Council of Europe recognises role played by ER and ICU doctors in organ donation

This year, the tribute to European donors was preceded by an important Resolution in which the Council of Europe recognises the role played by ER and ICU doctors in organ donation. These professionals are a key part of the Spanish transplant model.

Promoted by Spain, the Resolution was endorsed by 37 countries (the Council of Europe includes many more than the 28 countries that currently comprise the European Union). The Resolution recommends that Member States of the Council of Europe train ER and ICU doctors in all aspects of the organ donation process (identification of possible donors, communication in critical situations, assessment and maintenance of donors, and the determination of death) as a way to increase donations.

Training

For a long time, the Spanish transplant system has considered ER and ICU doctors as professionals who play a fundamental role in improving organ donation in Spain. In fact, the Spanish National Transplant Organisation (Spanish acronym: ONT) has already trained over 1,000 young ICU professionals on organ donation and transplantation during their internship periods and nearly 6,000 emergency professionals under agreements signed with the Spanish Intensive Medicine and Critical Care Society (Spanish acronym: SEMICYUC) and the Spanish Emergency Medicine Society (Spanish acronym: SEMES). Nowadays, these specialists are another great ally for the donation system throughout Spain.

The Council of Europe Resolution also encourages the incorporation of organ donation as a regular activity in the daily routine of Intensive Care Units and Emergency Rooms, with the assessment of results based on quality indicators and audits. This is one line of action being developed by the Spanish transplant system at all hospitals in Spain.

The Council of Europe also recommends the creation of a transplant coordinator or an intensive care specialist at ICUs to act as a manager of potential donors even though the donation process involves everyone at the unit in question. The transplant coordinator is one of the fundamental aspects of the Spanish transplant model and their work is decisive in improving organ donation in Spain. According to ONT data, 87% of hospital medical coordinators in Spain are intensive care specialists, although, in practice, the entire ICU team works together on the organ donation process.

Finally, it recommends the development of research programmes on donation at ICUs and ERs, something the ONT has been doing for some time, together with the SEMICIYUC and the SEMES.

This Resolution provides firm recognition of the efficacy of the Spanish transplant system, which with 36 donors per million population (pmp) in 2014 maintains its 23-year uninterrupted global leadership in this field, at a rate that is far higher than the EU average and that of the United States.

Spain provided 16.8% of all European donations last year, as 1,680 donors of the 10,033 registered in the EU in 2014 were Spanish.

Disparity within the EU

The number of donors in the EU is growing very slowly but consistently, from a rate of 18.3 donors per million population in 2009 to 19.6 per million population in 2014. However, in spite of this slight increase, a significant disparity exists between the various European countries, even among the most developed: data from the World Transplant Registry show a significant improvement in organ donation in those countries that have, either fully or partially, implemented the Spanish transplant model.

Croatia is such a country, where the rate has risen from 17.7 per million population in 2009 to 35.1 per million population in 2014, as is Portugal (27.3 donors per million population). Both these countries have fully developed an organ donation and transplantation system similar to the Spanish system. The same can be said of the United Kingdom, which posted a rate of 20.6 donors per million population last year compared to 12 donors per million population in 2009 following the incorporation of transplant managers at ICUs and the implication of intensive care specialists in the donation process. On the other hand, Germany is a case where the organ donor rate has fallen by over 30% in the last five years from 14.9 donors per million population in 2009 to 10.4 donors per million population in 2014.

More donations, the finest tribute

Through the ONT, the Spanish Ministry of Health, Social Services and Equality is joining in the acts to commemorate European Donation Day to express its gratitude for the solidarity shown by the public and the work undertaken by professionals. It also wishes to remind people that the best tribute to organ donors and their families is to increase the availability of organs every year. According to data from the ONT at 1 October, the number of donations from the deceased rose by 9% on 2014, with increases in the figures posted on the transplantation of all organs.