Organ transplantation in Switzerland: impact of the new transplant law on cold ischaemia time and organ transports.
BACKGROUND
On 1 July 2007 a new transplant law came into force in Switzerland. The principal item of this new law is the change from centre-oriented allocation to patient-oriented national allocation of organs. The aim of the present study is to assess the impact on cold ischaemia time (CIT) and transport requirements.


METHODS
From 1 July 2006 to 30 June 2008 168 brain-dead donors were registered by Swisstransplant in Switzerland. Donors have been analysed in a retrospective cohort study design. Donor characteristics, transportation requirements and CIT were assessed from the Necroreport.


RESULTS
74 donors (44%) were allocated in the period before the introduction of the new law (period A) and 94 donors (56%) after the new law. Donor characteristics were similar. In period A, 114 organs (37.9%) were allocated within the procurement centre, compared to 54 organs (15.5%) in period B. Transport time for liver and kidney was remarkably longer in period B. Overall, CITs remained largely stable except for a significant increase of nearly 115 minutes in the liver graft median CIT (p <0.01).


CONCLUSIONS
The new Swiss transplant law clearly entails an increase in the frequency of organ transports. Overall CIT is not affected. However, liver transplantation is afflicted by an increase in transports and CIT. This may affect mid-term outcome and should therefore be followed closely.
Uehlinger
Nadine B
NB
Swisstransplant, Swiss National Foundation for organ donation and transplantation, Bern, Switzerland.
Beyeler
Franziska
F
Weiss
Julius
J
Marti
Hans-Peter
HP
Immer
Franz F
FF
D050377:Cold Ischemia / Q000639:trends*; D015276:Health Care Rationing / Q000331:legislation & jurisprudence*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013557:Switzerland; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D019737:Transplants / Q000639:trends*