Organ Donation in Germany – An Analysis (Sponsor: Novartis Pharma GmbH, Nürnberg)

2020 ◽  
Vol 08 (01) ◽  
pp. 4-6

AbstractIn 2018 the number of organ donors in Germany increased by about 20 % compared with 2017 – from 797 to 955. However, this increase occurred after a long decrease in the rate of organ donation in the years 2010–2017. In that period the number of organ donors per year fell by more than one-third from 1296 donors to 797 [1]. This had dramatic consequences for the prognosis of patients with endstage organ failure: 1500 fewer organ transplantations were performed in 2017 compared with 2010.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Paola Frati ◽  
Vittorio Fineschi ◽  
Matteo Gulino ◽  
Gianluca Montanari Vergallo ◽  
Natale Mario Di Luca ◽  
...  

A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation.


2021 ◽  
Author(s):  
Janet E. Squires ◽  
Laura D. Aloisio ◽  
Wilmer John Santos ◽  
Danielle Cho-Young ◽  
Monica Taljaard ◽  
...  

Abstract Background: An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Methods: A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020. Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by two team members; all discrepancies were resolved by consensus. Two team members independently extracted data from studies. Results: A total of 1,017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), three (25%) were cohort studies, and three (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8 to 143% (Mdn = 33%), an increase in actual organ donors from 15 to 113% (Mdn = 27%), an increase in donor consent rate from -3 to 258% (Mdn = 12%) and an increase in deceased donor transplants from 13 to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions: Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.


Author(s):  
Pragya Paneru ◽  
Shyam S. Budhathoki ◽  
Samyog Uprety ◽  
Birendra K. Yadav ◽  
Rashmi Mulmi ◽  
...  

Background: With the global increase in the incidence organ failure and subsequent advancement in the medical technology, organ transplantation is growing as the best choice of treatment among the patients with various kinds of organ failure. However, the rate of deceased organ donation is relatively low in South-East Asia regions, including Nepal. This has created a mismatch between the demand and supply of organs for transplantation. World Health Organization encourages organ transplantation from a deceased organ donor as there is no risk to the donor. Thus, this paper aimed to assess knowledge and attitude of literate group specifically towards deceased organ donation.Methods: This was a cross-sectional study conducted among 299 students selected conveniently from medicine, law, and mass communication streams from 9 different colleges (3 colleges from each stream) of Kathmandu. Data was collected through a self-administered questionnaire. Knowledge level was classified into three different categories based on obtained scores and attitude was analyzed based on five-point Likert scale.Results: Almost half (48.8%) of the respondents while only 7% had high level of knowledge on the organ donation and transplantation. Similarly, 95% of the people had positive attitude towards organ donation. However, there was a weak correlation between knowledge and attitude of the respondents. None of the respondents carried an organ donation card.Conclusions: There is a need to plan robust strategies to educate people on organ donation so that they can make pragmatic decisions to register their names for deceased organ donation.


Author(s):  
Mahendra Kumar ◽  
Shelly Dhawan ◽  
Aditi Chaudhary ◽  
Sachin Dwivedi ◽  
Capt Anita Kumari

Organ donation is the donation of biological tissue or an organ of the human body from a living or dead person to a living recipient in need of a transplantation. Organ transplantation has made rapid strides over the last 6 decades and established its status from an experimental procedure to a well-established treatment modality. The great part of organ donation is most people can be organ donors. Nurses as being the largest part of any health care fleet can play a pivotal role in the dissemination of the right information, and nurse’s knowledge and commitment towards spreading awareness and motivating people pledging for organ donation are extremely important for the success of organ donation program.


Author(s):  
Amy Zarzeczny ◽  
◽  
Luiza Radu ◽  

On 3 September 2020, Saskatchewan launched an organ donor registry that allows participants 16 years and older to register their intent to be an organ donor either online or using a paper form. Saskatchewan has historically performed poorly at a national level with low rates of organ donations. Saskatchewan's new registry is intended to increase the numbers of organ donors in the province, while also helping to modernize its organ donation system and ease donation conversations with families. Saskatchewan's introduction of this registry brought the province in line with other provinces and territories across Canada that use similar systems, and provided a response to the surge in public interest around organ donation that followed the Humboldt Bronco bus crash tragedy and related ``Logan Boulet Effect.'' The 2019-2020 and 2020-2021 provincial budgets included dedicated funding for the development and launch of the registry, which was accompanied by a media campaign to increase public awareness. Though it is too early to evaluate the success of the registry, early indications suggest donation rates will be a key evaluation metric. Registries are commonly thought to help increase public awareness of, and support for, organ donation, but improving Saskatchewan's organ donation rates will likely also require companion measures to strengthen the culture and practice of donation in the province.


