Gloria Páez

Training of Health Care Students and Professionals: A Pivotal Element in the Process of Optimal Organ Donation Awareness and Professionalization

OBJECTIVE Successes in organ donation and transplantation programs are directly evidence-based education. Transplant Procurement Management (TPM) is an international educational project on organ donation and transplantation. Our purpose was to evaluate the TPM educational project. We compared the data of 17 years of experience, strategies, and methods. MATERIALS AND METHODS We retrospectively performed a descriptive analysis of all educational activities developed between 1991 and 2008. RESULTS We identified 7 crucial points. (1) In 1991, TPM was started under the auspices of the University of Barcelona (UB) and the National Spanish Transplant Organization (ONT; national training, face-to-face). (2) In 1994, TPM became international (international advanced training and country-based). (3) Since 1997 in Italy and 2006 in France, national training courses were organized adapting the same methodologies as the advanced international TPM courses. TPM also implemented short (1-3 days) introductory courses worldwide. (4) In 2002, the e-learning platform program was launched to facilitate the education of professionals. (5) In 2005, an international masters degree was created at UB under the Life-Long Learning Institute (IL3). (6) In 2006, the courses were expanded to include pregraduate health science faculties with the International Project on Education and Research in Donation at University of Barcelona (PIERDUB). (7) In 2007, the European-funded European Training Program on Organ Donation (ETPOD) project was started. Currently, TPM offers face-to-face, e-learning, and blended international courses. As of 2008, TPM has trained 6498 professionals in 89 countries on 5 continents. CONCLUSIONS TPM has impacted positively on the various essential levels in the process of organ donation and transplantation, with lifelong follow-up and an international network through the capacity to adapt to specific country needs as well as continuous quality improvement thanks to the collaboration of expert teachers and consultants.

ETPOD (European Training Program on Organ Donation): a successful training program to improve organ donation

Advanced training of healthcare professionals active in organ donation is highlighted as a major means to overcome organ shortage. The objective of this study was to improve donation rates in the selected European target areas (TAs) by providing an advanced training program. A prospective intervention study was conducted in 25 TAs with active donor programs from 17 European countries, between 2007 and 2009. A training program based on collaborative methodology was designed at three different professional levels (health workers awareness, junior transplant coordinators, managers). Courses evaluation scores and donation figures in each TA were collected and compared before and after intervention. Courses with new developed training tools were implemented reaching out 3286 healthcare professionals. Feed‐back questionnaires revealed a high degree of satisfaction among participants (average of 4.35 on a 1–5 scale). The number of utilized donors in the TAs increased from 15.7 ± 14.3 (95% CI: 9.8–21.6) to 20.0 ± 17.1 (95% CI: 13–27.1) (P = 0.014) and the number of organs recovered increased from 49.7 ± 48.5 (95% CI: 29.6–69.7) to 59.3 ± 52.1 (95% CI: 37.8–80.8) (P = 0.044). The European Training Program on Organ Donation is a successful training program, achieving a significant increase in organ donation figures.

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.

A colloquium on the congress "A gift for life. Considerations on organ donation".

Alessandro Nanni Costa, J. M. Simon i Castellvi, Antonio G. Spagnolo, Nunziata Comoretto, Jean Laffitte, Hakan Gabel, Francis L. Delmonico, Ferdinand Muehlbacher, Walter Schaupp, Alexandra K. Glazier, Valter D. Garcia, Mario Abbud-Filho, Jose O. Medina-Pestana, Mariangela Gritta Grainer, Pier Paolo Donadio, Anna Guermani, Riccardo Bosco, Francesco Giordano, Blanca Martinez Lopez de Arroyabe, Marco Brunetti, Marti Manyalich, Gloria Paez, Ricardo Valero, Rafael Matesanz, Elisabeth Coll, Beatriz Dominguez-Gil, Beatriz Mahillo, Eduardo Martin Escobar, Gregorio Garrido, and Felix Cantarovich

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.

