[Transplantation and outcome quality].
Organ transplants are procedures which require intensive personal and material resources. The results of organ transplants have continuously improved during recent decades. International data bases (registries) have documented the continuous evolution of organ transplantation. On the basis of the German Transplant Law guidelines for "Requirements regarding quality control for procedures related to organ procurement and transplantation" have been formulated by the German Medical Chamber. Thus, monitoring of outcome quality will become a requirement for all German transplant centers. In this paper, the guidelines for the different organ transplants (kidney, pancreas, liver, heart, lung) are discussed as well as quality control for living donor transplantation. Studies from the USA and Europe demonstrated volume-outcome relationships in organ transplantation. In addition, in kidney transplantation a centre-effect could be demonstrated which influences outcome more than the immunological match between donor and recipient. The introduction of required quality control may have far reaching consequences for the future structure of organ transplantation in Germany.
Bechstein
W O
WO
Chirurgische Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Universitätsklinik, Ruhr-Universität Bochum, In der Schornau 23-25, 44892 Bochum. wolf.bechstein@ruhr-uni-bochum.de
Wullstein
C
C
D002983:Clinical Competence / Q000331:legislation & jurisprudence*; D005858:Germany; D017408:Guidelines as Topic; D006782:Hospitals, Special / Q000331:legislation & jurisprudence; D006801:Humans; D016377:Organ Transplantation / Q000331:legislation & jurisprudence*; D017063:Outcome Assessment, Health Care / Q000331:legislation & jurisprudence*; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence*; D011786:Quality Control; D014019:Tissue Donors / Q000331:legislation & jurisprudence