2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Erika Yee ◽  
Seyedeh Maryam Hosseini ◽  
Bianca Duarte ◽  
Shannon Knapp ◽  
Nancy K Sweitzer ◽  
...  

Introduction: The majority of living organ donors are women, and the majority of deceased organ donors are men. This poses a problem for transplant candidates who have worsened survival with sex mismatched organs. The objective of this study was to identify reasons for disparities in organ donation between sexes and identify strategies to increase organ donors. Methods: We conducted a fifteen question survey using a crowdsourcing marketplace, Amazon’s Mechanical Turk, in September 2019. The survey assessed how participants make decisions about becoming an organ donor. The survey was distributed to U.S. adult participants, including eight write-in questions and two Likert scale questions. Qualitative descriptive analyses were used to understand reasons for and against becoming an organ donor. Quantitative results were compared with t test. Results: Among the 667 eligible participants representing 49 states, 54.9% were women and 63.1% were in the 18-40 age group. The majority of men (64.8%) and women (63.4%) were registered organ donors. Among men and women donors, three themes guided their willingness to donate: desire to help others, personal experience with organ donors/recipients, and believing organs would have no use to the donor once dead. Among men and women non-donors, decisions were guided by three themes: no reason, medical mistrust, considering becoming a donor. Themes varied by sex when considering whether to donate organs of a deceased family member. Women were guided equally by two themes: family member’s wishes and believing the deceased family member had no further use for organs. Men had similar themes but valued the family member’s wishes more. Women’s willingness to donate their own organs to family members (p=0.03) and strangers (p=0.02) was significantly higher than men. Among non-donors, both sexes would consider becoming organ donors if more information was provided. Conclusion: In a national survey of adults, women and men had similar reasons for becoming and not becoming an organ donor. However compared to men, women were more willing to donate their organs and more altruistic in the donation of family members’ organs. Women’s deceased organ donation may increase with further communication of women’s wishes before death and by improved public education about organ donation.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S31-S32
Author(s):  
J. McCallum ◽  
R. Yip ◽  
S. Dhanani ◽  
I. Stiell

Introduction: A significant gap exists between the number of people waiting for an organ and donors. There are currently 1,628 people awaiting organ donation in Ontario alone. In 2018 to date, 310 donors have donated 858 organs. The purpose of this study was to determine whether there were missed donors in the Emergency Department (ED) and by what percent those missed donors would increase organ donation overall. Methods: This was a health records and organ donation database review of all patients who died in the ED at a large academic tertiary care center with 2 campuses and 160,000 visits per year. Patients were included from November 1, 2014 – October 31, 2017. We collected data on demographics, cause of death, and suitability for organ donation. Data was cross-referenced between hospital records and the provincial organ procurement organization called Trillium Gift of Life Network (TGLN) to determine whether patients were appropriately referred for consideration of donation in a timely manner. Potential missed donors were manually screened for suitability according to TGLN criteria. We calculated simple descriptive statistics for demographic data and the primary outcome. The primary outcome was percentage of potential organ donors missed in the Emergency Department (ED). Results: There were 606 deaths in the ED from November 1, 2014 – October 31, 2017. Patients were an average of 71 years old, 353 (58%) were male, and 75 (12%) died of a traumatic cause. TGLN was not contacted in 12 (2%) of cases. During this period there were two donors from the ED and 92 from the ICU. There were ten missed potential donors. They were an average of 67 years, 7 (70%) were male, and 2 (20%) died of a traumatic cause. In all ten cases, patients had withdrawal of life sustaining measures for medical futility prior to TGLN being contacted for consideration of donation. There could have been an addition seven liver, six pancreatic islet, four small bowel, and seven kidney donors. The ten missed ED donors could have increased total donors by 11%. Conclusion: The ED is a significant source of missed organ donors. In all cases of missed organ donation, patients had withdrawal of life sustaining measures prior to TGLN being called. In the future, it is essential that all patients have an organ procurement organization such as TGLN called prior to withdrawal of life sustaining measures to ensure that no opportunity for consideration of organ donation is missed.


