Impact of Educational and Organizational Initiatives in Organ Donation in a Southern Brazilian State in the Last Decade

Abstract

BackgroundThe unbalance between the demand and supply of organs for transplant is a universal phenomenon. This study shows Santa Catarina's experience with educational and organizational initiatives in the state's transplant system to describe the result of such actions in increasing donation rates. MethodsThis is a before and after study. Medical data on potential organ donors, listed in the Santa Catarina Transplant Registry between January 2004 and December 2017, were analyzed. This 13-year period was divided into 3 phases. Phase 1, from 2005 to 2007, corresponds to the organization of the program without specific measures. Phase 2, from 2008 to 2011, is associated with theoretical/practical training on family interviews. Phase 3, from 2012 to 2017, is related to the implementation of a protocol for the management of potential deceased donors. ResultsReferrals grew from 35.1 per million population (pmp) (phase 1) to 49.4 pmp (phase 1) and 74.0 pmp (phase 3), translating into a 110.8% (P < .001) increase. Lack of family consent dropped from 39.8% to 27.8% in phase 3, a global reduction of 30.1% (P < .001). Loss of donors to cardiac arrest were reduced from 51.9% to 23.3% to 12.2%. Effective donors, which varied from 12.0 pmp to 20.0 pmp and 32.7 pmp, increased by 172.5% (P < .001). ConclusionsThis study demonstrates the positive association between articulated educational initiatives and improvements in potential donors' identification, which, associated with cardiac arrest loss control and increased family consent, brought about significantly better results in organ donation.