Organ shortage is a major factor affecting transplant programs. In Europe alone, there are almost 40,000 patients waiting on waiting lists, while dozens of patients die every day – waiting in vain for an organ donation. At the beginning of June, experts from the European ACCORD initiative met at a conference in Madrid to jointly address the issues of improving the system of organ donation and transplantation.
Organ transplantation is currently the most cost-effective treatment for kidney failure; in failure of organs such as the liver, lungs and heart, this is the only treatment available. However, even among EU countries with well-developed health services, there are significant differences in organ donation and transplantation activities. The topic of organ donation and transplantation is sensitive and complex (especially from an ethical point of view), therefore it requires the full attention and participation of society. The European Commission is actively dealing with this issue, as it is important to ensure the safety of patients and donors, the quality of transplanted organs, increase the availability of organs and at the same time fight against organ trafficking.
Organ shortage and organ trafficking
Every day, almost ten patients die, waiting in vain for a specific organ transplant within Europe. Waiting lists are long in all EU countries. The demand for transplants is growing faster than the list of potential donors. Various European initiatives are trying to increase the number of healthy people who decide to become donors during their lifetime.
There are large differences between member states' success in expanding the donor pool. In some countries, donors can be counted on the fingers of one hand per million inhabitants, in others there are dozens of them. Much depends on cultural, historical and social factors, as well as on the features of the health care system and the organization of the donation system in a given country.
Organ trafficking is not a new problem in the world. Already in the 1980s, experts began to notice the phenomenon of 'transplant tourism', when wealthy people from Asia began traveling to India and other Southeast Asian countries in order to obtain organs from poor donors. While organ trafficking in Europe only occurs on a relatively small scale, it is undoubtedly a very serious political and ethical problem that needs attention.
The shortage of organs is a problem in all European countries. But the sharing of expertise between EU member states has already proven itself in increasing the share of donors per population in some countries. Some member states have introduced procedures aimed at the efficient organization of the donation system, and as a result, increases in the availability of organs for transplantation were indeed demonstrable. Establishing an effective system for identifying persons who could become organ donors during their lifetime and/or after their death is a key element for increasing the donation rate. In the EU member states, it is also important to educate health professionals whose task it is to identify and work with potential organ donors - in order to improve the functioning of the entire transplant system.
In order to expand the pool of potential donors, the option of living donor donation should be widely promoted. At the same time, however, appropriate protective measures must be ensured - the protection of living donors and the prevention of organ trafficking. Organ donation and transplantation are medical procedures that require the full attention and participation of a mature society. In 2009, according to a Eurobarometer survey, up to 55% of Europeans said they were ready to donate their organs after their death. However, the answers to this question differed considerably among individual member countries. In the Slovak Republic, for example, only 29% of citizens discussed the possibility of donating at home.
Respond to new public health challenges
A well-prepared public awareness strategy about organ donation and transplantation can reduce the percentage of family refusals to donate the organs of their deceased relatives. The most cost-effective way of increasing the willingness of the public to donate organs consists in improving the knowledge of health professionals, as well as in quality media coverage of the issue of transplantation. The creation of a European organ donor card also contributes to raising public awareness.
The ACCORD European initiative, co-financed by the EU public health program, presented (after three years of intensive research, experience sharing and the creation of a donor register) its results and achievements at a professional conference in Madrid at the beginning of June. The ACCORD project aims to reduce inequalities in organ donation within Europe. It is intended to: strengthen the protection of living donors through common standards and by improving information systems; promotion of deceased organ donation by facilitating cooperation between health professionals and coordinators of the transplant process; as well as the continuation of the sharing of practical knowledge, experience and tools by introducing practical cooperation between countries - through the "twinnings" initiative (partnership of cities).
As it turns out, it is important that the results of European community programs are presented and approved at the political level (in the form of national policies). The main areas of possible improvement in organ donation and transplantation in the future were identified as: Improving the quality and safety of the donors themselves, as well as the process of donation and transplantation; Increasing the legal availability of organs; Increasing the activity and availability of transplant systems; Strengthening the Action Plan for cooperation between EU member states. You can read more about the issue of organ donation at: http://www.accord-ja.eu
Text: Bozena Baluchová, Photo: Pavol Markovič
