Out-of-Hospital Tissue Donation: Multidisciplinary Donor Circuit in a Forensic Institute

We aimed to implement an out-of-hospital system of generating donors that increases donation and answers the growing demand for tissue for therapeutic purposes.

The Catalan Health Service issued the 4/2015 instruction promoting the integration of the donation network through collaboration with the Donor Center of Catalonia (DCC). The creation of DCC facilitated the signing of an agreement between The Blood and Tissue Bank, the Department of Justice of the Generalitat de Catalunya, the Emergency Medical System, and the Hospital Clínic Barcelona for the procurement of tissues in the Institute of Legal Medicine and Forensic Sciences of Catalonia (IMLCFC), where the autopsies of all judicial deaths in the province of Barcelona are performed.

The Emergency Medical System informed the DCC of those instances that ended with the code "deceased." DCC assessed the possible donor on arrival at the IMLCFC, checked the medical history through the shared clinical record, and obtained family consent by telephone interview. If consent was obtained, then judicial authorization was sought.

In 2016, 152 donors of corneas were obtained (9.7% of the annual amount in Catalonia), 149 in 2017 (9.4% of the annual amount), and 133 donations in 2018. At the end of 2017, we started multitissue retrieval and obtained in 2018 a total of 76 donors.

Out-of-hospital tissue donation in a forensic institute is possible. In less than 3 years, IMLCFC has become the third largest eye tissue contributor among the Catalan tissue donation network and the first contributor in musculoskeletal tissues in 2018.