Training hospital transplantation coordinators in Brazil

In Brazil from 1993 to 1997, the rate of deceased organ donors did not increase, remaining fixed around 3 donors per million population (pmp/y). In 1997, seeking to improve this situation, we introduced a policy seeking to improve the transplantation rates. Among the organizational measures, we created hospital transplantation coordinators based on the Spanish model. Because there was not enough qualified personnel in this area, 18 basic courses (12 to 24 hours) were performed in 9 states, with the purpose to train 1020 coordinators. Furthermore 20 advanced courses (40 hours) were introduced to train these coordinators in 16 of the 21 Brazilian states that perform transplantations in addition to the Federal District, resulting in 920 new coordinators. As a consequence, there was a mean annual increase of 20% in donations, namely 600 deceased donors in 1999 (3.8 pmp), 840 in 2001 (5.2 pmp), and 1232 in 2004 (7.3 pmp). The potential rate of donors notification attained 4981 (29 pmp) in 2004, about 50% of the estimate figures. However, this rate is far lower than that necessary. It is important to continue coordination of new training (4 yearly) and retraining courses for qualified coordinators using 2-day intensive courses (16 hours).