Study Highlights System Deficiencies
The nationwide German secondary data analysis of all inpatient treatment cases shows that the decline in post-mortem organ donation is significantly associated with deficits in detection and reporting in organ donation hospitals, and less associated with a lower level of willingness to donate organs in the population. On the contrary—willingness to donate has even risen again. Systemic improvements are therefore overdue, and politics can no longer just pass the blame to the population.
As early as in 2015, the German Kidney Transplant Initiative (Initiative Nierentransplantation) presented a 5-point plan with measures to increase organ donation, such as empowering transplantation officers in hospitals. It must be ensured that transplantation officers can perform their duties without constraints and with a high degree of responsibility. Presently, this is not the case everywhere—in many hospitals, the transplantation officer has only superficial functions. It is thus no wonder that the donation rate is so low.
Additionally, the expenses of donation hospitals must be adequately remunerated. A first step would be to pay for the treatment time in the intensive care unit incurred by the extended length of stay of donors. Further, a transparent reporting system would help allow comparison of organ donation hospitals and identification of those hospitals that need special support for organ donation. Currently, only the number of organ donations carried out per hospital is published. Presenting data on the realized organ donations in relation to the number of possible donors per hospital (analogous to the study ) would reveal organ donation hospitals with funding needs.
Prof. Dr. med. Andreas Kribben
Deutsche Gesellschaft für Nephrologie (DGfN), Berlin
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Schulte K, Borzikowsky C, Rahmel A, Kolibay F, Polze N, Fränkel P, Mikle S, Alders B, Kunzendorf U, Feldkamp T: Decline in organ donation in Germany—a nationwide secondary analysis of all inpatient cases. Dtsch Arztebl Int 2018; 115: 463–8 VOLLTEXT|