IRODaT: The International Online Registry for Organ Donation and Transplantation 2007

OBJECTIVE IRODaT, an international registry for organ donation and transplantation, presents preliminary data reports on global trends on a regular basis and at various times of the year. The purpose of this report was not only to present statistics, but also to make organ donation effectiveness rates a useful tool to reveal similarities between various countries on an international level. MATERIALS AND METHODS The IRODaT database produced this report for 2007 thanks to early reporting performed by professionals in coordination and transplant services from 49 countries. The countries were grouped as follows: countries with >200 total donors countries with 50 to 200 donors, and countries with <50 donors. RESULTS The percentages of deceased and living donors according to the total number of donors from the 49 countries showed that countries performing >200 effective donation procedures yearly in 2007 showed a clear positive trend when compared for number of living donors, donors per million inhabitants, and number of transplantable organs per donor. CONCLUSIONS The results obtained through this new presentation of the IRODaT provide a quick, clear, and illustrative view of organ donation activity in various countries.

Self-Sufficiency in Organ Donation and Transplantation

Introduction WHO reports around 130000 of solid organs transplants each year covering about 10% of the needs worldwide. Participants to the third WHO Global Consultation on Organ Donation and Transplantation urged for self-sufficiency. Countries as Spain, Croatia, Portugal, Belgium and USA have the highest organ donation rates worldwide. Despite different organ donation models in these countries, they dedicate full-time or part-time transplant/organ donor professional experts that coordinate the living and deceased organ donation process, provide specialized training, ensure the quality assurance programs, undertake research activities and estimate the costs and the resources required by the process. Materials and Methods The study analyses the impact of two combined factors on self-sufficiency in nine different countries: The establishment of national and/or regional organ procurement organizations or competent authorities (and delegated bodies), as referred to in the EU Directive 2010/53/EU, that encompass the functions required to authorize, organize and monitor the donation and transplantation process. The delivery of continuous medical education for health care professionals about to join or already involved in the process of organ donation for at least five years. Results Six European countries (Croatia, France, Italy, Portugal, Slovenia, Spain), one from Asia (China) and 1 from Middle East (Iran) were compared over a period of more than five years. Steady increase in deceased donors per million population (pmp) was reported in all countries as following: China from 0,025 (2010) to 3,1 (2016), Croatia from 4,3 (1996) to 38,6 (2016), France from 15,1 (1996) to 28,7 (2016), Italy from 11 (1996) to 24,3 (2016), Portugal from 21,2 (1996) to 32,6 (2016), Slovenia from 11 (2000) to 20,4 (2016), Spain from 26,9 (1996) to 43,4 (2016), and Iran from 0 (1999) to 11,5 (2016). It is essential to highlight that in China, the number of organs donated almost doubled in 2016 (4080), as a result of building the organ donation system, optimizing the legal system, banning the organ procurement from executed prisoners in 2015, and implementing continuous medical education. Conclusion Continuous multifactorial approach tackling organ donation at different professional involvement leads to a steady increase of donation rates and better self-sufficiency.

Knowledge Improvement Results of the European-Mediterranean Postgraduate Program on Organ Donation and Transplantation Project (EMPODaT): A 3 Years’ Training Project in Egypt, Lebanon and Morocco

