Increasing deceased organ donor numbers in Johannesburg, South Africa: 18-month results of the Wits Transplant Procurement Model

Abstract

The global context Globally, persistent shortages of deceased-donor organs remain one of the greatest challenges to expanding access to solid-organ transplantation for individuals with end-stage organ failure. [3] In many countries, attempts have been made to increase deceased organ donation, with varying success. Generally, with successful initiatives, multipronged approaches include various combinations of the following: (i) legislative change, for example using the 'optout' rather than the 'opt-in' system; (ii) substantial government buy-in; (iii) robust hospital-based programmes that facilitate quick identification and referral of potential donors; and (iv) extensive human, infrastructural and health system resources to ensure sustainability. [4,5] Deceased-donor shortages persist in SA, resulting in the deaths of many patients waiting for organ transplants. [6] General roles of the TPC The exact scope of practice for TPCs varies from country to country, but their job encompasses some general responsibilities and duties. [7] These include promoting referrals, obtaining consent from the families of deceased donors, medical maintenance of the donor, and interprofessional communication (Fig. 1). This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. HEALTHCARE DELIVERY

Assessing Global Organ Donation Policies: Opt-In vs Opt-Out

“…Families may have personal contextual objections to organ donation, may not be familiar with the wishes of their loved one or may be unable to fully comprehend what is being asked of them at a time of grief. 38 The USA utilises an opt-in system, and proves a useful exemplar of these barriers. It is estimated that 15–45% of deceased donors are lost during the consent process with families in the USA.…”

“…As such most countries with high donor numbers have introduced measures to improve interaction with potential donor families during the process of seeking their consent or authorisation for donation. 38 Many countries have also attempted to increase family consent rates by encouraging individuals to openly express their donation preferences whilst still alive.…”