[Optimising tissue donation process in a university hospital: 10 years of experience]

The demand of tissue for transplants requires a continuous effort in detecting potential donors and assessing the causes of death. We aimed to assess the capacity to optimise tissue donation rates with the implementation of an active detection system of hospital deaths alongside a comprehensive assessment of the causes of death according to current international and local tissue banks' standards.

An early and pro-active detection programme of hospital deaths was implemented in 2002. The potential increase in donation was analysed according to modified criteria: age (80 to 85 years), acceptance of corneal phacoemulsification, autoimmune diseases, and sepsis reassessment. During the 2002-2011 decade, the criteria for absolute exclusion remained the same. The conversion rate from potential donors to actual donors of one or more tissue types was analysed.

A total of 16.531 cases of cardiac arrest were analysed, and 11.191 of the cases fulfilled criteria of absolute exclusion. The modification of criteria led to an increase of potential donors: 10.4% age factor, 4.5% autoimmune diseases/phacoemulsification factor, 11.8% sepsis factor (P<.00). The study indicated a total increase of 16% (P<.00). A total of 2.371 successful donations were generated. The efficiency to generate donors increased from 11 to 21% during the aforementioned decade (P<.00).

A pro-active detection system of hospital deaths combined with a continuous re-assessment of the acceptance criteria for each tissue type in the hospital setting leads to an increase in the potential donors' rate.