Eurotransplant Meeting 2000
Eurotransplant is an international organization located in Leiden, The Netherlands, that allocates donor organs procured within 6 participating countries: Austria, Belgium, Germany, Luxembourg, The Netherlands, and the newest member, Slovenia. Eurotransplant arose from private initiative, led by Professor Jon J. van Rood in 1967. At that time, excessive HLA mismatching between donors and recipients resulted in a high incidence of kidney rejection. Professor Van Rood's vision was for central registration of all patients on a common waiting list, which would lead to a greater chance of compatibility between donors and recipients and improve the results of transplantation. This goal has been achieved and HLA matching continues to have a favorable impact on renal allograft outcome, providing that the cold ischemia time is kept short.

The Eurotransplant participating transplant centers have a collective waiting list of more than 15,000 patients. In the beginning, Eurotransplant activities focused solely on kidney transplantation, but at present heart, liver, pancreas, lung, and bowel transplantation are served as well. Eurotransplant's activities are financed by health insurance companies in the participating countries. New agreements are made annually and registration fees are adjusted accordingly.

Delegates from Eurotransplant participating centers meet at least twice a year in the fall and winter to discuss general and organ-specific issues related to organ procurement, organ allocation policies, and to elect their representatives to Eurotransplant. This report is from the autumn 2000 meeting held in Leiden.

In an effort to increase organ donation with the region, Eurotransplant works collaboratively with transplant coordinators to educate nursing and medical staff about the importance of and the procedures for optimal organ donation. Eurotransplant also supports Donor Action, an international initiative to alleviate the organ shortage. In 1994, 3 organizations -- Eurotransplant International Foundation, Organización Nacional de Transplantes (Spain), and the former Partnership for Organ Donation (U.S.) -- agreed to pool their expertise in the form of a working group to develop an international in-hospital programme to increase organ donation. The result was Donor Action.

Reviewing the factors that affect organ donation, the Donor Action Working Group evaluated hospital procedures, public perception, and the importance of communication about donation issues in the family. They found that the average hospital was missing the opportunity for a significant percentage of potential donors, primarily because not every potential donor was being identified and many families were not being presented with the option of donation. In addition, many hospitals were found ill prepared to inform families about donation. As a result, the Donor Action Working Group focused its effort on assisting hospitals and in particular, their critical care unit staff, to increase donation rates through improved practices.

Donor Action is a critical care unit initiative, providing a systematic method for increasing donation rates through implementation of best practices. The program identifies how and why potential donors are missed and recommends corrective measures; highlights staff needs in donation-related activities; provides a clear structure for various roles and responsibilities crucial to the donation process; and provides practical tools, guidelines, and training. A key component of the program is a Critical Donation Pathway. The Donor Action program is designed to be flexible in response to the needs of individual hospitals and critical care units.

As of mid-2000, 26 Donor Action program licences were in effect in 17 countries. An analysis of data from collected from 1995-2000 revealed that the introduction of Donor Action increased donation initially by 30% to 400% and that improvements were sustained for up to 3 years.