Chloë Ballesté

EULID Project: European Living Donation and Public Health

The choice of transplantation from a living donor offers advantages over a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety. Furthermore, there are several controversial ethical aspects to be taken into account. Several national and international institutions and the scientific community have stated standards that have great influence on professional codes and legislations. Living organ donation and transplantation are to some extent regulated by parliamentary acts in most European countries. It is necessary to take a step forward to develop a legal framework to regulate all of these processes to guarantee the quality and to prevent illegal and nonethical practices. It is also necessary to develop and implement living donor protection practices not only in terms of physical health, but also to minimize potential impacts on the psychological, social, and economic spheres. Finally, an additional effort should be made to create a database model with recommendations for registration practices as part of the standardized follow-up care for the living donor. The European Living Donation (EULID) projects (http://www.eulivingdonor.eu/) main objective was to contribute to a European consensus to set standards and recommendations about legal, ethical, and living donor protection practices to guarantee the health and safety of living donors.

Organ procurement: Spanish transplant procurement management

Transplantation is an accepted therapeutic option to save or improve the quality of life when organ failure occurs or tissue replacements are needed. However, the lack of organs is the major limitation. The deceased organ procurement organization and professionals provide the solution to this international problem. In this review, we identify the elements involved in the organ procurement management process to analyze the possibility of implementation of deceased organ procurement for a transplantation program. While the donation rates are subject to several negative factors including religious, economic, cultural, and legal issues, the existence of well-trained professionals may considerably increase them. Professional training in organ donation along with the establishment of a solid organizational system has been identified as the crucial factor in developing efficient organ donation and transplantation programs.

The PIERDUB Project: International Project on Education and Research in Donation at University of Barcelona: Training University Students About Donation and Transplantation

INTRODUCTION Donation and transplantation is an accepted therapeutic option when organ failure or tissue replacements are needed to save or improve the quality of life. However, in most medical schools there is no specific training for it, thus disregarding the key role of university students for the future success of the process. OBJECTIVES Knowledge diffusion about the donation procedure to clarify doubts and stimulate positive attitudes toward donation. Training university students in the donation and transplantation process. Research about the previous donation knowledge and the impact in donation indexes. METHODS Three different phases have been designed: (1) Training the University of Barcelona Health Sciences School students; (2) Training the Health Sciences School students in other faculties of Catalonia, Spain, and International; and (3) research. RESULTS Since 2005, we have offered yearly an Optional Credits Course to medical students with duration of 45 hours, and two Donation days opened to health sciences students. Since 2007, promotional campaigns have been carried out in medicine and other health sciences faculties. Until now, 818 answered surveys have been collected to evaluate previous knowledge among university students. CONCLUSION Training medical and other health sciences students in the donation process will improve quality of medical education and develop a trainer role for future professionals to help improve donation rates.

Knowledge Transfer and Leadership in Organ Donation from Europe to China: KeTLOD

Introduction KeTLOD is an “Erasmus+ project that facilitates the development and implementation of a postgraduate program in organ donation in accordance with the European Space for Higher Education guidelines and customized to the needs of Chinese healthcare professionals as beneficiaries of the program. Universities from 3 different European countries (Spain, France, and Italy) and China (Shanghai Jiao Tong University (SJTU) – Renji Hospital, Hospital Capital Medical University (CCMU), Kunming University (KU), Wuhan University (WHU), Second Military Medical University Shanghai (SMMU), Nanchang University (UN), Guangxi University of Chinese Medicine (GUCM) – Transplant Institute of Medicine Nanning) collaborate to develop this new lifelong learning strategy. Methods Project evaluation is being performed on 3 levels: Donation Diagnosis (DD), Training and Quality. DD was carried out before designing the two-level educational initiative, following different adapted questionnaire methodologies and conducted in 3 parts: “Donation activity”, “Existing trainings & Specific training needs” and “Online feasibility &University requirements”. First educational level consisted of a Train the Trainers (TxT) blended program (online and face to face) addressed to future Chinese trainers. Together with them and the European experts the second training level is being developed and implemented as 1-year postgraduate program (PP) of 25 ECTS credits (625 hours). The program employs blended learning methodology (local and international seminars, online training and traineeships). Pre- and post-training tests, self-assessing activities, and traineeship activity charts are being used to evaluate the students. The accreditation procedures of PP are in progress. To assess the program, qualitative and quantitative tools are being employed such as questionnaires, rubrics and interviews. Results DD showed a lack of academic training in the field in the beneficiary Chinese universities. TxT was completed by 22 Chinese trainers. The training program was evaluated with 4.95 and its applicability to their job with 4.90 (on a scale from 1-poor to 5-excellent). A total of 140 participants from the 7 Chinese universities were selected on specific criteria for PP. The academic year started and 7 local seminars on organ donation have been organized so far, one in Beijing, 3 in Kunming and 3 in Shanghai. The online training is currently being produced and the international seminar along with the traineeship charts are being drafted. Conclusions KeTLOD is an ambitious initiative that sets the basis of an academic training in organ donation in 7 Chinese universities, following successful European models and in compliance with the European Space for Higher Education.

Continuous Training of Critical Care Professional to Increase Organ Donation Rates in Yunnan Province and Guangxi Autonomous Region in China

Background The lack of awareness and knowledge of the critical care professional toward organ donation has been proven to be the major reason for low organ donation rate. Without any administrative policy for mandatory reporting potential donors to Organ Procurement Organization (OPO) in China, education and training plays an essential role in merging organ donation into the clinical practice in critical care units. Methodology Separately both Organ Procurement Organization of First People’s Hospital of Kunming City (KMOPO) and the OPO of No.303 Hospital of Chinese Peoples Liberation Army collaborated with the Donation and Transplantation Institute DTI in Spain to design training programs for the health care professionals in the regions. A diagnosis study was performed and the needs for trainings were identified. The Transplant Procurement Management courses TPM® were adapted and performed in both regions. This training program has been verified by the provincial continuous education program of health care professionals. TPM courses include practical sessions and simulations to enhance proactive learning. They develop all phases of organ donation as well as strategies for successful organ procurement. International experts work in conjunction with the local skilled experts to lead the curse and interpreting during lectures were provided. Results KMOPO and TPM®, implemented the regional training program since 2014, aiming at continuously enhancing the knowledge and skill of critical care professionals in organ donation. In total, there were 146 students trained in 3 years. 60 out of these were ICU specialist. The annual number of donation after citizens’ death performed in KMOPO per million per population (pmp) has been increasing, from 0.33 in 2014 to 1.31 in 2016, accounting 107 (78.10 %) deceased organ donors in the region. Meanwhile in Guangxi province there have been 2 regional TPM courses in collaboration with DTI and the 303 OPO. The number of participants was 91. Out of this 72(80%) were ICU specialist. The number of the deceased donors in pmp for the Guangxi region have increase from 1.6 in 2014 in 1.99 in 2016. Counting of a total of 296 (49.25%) organ deceased cases in this region in the study period. Discussion Through adequate education program the awareness, knowledge and skills of the health care professional in China proved to enhance better understanding of organ donation practice and empower the professional abilities to increase the number of the potential donor and consequently the number of organ available for transplantation. The similar methodology should be expanded in more OPO around China.

European Living Donation and Public Health (EULID Project)

Donation from alive people has been growing strongly in the recent years, thanks to the advance in the field of organ transplantation and its success as a treatment to procure quality-adjusted life years for many patients with end–stage diseases. The choice of transplantation from a living donor (LD) offers some advantages compared to that for a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety, and there are several controversial ethical aspects to be taken into account.