Implementation of a National Organ Procurement Program: The Lebanese Model

Abstract

Organ shortage is universal. It represents the main obstacle to organ transplantation since, despite all the scientific advances to date; the latter relies exclusively on human organs.In Lebanon, the National Organization for Organ and Tissue Donation and Transplantation-Lebanon (NOOTDT-Lb) has been working to promote organ donation by proposing a Lebanese model that comprises two complementary divisions for deceased and living donations. The deceased donation system: For the past three years NOOTDT-Lb has been implementing, with the financial help of the Spanish government through the “Agencia Espagnola de Cooperacion International para el Desarrollo” (AECID) and technical support of the “Donation and Transplant Institute - Barcelona” (DTI) a national program for organ procurement from deceased donors. Adapted from the universally successful Spanish model, this program depends on the active cooperation of the different players involved. It consists of: 1) Hospital organ procurement units with Hospital Organ Procurement Coordinators in committed hospitals, 2) Preset protocols that guide each step of the organ donation procedure; 3) a fair and transparent organ allocation system with an annual review by an allocation committee where NOOTDT-Lb and all the transplanting centers are represented; and 4) a registry for donation and transplantation. To back this system up, NOOTDT-Lb ensures continuing education programs for healthcare personnel that are intended to update their knowledge and stimulate their interest in promoting deceased donation. NOOTDT-Lb, with the help of the Donation and Transplantation Institute (DTI), also carries out regular audits of the committed hospitals. In addition, The Ministry of Health (MOH) has removed all financial disincentives to donation and is actively working to introduce the topic of organ donation into the hospital accreditation system. The living donation system:NOOTDT-Lb has tried to promote living donation as well by facilitating genetically related donation and attempting to regulate non-genetically related donation through national medical and ethical committees. A ministerial decree covering these regulations was issued in agreement with the Lebanese Order of Physicians and under the supervision of NOOTDT-Lb. In conclusion, the program is progressing slowly but steadily. Its implementation obviously requires more public awareness but after reviewing our 2010 and 2011 results it has become clear to us that full and active adherence of the healthcare professionals remains a prerequisite to a successful program.