Introduction The consortium constituted by 4 European Univ., 1 European Foundation and 6 beneficiary Univ. from Egypt, Lebanon and Morocco (fig 1) implemented the EMPODaT project from 2010 to 2014. Its aim was to cooperate in a higher education program of Organ Donation and Transplantation in Egypt, Lebanon and Morocco Univ. in accordance with the European Space for Higher Education guidelines as a TEMPUS product (an Education, Audio-visual and Culture Executive Agency (EACEA) program). Figure. No caption available. Materials and Methods Training (available in English and French) was designed in 1 academic year of 30 ECTS credits (750–900 hours) employing blended learning methodology. Pre- and Post-training tests, self-assessing activities, and traineeship activity charts were used to evaluate the students. The results obtained in the pre- and post- test of the donation and the transplantation modules were analysed using mixed models between countries and specialization background of the students. Results and Discussion 90 students were trained (15 per Univ.), 39W-51M, 79 doctors (23% ICU, 22% surgeons) and 11 nurses.Significant differences were found among improvement knowledge between the countries and specialization background (donation, transplantation or other fields). Donation knowledge improved in all countries but Morocco was the most beneficiated (Mean diff. Morocco 3.71±0.32 > Lebanon 1.83±0.32 >Egypt 1.42±0.32) no significant differences were found between background specialization groups. Meanwhile the improvement of transplantation knowledge were no significant comparing countries but the donation background group was significantly more beneficiated (Mean diff. Donation 5.04±0.29> Nursing 4.92±0.49 >Transplantation 4.01±0.23). Figure. No caption available. Figure. No caption available. Conclusion Students profile was homogeneous among the 3 beneficiary countries and the gender balance was respected in all universities. Knowledge improvement in organ donation was greater than in transplantation topics. Morocco was the most beneficiated country obtaining better final scores in the donation module and the students with donation related specializations were the most beneficiated of the Transplantation topics. Ashraf Adel Mosharafa . Ahmed Ali Morsy Ali. Mohamed Adel Bakr. Ahmed Ibrahim Kamal Abdelkader. Hussein Sheashaa . Farida Younan. Georges S. Juvelekian. Maha Khachab. Nadia Tahiri Jouti. Mohammed Benghanem Gharbi. Wissam Faour. Rabia Bayahia. Taoufik Dakka. Peter Desatnik . Patrick Jambou. Klaus Michael Lücking. Przemyslaw Pisarski. Patrick Samson-Himmelstjerna. Antoine Stephan. Francesc Martí.

Training and Social Awareness for Increasing Organ Donation in the European Union and Neighbouring Countries: EUDONORGAN

Introduction LEUDONORGAN is a service contract awarded by the European Commission on the initiative of the European Parliament that aims to provide training and increase social awareness in the European Union (EU) and neighbouring countries to enhance the positive attitude towards organ and tissue donation, and ultimately help improving donation rates. Methods Four European countries (Spain as leader, Croatia, Italy and Slovenia) agreed to join the project and took responsibilities in two core work packages (WPs), WP1: Training and WP2: Social Awareness and two horizontal WPs, WP3: Dissemination and WP4: Evaluation. In WP1, specific selection criteria for training beneficiaries (healthcare professionals and other key players) were provided to the Competent Authorities of Member States (MS) and European patient associations with the request to propose potential candidates. In parallel, the training methodology along with module contents and educational resources were designed and developed. The training program amounted to 100 study hours and it employed a blended learning methodology (webinars, e-learning and face to face). The e-learning included two different routes: one for healthcare professionals and another for other key players, and was provided in self-study format. The face to face session was mainly practical and promoted interactivity in the learning environment created, networking and best practice exchange. A survey on attitude towards organ and tissue donation was carried out among participants before and after training. As part of WP2, organ donation data was collected from MS and neighbouring countries to facilitate the organization of six tailored awareness events in the European Union in 2018-2019. Results In WP1 we received 173 applications out of which 101 participants from 28 different countries were selected as following: 79 were healthcare professionals (51 MDs, 27 RNs and 1 medical student) and 22 other key players (8 transplant patients and patients’ representatives, 2 journalists, 8 communication experts, 1 manager and 3 others). The e-learning was evaluated with 4,45 (on a scale from 1-poor to 5-excellent) and we could see 25,22% of knowledge improvement among healthcare professionals and 29,47% among other key players upon completion. The face to face session was evaluated with 4,44 (on a scale from 1-poor to 5-excellent). A total of 96 participants attended all sessions successfully and were certified. Survey results on attitude towards organ and tissue donation are currently being analysed.In WP2, 6 Member States expressed interest to organize awareness raising events. European organ donation data has been analysed and 6 tailored agendas were proposed. By 2019, a minimum of 350 to 400 participants from the EU and neighbouring countries will benefit from this project. Conclusions EUDONORGAN is a unique and challenging initiative that aims at tackling organ and tissue donation at different involvement levels.