International collaboration and organ exchange in Switzerland

Background

Organ exchange among organ procurement organisations (OPOs) serves three main purposes: firstly, it reduces the loss of donor organs for which there is no suitable recipient on the waiting list of an OPO; secondly, it improves the odds of specific patient groups for receiving a matching donor organ; thirdly, it allows an optimised donor-recipient match, due to an expansion of the donor and recipient pool. However, only few published studies provide figures for the significance of international organ sharing. This study aims to assess the impact of organ imports on the Swiss transplant activity.

Methods

We retrospectively analysed the data related to international organ exchange and its impact on the Swiss transplant activity. Information about organs from deceased donors offered by foreign OPOs was extracted from the Swiss Organ Allocation System for the period from 1 January 2009 to 31 December 2013.

Results

During the study period, 1028 organs were offered by foreign OPOs for allocation to patients needing transplantation in Switzerland. Of all organs offered, 35.9% originated from the Agence de la Biomédecine (France) and 25.6% from the National Health Service Blood and Transplant (United Kingdom). Totally 137 organs (13.3%) were accepted by the Swiss transplant centres for transplantation. These imported organs account for 7.2% of the transplants performed between 2009 and 2013. The impact of imported organs on the transplant activity was largest for the liver (14.2%), followed by heart (8.9%), lung (6.3%) and kidney (4.0%).

Conclusions

Our study showed that international organ exchange substantially contributed to the Swiss transplant activity during the period analysed. The collaboration between OPOs can be life-saving, especially for paediatric patients and selected adult transplant candidates. More patients might benefit from organ sharing if the standards for international collaboration could be further harmonised.