The First Independent Provincial OPO in China: The Shanxi Experience.

John Edwards is the clinical administrator for Gift of Life Donor Program in Philadelphia, Pa, overseeing all clinical aspects of organ and tissue recovery, and a faculty member for the Gift of Life Institute, Philadelphia, providing training and mentoring for healthcare organizations nationally. Patti Mulvania oversees the clinical education program for the Gift of Life Donor Program in Philadelphia and is a faculty member of the Gift of Life Institute, specializing in consent and clinical communication. Virginia Robertson is the associate director of the Gift of Life Institute in Philadelphia. Formerly, she was the director of hospital services for the Gift of Life Donor Program. Gweneth George is the director of hospital services for the Gift of Life Donor Program in Philadelphia. She directs a team of nearly 20 hospital development staff accountable for donation performance in 150 acute care hospitals. Richard Hasz is vice president of clinical services for the Gift of Life Donor Program in Philadelphia. He oversees the day-to-day clinical operations, including transplant coordination, hospital development, organ preservation, and tissue recovery. Howard Nathan is president and chief executive officer of the Gift of Life Donor Program in Philadelphia. The program has been involved in coordinating more than 22 000 organ transplantations and tens of thousands of tissue transplantations since 1974.

Organ Donation Breakthrough Collaborative

Transmission of Multidrug-Resistant Escherichia coli Through Kidney Transplantation—California and Texas, 2009

This article went through the same peer review process as all articles do.

Maximizing donors' gifts: A comparison of actual and expected solid organ yield among VCA donors.

Expedited SARS-CoV-2 screening of donors and recipients supports continued solid organ transplantation.

Introduction: It has been 10 years since the kick-off of national pilot program of deceased organ donation (OD) in China. The number of deceased OD has increased from 34 in 2010 to 6302 in 2018, accounting for more than 15% of the global annual total. As described by World Health Organization, China has established a scientific-ethical system to foster the OD and organ transplantation (OT) practices. This paper provides a 10-year review for the development of OD in China at the professional level, aiming to look for the best practice in achieving self-sufficiency for OT through enhancing professionalism. Materials and Methods: By reviewing the progress of promoting OD toward professionalism in the recent decade, from a professional prospective. Results: In the past decade, foundation has been laid out for OD to be developed as a an interdisciplinary subject. Those include: 1) The legal framework: following the implementation of National Regulation on Human Organ Transplantation, the legal framework for OD and OT has also been built at the regional level. 2) Interdisciplinary integration: the practice of OD involves not only the knowledge in medicine, but also in law, ethics, health economy and social humanities. This integration has been reflected in the content of our clinical guideline and the multidisciplinary background of professionals participating daily. 3) The set-up of clinical pathway and dedicating teams for OD: The educational pathway for professionals in the field has been established. More than 2600 donation coordinators have been certified by China organ donation administrative center. Through the joint effort from the international and local group, more than 2000 Chinese medical staffs form ICU, emergency department, neurology, hospital management also received training for the filed. A selecting group of doctors in each region has been trained and certified by national authority. 4) Management model for OD was launched: In 2019, National Health Commission called for the construction of organ procurement organizations (OPOs) in the hospital/regional level, meanwhile, being independent with any transplant teams. 5) The implementation of quality-control system for OD has been put into practice, both at national/hospital level. Discussion: Even in many of well-developed countries in this field, actions have been taking continuously to improve OD rate. It is also the responsibility for local experts to absorb such valuable experience worldwide and to implement program that best fits to the local situation. Conclusion: Sets of action have been taking in the country to promote OD as a new scientific subject. However, The OD rate per million population (4.53 in 2018) is far from satisfaction. In additional to the strong governmental support, professionalism is another key element and the next step in achieving self-sufficiency for OT for the country. Meanwhile, it is necessary to create an academic atmosphere and a clear career path for staffs in the fields.

Navigating the COVID-19 pandemic: Initial impacts and responses of the Organ Procurement and Transplantation Network in the United States.