2020 ◽  
Vol 20 (2) ◽  
pp. 155-166
Author(s):  
Jordan A. Parsons ◽  
Greg Moorlock

Following several international examples, England introduced a system of deemed consent for organ donation in May 2020. This had been planned for over a year. However, the unprecedented circumstances of the COVID-19 pandemic raise issues that make the timing of this change unfortunate. The planned public awareness campaign has thus far been overshadowed by media coverage of the pandemic, and will likely continue to be, creating a situation in which a significant portion of the population may be unaware of having become potential organ donors. Further, the immediate impact of the new policy is likely to be significantly weakened by the suspension of the majority of organ donation and transplant activity. In this article, we first outline the details of the new model introduced in England, before considering the impact of the pandemic on transplantation services. We put forward three ethical reasons why, given the unprecedented circumstances, the change should have been postponed. We argue that (1) COVID-19 dominating headlines will prevent widespread awareness of the change, thereby undermining the autonomy of those who do not wish to be donors; (2) a lack of transplant activity during the pandemic will make the impact of the change difficult to measure; and (3) trust in the new system may be damaged given controversial decisions regarding Do Not Attempt Cardiopulmonary Resuscitation orders and the allocation of scarce intensive care resources. These reasons combined make for a shaky start at best and present a risk of the new system failing to achieve its desired and essential effect of increasing the number of voluntary organ donors.


2019 ◽  
Vol 29 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Tobias Reynolds-Tylus ◽  
Brian L. Quick ◽  
Andy J. King ◽  
Miriam Moore

Context: Organ donation campaigns are maximized when promotional messages address salient issues among the intended audience. A diverse sample (N = 1573) was recruited to identify the reasons for (not) registering as an organ donor. Objective: Relying on an established coding scheme, an updated explanation for why individuals register (or not) as organ donors is provided. Moreover, registration trends with respect to race, biological sex, and age is presented. Method: Participants exiting Department of Motor Vehicle offices (N = 12) were surveyed to understand their reasons for registering and not registering as organ donors. Results: Benefits of donation followed by prior registration, rational arguments, and personal experiences represented nearly 90% of the coded responses for registering. Conversely, negative beliefs, decisional uncertainty, perceived disqualification, no reason, general fear/disgust, and lack of opportunity constituted nearly 90% of the coded responses for not registering as an organ donor. Whites and Latinx individuals were more likely to register as organ donors compared to African Americans. Participants in the lower (18-24) and upper (65+) age brackets had the lowest donor registration rates. Conclusion: Promotional efforts should continue to target younger and older audience segments with information about organ donation as well as African Americans. Results from the current study suggest emphasizing the benefits of organ donation as well as overcoming negative beliefs, decisional uncertainty, and perceived disqualifications.


2015 ◽  
Vol 05 (04) ◽  
pp. 051-057 ◽  
Author(s):  
Vaishaly K. Bharambe ◽  
Rathod H. ◽  
Paranjape V. M. ◽  
Kanaskar N. ◽  
Shevade S. ◽  
...  

Abstract Purpose : Bodies for purpose of dissection and organs for transplantation surgeries are needed for education of medical students and treatment of cases of end-stage organ failure. However deceased organ donation rate in India is very dismal. In the present study the authors assess the knowledge and attitude of the people living in an urban city in India towards organ and body donation. Materials/Methods : A questionnaire was distributed amongst all willing patients and their relatives attending the out-patient Department at our Hospital. This was followed by an awareness session wherein the researchers discussed body and organ donation and its need in India. Information sheet was handed to all and the willing respondents were given eye and body donation forms, and donor cards. Result: 41/65 people consented to participate. 41.5%, 31.7%, 12.2% and 12.2% had obtained knowledge regarding organ donation from newspaper, television, family members and internet respectively. 26.8% claimed that they were imparted knowledge by health care professionals. 78%, 53.7% and 19.5% were aware about eye, kidney and liver donations respectively. 17.1% were aware of body and lung donation each. Awareness of donation of other organs was found to be in the range between 4.9% to 14.6%. 43.9% were willing to be organ donors and 3 persons filled the body donation forms. Conclusion: Newspapers, healthcare professionals could be utilized to further the awareness regarding body and organ donation. Carrying out awareness programmes will help to reach information to each individual, clarifying any myths and increasing understanding and motivation levels among


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