Cadaveric organ donation in Israel: the facts and the perspectives

Transplantation is limited worldwide by the shortage of organs. The main reasons are a low detection rate of potential donors and a poor motivation and qualification of health care professionals to request for family authorization for organ donation. The aim of our study was divided into two parts: to evaluate the potential and effective organ donor rate in Israel, and to assess the effects of an education program on the knowledge and attitudes of health professionals in regard to organ donation.

Part 1: We collected data on all potential and effective cadaveric donors from 1991 to 1998. We compared these figures to those obtained from European or American organizations. Part 2: We conducted 7 seminars for a total of 167 health professionals from 10 hospitals. A questionnaire was completed before and after the seminar, and differences in knowledge and attitude were compared. Pearsons correlation and students t-test were used for statistical analysis.

Potential organ donors varied from 77 to 201 per year and effective organ donors increased from 4.8 to 14.1 pmp. Multiorgan donation increased from 1991 to 1998 reaching 60% of the cases. Knowledge on brain death, legal and religious aspects, protocols and approach to the family improved significantly (p<0.001) after 2 days of an intensive workshop.

The rate of potential and effective organ donors is low in Israel, in comparison with other developed countries. These results are explained by problems encountered at every step of transplant procurement. We believe that a model, involving experts in brain death determination, maintenance of the donor, family approach and organ procurement could reach results close to other developed countries.