China has developed a new national program for deceased-organ donation to address the need for organ transplantation in the country. The program adheres to the World Health Organization (WHO) guiding principles, is compliant with the Declaration of Istanbul, and respects the cultural and social values of the Chinese people. The experience of pilot trials conducted between 2010 and 2012 was evaluated to generate a comprehensive design of a national program of organ donation and transplantation for implementation throughout China. The legal framework for this program was established from a series of legislative steps since 2007. Accountable national committees have been established to oversee activities of organ donation and transplantation across the nation. The Ministry of Health (MOH) has accredited 164 organ transplant hospitals in China, each of which has an organ procurement organization (OPO) to conduct organ donation and organ recovery. National protocols for deceased-organ donation in China include category I (organ donation after brain death), category II (organ donation after circulatory death), and category III (organ donation after brain death followed by circulatory death). The China Organ Transplant Response System (COTRS) has been developed to allocate organs equitably and transparently. Scientific registries have been established to evaluate the performance of transplant centers and OPOs. China is in the process of implementing a new national program for deceased-organ donation. The program includes a unique approach of organ donation, China category III, which will be promulgated throughout China and is intended to gain widespread acceptance of Chinese society.

Open Letter to Xi Jinping, President of the People’s Republic of China

Recent Trends and Results for Organ Donation and Transplantation in the United States, 2005

Organ donation and transplantation trends in the USA, 2003

Several machine learning classifiers were trained to predict transplantation of a liver graft. We utilized 127 variables available in the DMG dataset. We included data from potential deceased organ donors between April 2012 and January 2019. The outcome was defined as liver recovery for transplantation in the operating room. The prediction was made based on data available 12-18 h after the time of authorization for transplantation. The data were randomly separated into training (60%), validation (20%), and test sets (20%). We compared the performance of our models to the Liver Discard Risk Index. Of 13 629 donors in the dataset, 9255 (68%) livers were recovered and transplanted, 1519 recovered but used for research or discarded, 2855 were not recovered. The optimized gradient boosting machine classifier achieved an area under the curve of the receiver operator characteristic of 0.84 on the test set, outperforming all other classifiers. This model predicts successful liver recovery for transplantation in the operating room, using data available early during donor management. It performs favorably when compared to existing models. It may provide real-time decision support during organ donor management and transplant logistics.

Introduction: While the reform of organ transplantation in China has achieved success, the organ procurement model for different regions in the country varies. Starting from a hospital-based organ procurement organization (OPO), Shanxi OPO was established as the first independent non-profit provincial OPO in China, which covers a donation area of 37.29 million population and serves 6 transplant hospitals in the region. Shanxi OPO was established in 2018 under the supervision of Shanxi provincial health commission. This study compares results before and after the establishment in regard to the quantity, quality and efficiency of organ donation and transplantation (OD & OT) within Shanxi Province, aiming at exploring a feasible and up-to-date procurement management mode in China. Method: From the point of organizational structure, personnel composition, equipment management and core quality indicators, we analyze the data from 2015 to 2021 and compare the results before and after the establishment of the provincial OPO. Results: In the past two years, a professional team with 7 departments has been built. Besides, advanced facilities like those for donor maintenance and information collection are equipped. Then in 2020, an ethics and scientific committee have been founded to guide scientific research and supervise ethical norm compliance. Through analyzing the quality control indicators, the number of OD has increased from 35 cases (PMP: 0.99) in 2015 to 126 cases (PMP: 3.61) in 2021, with an increase rate of 260%. The growth trend remains within Shanxi Province even under the influence of COVID-19 pandemic in 2020, while the case number of the country decreased. Since 2018, the number of organs procured from per donor and the organ utilization rate of Shanxi OPO have risen year by year, reaching 3.02 and 98.7% respectively in 2021. Moreover, the DBD rate has increased from 1.1% in 2019 to 20.63% in 2021, though there is still a gap compared to the national and international level. These positive changes indicate that the quality of our service in organ viability assessment, donor maintenance, organ recovery and coordination have been gradually improved. Conclusion: Efficiency and quality of the organ procurement and allocation have been greatly improved in the past few years because of the establishment of Shanxi OPO. This kind of provincial OPO also provides a solution, which will lead a clear direction for the standardization of organ procurement in China.

The establishment of a national organ donation and transplantation system has gone through a long and difficult process in China. A nationwide organ donation system that followed the guiding principles of the World Health Organization and conformed to our national conditions was initially established under the leadership of Chinese National Health and Family Planning Commission (NHFPC) and China Red Cross Federation after 10-years unremitting efforts. This symbolized a new era in the history of organ donation and transplantation in China during which citizens voluntary donations is the sole legitimate source for organ transplantation. Despite all the improvement, China's organ donation and transplantation system is still in the infancy and has a long way to go. Critical care medicine, as one of the main subjects in organ donation, related to many key points and plays an indispensable role in this system. Key words: Organ Donation; OrganTransplantation; System; Reform