Evolution of Donation and Transplantation after Circulatory Death Activities (2012-2016): Review of the Newsletter Transplant of the Council of Europe

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Abstract

Introduction

The Newsletter Transplant of the Council of Europe publishes donation and transplantation international figures for organ, tissues and haematopoietic stem cell, and the documents produced by the committee of experts on the organizational aspects of co-operation in organ transplantation. It is edited annually since 1996 by the Spanish National Transplant Organization (ONT). We have taken into account the last 5 years (2012-2016) with the objective of describing the evolution of donation after circulatory death (DCD) figures and transplants performed from cardiac death donations.

Materials and Methods

Data Source: Information of the Newsletter is collected through a network of national focal points designated by the Ministries of Health of the participating countries, by means of a specifically designed questionnaire.Scope and Study Period: We selected the 22 countries that are nowadays performing DCDto perform a descriptive analysis and assess the development of their cardiac death donation and transplantation activities during the period 2012 to 2016. Neither Canada nor Russia report data for transplantation from DCD, so they have not been taken into account in that area.

Results and Discussion

In 2012 there were 2339 DCD vs 3557 in 2016, representing a 52% increase. By countries, the biggest increase has occurred in Italy, a 300% increase, going from 5 donors (0.08 per million population) to 20 (0.33). The country with the largest number of actual donors in absolute numbers is USA: 1684. The country with the highest rate of DCD pmp in 2016 is Spain (10.74). Since 2012, DCD is being performed in 8 more countries: Ireland, Israel, Lithuania, New Zeland, Norway, Poland, Portugal and Saudi Arabia.There has been a decrease in DCD in two countries: Russia and Latvia. Solid organ transplants from DCD have increased in this 5 year period. Kidney transplants have gone from 3179 (4.34 pmp) to 5176 (6.91). Increases over 100% were reported in Italy and Spain. There were decreases in Austria, Ireland, Latvia and Netherlands.

Results and Discussion

Liver transplants from DCD are performed in 11 of the 20 countries for which data is available. In 2012 it was only performed in 9 countries. Liver transplants from DCD have increased from 534 (0.73 pmp) in 2012 to 970 (1.30) in 2016.

Results and Discussion

Increases over 100% were observed in France and Spain. There were decreases in Australia and Austria.There were 138 lung transplants from DCD in 2012 and 266 in 2016. Lung transplants from DCD are only performed in 9 countries.

Results and Discussion

There have not been variations in pancreas transplants during the study period. There were 71 transplants in 2012 and 72 in 2016. Pancreas transplants from DCD were performed in 3 countries during 2016.

Conclusion

DCD and transplants from DCD vary amongst countries reporting to the Newsletter Transplant. There is a steady increase in DCD donation and transplantation taking into consideration all the data available.

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