Evaluation of organ procurement in an area under the influence of a training program.
BACKGROUND
The procurement of organs was evaluated in an area of 1,450,000 inhabitants. This area provides two international programs and two training courses for transplant coordinators. One of them deals with the entire process of donation and transplantation, and the other is a monographic course about family consent and donation request. One transplantation coordinator manages the area.


METHODS
The results of the last 6 years have been analyzed concerning the procurement of organ donors (related to brain death [BD] donors, exitus at the hospital, and the intensive care unit [ICU]); loss in the process, such as medically unsuitable; problem detection; and family refusals.


RESULTS
During the past 6 years the donor potential increased from 1.67% to 4.06%. The BD by exitus in the ICU increased from 7% to 14.01% (the average in Spain 12.2%); the cases of BD in ICU beds increased from 0.5% to 1.31% (average in Spain 0.8%). The loss for medical exclusion criteria decreased from 27% to 20% and in family refusals from 19.7% to 13.6%. The efficiency of the process in percentage of actual donations by BD increased from 52.4% to 65.3% (average in Spain 49%). The actual donors per million population (PMP) increased from 37 PMP to 59 PMP. The average number of organs obtained from donors increased from 3.1 to 3.6, and the transplants increased from 2.7 to 3.04 per donor. The average waiting period for a renal transplant was reduced from 365 days to 199 days.


CONCLUSIONS
The training of coordinators and the net system of regional coordinator, area coordinator, and hospital coordinator improved our donation rate.
Santiago
C
C
Transplant Coordination Service, Hospital General de Alicante, Spain. cadesantiago@telefonica.net
Gómez
P
P
Olivares
J
J
de La Concepción
M
M
D001293:Attitude to Death; D001926:Brain Death; D006801:Humans; D045808:Refusal to Participate / Q000706:statistics & numerical data*; D013030:Spain; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000639:trends*