title: THE MALFUNCTIONS OF A NATIONAL TRANSPLANTATION SYSTEM: MULTI-LAYERED EXPLANATIONS FROM WITHIN.
abstract: Romanja has one of the lowest posthumous organ donation and transplantation rates in Europe.
  
  
  OBJECTIVE
  To explore the perspectives on the national transplantation system deficits shared by the physicians responsible for the identification and referral of potential posthumous organ donors.
  
  
  METHODS
  The study consists of semi-structured interviews with the key informants (ICU physicians, neurologists and neurosurgeons) in county hospitals in Moldavia.
  
  
  RESULTS
  The explanations for the current Romanian organ transplantation rate, as emerged from the participants' answers, are multi-layered. Overall, the national transplantation system is accused of being plagued with serious problems: it is underfunded, understaffed, its resources have been distributed unevenly among medical centers, the communication between its elements is disrupted, leaving the majority of the transplant professionals practically detached from its upper layer and affecting their motivation to perform their transplantation-related tasks. Furthermore, some of the participants point to the strong reluctance of the population to donate their deceased relatives' organs.
  
  
  CONCLUSIONS
  The results suggest a set of possible multi-level interventicrnq that could alleviate these problems.
authors.forename: A
authors.initials: A
authors.lastname: Holman
authors.forename: Ioan
authors.initials: I
authors.lastname: Beatrice
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016377:Organ Transplantation; D010820:Physicians / Q000706:statistics & numerical data*; D012383:Romania / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*