Dados do Trabalho

Título

Successful implementation of the Spanish model of organ donation in a Brazilian State

Objetivo

To evaluate the impact of adapting the Spanish model of organ donation in a State of a middle-income country.

Métodos

This was a quality improvement project, conducted in Santa Catarina from 2008 to 2023. Interventions consisted with continuous and massive education of critical care professionals and donor transplant coordinators, including courses on communication in critical situations and management of potential donors after brain death (DBD); central office as a support agency; establishment of a network of in-house donor transplant coordination, led by intensivists; audit of all patients with signs compatible with brain death; and reimbursement of hospitals for donation activities. Outcomes: actual DBD donors, DBD referrals, DBD losses due to family decline and cardiac arrest. Outcomes were evaluated in 4-year intervals and compared by Chi-squared test.

Resultados

From 8,064 potential DBD donors referred, 3,609 (45%) were actual donors, 903 (11%) were lost to cardiac arrests and 1,992 (25%) due to a family refusal. There was an upward trend in actual DBD donor rates per million population (pmp), from the 1st to the 2nd 4-year period (20.0 pmp to 29.1 pmp; p<0.001), with a further increase to 41.4 pmp in the 3rd period (p<0.001) and the last 4-year period (41.8 pmp; p=0.83). Compared with the baseline, there was an overall increase of 109% in the number of actual donors in the last 4-year period.

Conclusão

An in-house donor transplant coordination model led by intensivists and educational initiatives based on the Spanish model may positively impact in organ donation activity.