Abstract

System organization is one of the principal elements for success of a country's donation and transplantation activities. Nicaragua still does not have a specific institution that organizes and coordinates donation and transplantation; it does not perform transplantations from brain dead donors. With the counsel of the Transplant Coordination Service of the Hospital Clinic, Barcelona, Spain, we documented the current donation and transplant situation of Nicaragua, its health services and institutions, and their relevant demographic aspects. We analyzed some organizational models implemented around the world and in Latin America as well as the essential elements of “The Spanish Model”, proposing an organizational model adapted to the Nicaraguan reality. For a small country with specialized services concentrated in the capital, Managua, we envisioned the creation of a two-tier system: First, a national cooordination of transplants who leads a group that is decentralized and subordinate to the hierarchy of the Ministry of Health, to organize and coordinate donation and transplantation activities. Second, a hospital coordinator who works with doctors in intensive care units and neurosurgical intensive care units to detect potential organ donors and communicate with the national coordinator of transplants, who directs the process. Nicaragua has the basic conditions for implementation of donation and transplantation from deceased donor, as well as institutions with the capacity to maintain their function as documented by this viable, functional organizational model.

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