Spain, one of the world leaders in deceased donor organ donation, has expressed its willingness to be in long-term collaboration with Kerala so that the State can adopt the best practices in that country to suit the local context and improve its deceased donor donation programme, Mrithasanjeevani.
Spain will also help Kerala implement a quality assurance programme for the periodic assessment of Mrithasanjeevani so that the gaps can be identified and quality standards improved.
“The Spanish model has evolved over the past 30 years. We have helped many other nations such as Portugal, Croatia and France develop their own organ donation programmes by training them to adopt our best practices. In Spain, we have a conversion rate (conversion of brain death into potential organ donors) of 85%. We are happy to help Kerala revive Mrithasanjeevani and improve the donation rates,” Maria Paula Gomez of the Donation and Transplant Institute (DTI ), Spain, told The Hindu .
Training
Dr. Gomez is in the city, along with a three-member team from Spain, including critical care specialists and transplant procurement managers (TPMs), to lead a two-day training programme being organised for the TPMs in the State.
Some 55 ICU physicians, who recently donned the role of TPMs in various private and public sector hospitals, are participating in the training, being organised by the Kerala Network for Organ Sharing. “We have been helping hospitals implement a quality assurance system with specific indicators to monitor and assess the hospital’s organ donation potential (if all brain deaths are identified), brain death conversion rates, family refusal rates, number of organs harvested per donor, medical contraindications for donation and so on. This is important so that the hospitals have a total picture of their organ donation programme,” said Nuria Masnou, a TPM with the University Hospital Josep Trueta, Girona.
Periodical assessment
In Spain, quality assessment is done periodically by in-house TPMs in hospitals as well as by an external assessor. “The aim is not to penalise hospitals, but help them improve their organ donation programme,” Dr. Gomez said.
In Spain, organ donation was equated with the gift of life and it had never been difficult to talk to people about death. They also seemed to understand that one day they could also be in need of an organ transplant, said Dr. Masnou.
Expenses covered
Spain has implemented Universal Health Coverage and all expenses for organ transplant are covered. Brain death certification is mandatory in the ICUs and mechanical ventilation is removed and all treatment stopped if families do not wish to go ahead with organ donation.
“The success of the Spanish organ donation model has been that it is our ICU physicians who have been leading the organ donation movement from inside the hospitals. As TPMs, they work hard to change the culture of the hospital and to ensure that all brain deaths result in organ donation,” Dr. Gomez said.
