First Series of Brain Death Organ Donors in United Arab Emirates - SEUSA Program Implementation

Abstract

Introduction The Middle East region faces some common challenges regarding organ donation and transplantation, like lack integrated approach across (private-public) healthcare systems, poor knowledge and awareness among public and professionals and lack of full regulatory frameworks. In the region deceased donor per million population (pmp) rate is low despite very good medical infrastructure and availability of medical experts compared to European average of donors pmp in 2016 of 21.5 dpmp. Two separate populations studies showed positive public attitudes for donation with 60-68 % surveyed wishing to donate their organs after death. In 2016 UAE issued a new Transplant law and addressed the legal requirement for deceased donation and the Ministry of Health and Prevention issued additional needed guiding documents for its implementation. In order to design a self-sufficient DD program and improve the skills of the health care professionals in the field, the UAE national Transplant committee in UAE and DTI Foundation have been working together to implement SEUSA tools. Methodology The SEUSA methodology is based on application of the tools from the most successful models in organ donation (OD), Spain, Europe and USA, and by implementing specialized trainings for health professionals based on the model of transplant procurement management TPM trainings. Since 2015, 3 yearly intermediate TPM training courses have been conducted for physicians and nurses on every step of the organ donation process. Visits form UAE professionals to Barcelona for educational purposes and experience interchange have also been performed. From 2017, visits from DTI international experts to UAE hospitals have been organized. During the hospital visits, interviews were conducted with local healthcare professionals, recommendations were provided about the establishment of in-hospital organ procurement units and a deceased alert system was defined for possible donor identification. Prior to the visits, ODDS (Organ Donation Diagnostic Surveys) were completed to assess the donor potentiality of each hospital. Results 128 healthcare professionals, mainly from the 10 leading hospitals, have been trained as Transplant Procurement Managers. Between July 2017 and February 2018, a total of 6 potential donors have become actual brain-dead organ donors. 19 organs have been recovered allowing the beginning of deceased cardiac, liver and lung transplantation and expansion of living related kidney transplantation programs in the UAE and full activation of organ sharing model between UAE and the Kingdom of Saudi Arabia. Conclusion Adequate in-hospital structure, organ donation training, and international collaboration alongside institutional and regulatory support from government has proven to be key for the establishment of deceased organ donation in the UAE. SEUSA program continues its implementation in UAE during 2018.