Cross Border Organ Exchange Among EU Members States. Preliminary Results of the Foedus-EOEO it Portal

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Abstract

Introduction

FOEDUS-EOEO portal for the exchange of surplus organs among European Union (EU) Member States (MS) (available at www.foedus-eoeo.eu) is the result of a 3-year EU-funded Joint Action, aimed at facilitating organ exchange between the MS in compliance with Directives 2010/53/EU and 2012/25/EU.

Methods

FOEDUS-EOEO platform became fully operational as of June 1st 2015, it is accessible through user-id and password and allows sending offers or requests of surplus available organs simultaneously to registered EU countries avoiding any delay in information transmission. Out of 24 registered countries 10 (BG, CZ, FR, GR, IT, LT, SK, ES, PL, CH) have been actively using it to present. The portal allows managing multilateral and bilateral organ exchange agreements, clinical information are transmitted using an agreed-upon donor form. Organs are allocated on the basis of the first-come first-served principle. Each registered member has access to a report-generating function, through which activity data files in either pdf, excel and xml format can be downloaded, analysing portal activity by several variables.

Results

From June 1st 2015 to March 31st 2017, 380 organs have been offered through the portal, 53 of these have been transplanted, including 23 paediatric transplantations. The most offered organ were lungs (89) whereas the most requested organ was heart (140) and the most transplanted was liver (30). Among the EU countries using the portal France is the most offering country (21) and Italy is the country where most organs have been transplanted (16). Distribution among age groups was rather homogenous, interestingly 11 out of 53 organs were retrieved from really small children (0-3 year-old), therefore allowing to meet the needs of an important group of patients for which it is often difficult to find a correct size match in national programs.

Conclusions

The development and use of FOEDUS-EOEO platform has allowed to speed up communication processes between the involved EOEOs but also to ensure the transparency and traceability of the exchanged organs. The adoption of a common clinical information form has also contributed to smooth the assessment procedures by coordinators. As a result, whenever suitable matches between donors and recipient are found, available surplus organs can be effectively allocated. In particular an increased number of pediatric patients benefit from this exchange. After the expiration of funding support by EU Commission, ten organ Competent Authorities (CZ, FR, IT, LT, PL, RO, SK, ES, CH, UK) have signed a cooperation agreement, thus committing to fund the maintenance of the portal and encouraging other EU countries to join. These encouraging preliminary figures show that this new IT tool has already become a key instrument for offering additional life-saving opportunities to EU citizens.

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