Activity of hospital transplant coordinators in Malopolskie Province (Poland).
BACKGROUND
In Poland as well as in other European countries, the number of organs from deceased donors is too small to meet the needs of transplantation therapy.


METHODS
This situation can be improved by increasing the number of hospital transplant coordinators in hospitals with potential of donation. Since 2010, 200 Polish hospitals have employed coordinators whose role is to recruit deceased organ donors, to monitor the potential of donation (quality assurance program), and to run the training courses. In Malopolskie Province, there are 26 hospitals in which organ procurement from brain-dead donors is possible. In 13 hospitals, donor transplant coordinators have been employed. The objective of this study was to evaluate the activity of hospitals in Malopolskie Province in the field of donor recruitment before and after employment of coordinators (19 months before and after). For the purpose of the study, the number of hospitals with positive effects and with no effects of coordinator employment was calculated, and several donation rates were compared in the period before and after employment of the coordinator. We also compared the number of deceased organ donors in 13 hospitals employing a coordinator and in 13 hospitals without a coordinator.


RESULTS
The desired impact of employment of coordinators in Malopolskie Province measured by improvement of organ donation rates was observed in half of the hospitals (7 of 13; 54%) with a transplant donor coordinator. The number of potential organ donors increased by 100% (from 24 to 48), and the number of actual organ donors increased by 113% (from 16 to 34). The percentage of family objections to organ donation decreased (from 17% to 8%). The best result of employing coordinators was observed at university hospitals and multidisciplinary hospitals and at hospitals in which the coordinator was a physician. The worst effect was recorded at county hospitals.


CONCLUSIONS
The employment of hospital transplant coordinators in Malopolskie Province has a global impact on the increase of the number of actual organ donors in that region and improvement of organ donation rates, but it is effective only in half of the hospitals with coordinators. It indicates that other measurements should also be undertaken to run donation programs.
Department of Surgical and Transplant Nursing, Medical University of Warsaw, Warsaw, Poland.
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A
Sikora
Department of Surgical and Transplant Nursing, Medical University of Warsaw, Warsaw, Poland; Polish Transplant Coordinating Center-Poltransplant, Warsaw, Poland.
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J
Czerwiński
Polish Transplant Coordinating Center-Poltransplant, Warsaw, Poland.
T
T
Danek
Department of General and Transplant Surgery, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland. Electronic address: wojciech.lisik@wum.edu.pl.
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W
Lisik
D001926:Brain Death; D006801:Humans; D008297:Male; D010564:Personnel, Hospital; D011044:Poland; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D000078329:Workforce