Quality and safety in the Italian donor evaluation process

Area of Science:

• Transplantation medicine
• Public health
• Infectious disease control

Background:

• Organ shortages necessitate using organs from elderly donors, increasing potential risk factors.
• Transmission of infectious or neoplastic diseases from donor to recipient is a significant concern.
• Ensuring organ quality and avoiding unacceptable risks are paramount in organ transplantation.

Purpose of the Study:

• To describe the risk management process implemented by Italian transplant centers.
• To outline the development and application of national guidelines for organ donor evaluation.
• To detail the support provided to healthcare workers for assessing donor suitability.

Main Methods:

• Establishment of a national commission of experts by the Italian National Transplant Centre in 2001.
• Development of guidelines for the evaluation of potential organ donors.
• Implementation of an expert task force for second opinions in doubtful cases and provision of information tools.

Main Results:

• 9,519 potential cadaveric donors were reported in Italy following guideline implementation.
• 1,611 donors (16.9%) presented a neoplastic or infectious risk.
• 674 donors had neoplastic disease and 937 had infectious disease; 4,861 donors were transplanted (48.5% utilization rate).

Conclusions:

• New guidelines and actions have been implemented in Italy to enhance organ safety.
• European initiatives are also underway to improve organ safety.
• The impact of these implemented actions will be evaluated in the future.