on donation rates from deceased donors and subsequent transplant successes. These factors include legislative measures (national laws and European Directives), optimization of the donation process, use of expanded criteria donors, innovative preservation and surgical techniques, organizational efforts, and improved allocation algorithms.
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Affiliation(s)
- Leo Roels
- Donor Action Foundation, Linden, Belgium
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23
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Matesanz R, Domínguez-Gil B, Coll E, de la Rosa G, Marazuela R. Spanish experience as a leading country: what kind of measures were taken? Transpl Int 2011; 24:333-43. [PMID: 21210863 DOI: 10.1111/j.1432-2277.2010.01204.x] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A recent call for self-sufficiency in transplantation issued by the WHO faces variable worldwide activity, in which Spain occupies a privileged position, with deceased donation rates of 33-35per million population (pmp) and 85 transplants pmp. An evaluation of current challenges, including a decrease in deaths because of traffic accidents and cerebrovascular diseases, and a diversity of cultures in Spain, has been followed by a comprehensive strategy to increase organ availability. Actions include an earlier referral of possible donors to the transplant coordination teams, a benchmarking project to identify critical success factors in donation after brain death, new family approach and care methods, and the development of additional training courses aimed at specific groups of professionals, supported by their corresponding societies. Consensus documents to improve knowledge about safety limits for organ donation have been developed to minimize inappropriate discarding of organs. Use of organs from expanded criteria donors under an 'old for old' allocation policy has resulted from adaptation to the progressive decline of optimal organs. National strategic plans to deal better with organ shortage, while respecting solid ethical standards, are essential, as reflected in the WHO Guiding Principles and the Istanbul Declaration on Organ Trafficking and Transplant tourism.
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