Strategies to optimize deceased organ donation

Organ shortage is one of the main limitations to deal with in organ transplantation. Although the number of patients in the waiting list increases over time, the number of transplants performed does not increase or increases at a much lower rate because of the scarcity of organs to fulfil the demands. Several classic approaches have proven to have a limited or transient impact on the figures of organ donation. The sustained increase in deceased organ donation rates in Spain during the last years, reaching values of 33 to 35 donors per million population, obeys to the implementation of a set of measures, mainly of organizational nature, that is internationally known as the Spanish Model of Organ Donation. With the creation of the National Transplant Organization in 1989, always acting as an agency in support of the process of donation besides organ sharing, a network of highly trained and motivated physicians with the main responsibility of developing a proactive donor detection program was established. A continuous audit of brain death in intensive care units of transplant procurement hospitals has been applied in the last 7 years as a valuable tool to evaluate the potential of donation and the weaknesses of the process, identifying areas to be improved. Great effort in training and education, close attention to the mass media, and reimbursement to procurement and transplant centers for the developed activity have been other measures indeed contributing to the successful Spanish results. The application of the Spanish Model of Organ Donation to other regions and countries across the world, such as the region of Tuscany in Northern Italy and some Latin American countries, has proven to be feasible always that minimal requirements are fulfilled. What these figures show is that a positive change in organ donation rates can be achieved if steps are taken into the right direction.