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[Organ donation after circulatory death].

J de Jonge1, M Kalisvaart2, M van der Hoeven2

  • 1Department of Surgery, Erasmus University Medical Centre, Suite H813, 2040, 3000CA, Rotterdam, Netherlands. j.dejonge.1@erasmusmc.nl.

Der Nervenarzt
|January 27, 2016
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Summary

The Netherlands significantly increased organ donation rates by implementing organ donation after circulatory death (DCD) and improving deceased donation processes. This initiative boosted donor numbers and optimized organ transplantation logistics.

Keywords:
Brain deathEnd of life careMedical ethicsNetherlandsOrgan transplantation

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Area of Science:

  • Medical Ethics
  • Public Health Policy
  • Transplantation Medicine

Background:

  • The Netherlands faced critically low organ donor rates in 1999, necessitating urgent policy changes.
  • Low organ donor numbers impacted transplantation rates and patient outcomes.

Purpose of the Study:

  • To analyze the developments and processes of deceased organ donation in the Netherlands.
  • To evaluate the impact of implementing organ donation after circulatory death (DCD) over 15 years.

Main Methods:

  • Introduction of socio-medico-legal regulations for organ donation.
  • Implementation of organ donation after circulatory death (DCD) alongside improved organ donation after brain death (DBD) procedures.
  • Establishment of a national organ donor database, enhanced public information, and specialized transplantation coordinators.

Main Results:

  • Postmortem organ donation rates increased from 10 to 16.4 per million inhabitants between 1999 and 2014.
  • Organ donation after circulatory death (DCD) now accounts for up to 60% of donations in the Netherlands, significantly higher than the USA's 10%.

Conclusions:

  • The Dutch strategy, particularly the integration of DCD, has successfully enhanced deceased organ donation rates.
  • Collaborative efforts among medical associations, government, and public health services were crucial for improving organ donation and transplantation outcomes.