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Published on: August 15, 2022
Recommendations for further improvement of the deceased organ donation process in Belgium
Pieter Hoste1,2,3, Patrick Ferdinande4, Eric Hoste5,6
1a Department of General Internal Medicine , Ghent University Hospital , Ghent , Belgium.
Insights
Belgium misses deceased organ donors, particularly after circulatory death (DCD), despite high donation rates. Improving donor detection and conversion rates is crucial for enhancing organ procurement outcomes.
Area of Science:
- Medical Science
- Public Health
- Transplantation Medicine
Background:
- Belgium demonstrates high deceased organ donation rates.
- However, medical records indicate missed opportunities in identifying potential deceased donors.
- Significant gaps exist in the deceased organ donation pathway.
Purpose of the Study:
- To analyze missed deceased organ donation opportunities in Belgium.
- To identify barriers and challenges in the donation process.
- To provide expert recommendations for improving deceased organ donation and procurement.
Main Methods:
- Analysis of medical record data from the Donor Action database (2010-2014).
- Evaluation of potential donor identification and conversion rates for brain death (DBD) and circulatory death (DCD).
- Expert panel review of key issues including monitoring, donor pool, legislation, registration, reimbursement, education, and clinical guidance.
Main Results:
- Between 2010-2014, 12.9% of potential DBD and 24.6% of potential DCD donors were not identified.
- Conversion rates were 41.7% for DBD and 7.9% for DCD, highlighting significant room for improvement.
- Identified issues span monitoring, donor pool management, legislation, registration, financial incentives, training, and clinical protocols.
Conclusions:
- Belgium can improve deceased organ donation rates by addressing identified gaps in donor identification and pathway management.
- Specific focus is needed on increasing the identification and conversion of donors after circulatory death (DCD).
- Implementing expert panel recommendations is vital for optimizing the organ donation process and increasing organ procurement.
Abstract:
Belgium has achieved high deceased organ donation rates but according to the medical record data in the Donor Action database, deceased potential donors are still missed along the pathway. Between 2010 and 2014, 12.9 ± 3.3% of the potential donors after brain death (DBD) and 24.6 ± 1.8% of the potential donors after circulatory (DCD) death were not identified. Conversion rates of 41.7 ± 2.1% for DBD and 7.9 ± 0.9% for DCD indicate room for further improvement. We identify and discuss different issues in the monitoring of donation activities, practices and outcomes; donor pool; legislation on deceased organ donation; registration; financial reimbursement; educational and training programs; donor detection and practice clinical guidance. The overall aim of this position paper, elaborated by a Belgian expert panel, is to provide recommendations for further improvement of the deceased organ donation process up to organ procurement in Belgium.
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