ABSTRACT
High-quality development is the primary task of building a socialist modern country in an all-round way. Organ donation and transplantation in China are evolving from high-speed growth to high-quality development, which put forward new requirements for the safe, stable and healthy operation of Organ Procurement Organization (OPO). Safety is the foundation and prerequisite for achieving the goal of high-quality development. As an independent and comprehensive department, internal audit should create new achievements in the new era. The department should include OPO and organ donation into the scope of internal audit, shift the emphasis upon the overall development of organ donation. Besides, it should fully consider the actual situation in different places, conduct all-round, objective and fair evaluation, provide evaluation and consulting services for OPO to properly implement organ donation, and give full play to the supervision and prevention role of internal audit.
ABSTRACT
Objective To explore the important factors influencing organ donation willingness and coordination effect of organ donation coordinators. Methods A questionnaire survey was conducted among 349 national organ donation coordinators by convenience sampling, including 145 males and 204 females, aged 27 (23, 36) years. Multiple linear regression and disordered logistic regression were used to investigate the important factors influencing the willingness to donate organs and coordination effects. Results Among 349 organ donation coordinators, 146 (41.8%) were willing to donate organs, including 101 (28.9%) who had signed the consent card for organ donation. Adequate awareness of organ donation laws, high education level, marital experience, and good self-perceived health status all showed positive effects on organ donation willingness of organ donation coordinators (all P < 0.05). High income, long length of service as organ donation coordinators, full-time mode of employment, high willingness to donate organs, and adequate awareness of donation conditions and donation procedures all showed positive effects on the coordination effect of organ donation coordinators (all P < 0.05). Conclusions The willingness to donate organs is increased as the higher awareness of organ donation laws of organ donation coordinators, while enhancing the willingness to donate organs of organ donation coordinators exerts positive impact upon improving the coordination effect of organ donation coordination. Therefore, an all-round organ donation coordinator training system should be established to improve the success rate of organ donation advocacy and promote the development of organ donation.
ABSTRACT
Objective:To explore the employment experiences of coordinators of In-Hospital Organ Procurement Organization (OPO).Methods:Based on purpose sampling, 12 full-time In-Hospital OPO coordinators in Chongqing City were recruited from July to December 2020. A semi-structured and in-depth interview was performed and the data was analyzed by Colaizzi.Results:4 first-level themes were extracted, including professional identity process, negative emotional experience, improvement of professional practice competence and job expectancy. 12 second-level themes were identified including career expectations and identity confusion, professional values, shortage of respect and ratification, huge workloads, great psychological pressure, influence of the bereaved families, enhancement of the ability to communicate, improvement of problem-solving ability, improvement of team-work ability, optimization of scenario simulation, a perfection of the assessment system, a clear career path.Conclusions:In-Hospital OPO coordinators are lack of professional awareness in an initial stage. While feeling a sense of professional value, they also experience some negative emotions. Furthermore, their competences are improved in practice and they, meanwhile, express a strong desire for career development. It is suggested that the administrators could explore establishment of academic education, enhancement of psychological and social support, creation of pretty working environments and improvement of training, assessment and promotion systems to facilitate the career development of coordinators.
ABSTRACT
Objective To explore the standardized management mode of the Ethics Committee for organ donation after citizen’s death in hospitals. Methods The situations of ethical review before and after the standardized adjustment of the Ethics Committee of human organ donation in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. Baseline data of donors before and after standardized adjustment of the Ethics Committee of human organ donation were compared. The influence of standardized adjustment of the Ethics Committee on the attendance rate of committee members and duration of ethical review were analyzed. Results No significant differences were observed in donors' ethical review data, such as gender, age and death determination, before and after standardized adjustment of Ethics Committee structure (all P>0.05). Significant difference was noted regarding the cause of death in ethical review (P<0.05). Univariate analysis showed that there were significant differences in the impact of Ethics Committee standardization adjustment and cause of death on the attendance rate of committee members (both P<0.05). Multivariate analysis revealed that gender, cause of death and standardized adjustment of the Ethics Committee were the influencing factors of the attendance rate of committee members, and the attendance rate of committee members after standardized adjustment was higher than that before adjustment (P<0.05). Univariate analysis showed that there were statistically significant differences in the effects of Ethics Committee standardized adjustment, attendance rate of committee members and cause of death on the duration of ethical review (all P<0.05). Multivariate analysis indicated that standardized adjustment of the ethics committee was the influencing factor of the duration of ethical review, and the duration of ethics review after standardized adjustment was shorter than that before adjustment (P<0.05). Conclusions Appropriate arrangement of the total number of ethics committee members and standardizing the review process may improve the efficiency of ethical review. Scientific evaluation mechanism for ethical committee members should be established by dynamically adjusting the ethical committee members, clarifying the responsibilities and tasks of members and secretaries, aiming to further improve standardized management level of ethical review for organ donation after citizen’s death.
ABSTRACT
Human Organ Procurement Organization (OPO) is an indispensable part of organ donation. In recent years, with rapid development of organ donation in China, united OPO has been established based on China's national conditions and establishment of global OPO. This innovative model serves as favorable supplement and exploration for the development of OPO, promoting the development of organ donation to enter a new stage. However, there are still some shortcomings during the process of development. Efforts should be made to catch up with the development of organ donation, aim at long-term goals, and promote development in a targeted manner. In this article, by analyzing the advantages and disadvantages of united OPO in the development of organ donation, the establishment of a long-term operation mechanism of united OPO was analyzed from policy support, talent training, technology upgrading, quality control, ethical review, financial management and full-course supervision, aiming to provide reference for further development of united OPO in China.
ABSTRACT
The problems that China's organ transplantation development facing are the disciplinary construction of Organ Procurement Organization (OPO), the cost of organ donation and financial management, and the construction of organ transplantation technology system under the "Chinese model". As long as we stick to the development path of specialization of organ donation, disciplinarization of OPO construction and systematization of organ transplantation, we will definitely be able to create Chinese technology, Chinese standards, Chinese team and Chinese system with Chinese characteristics and advancement.
ABSTRACT
Objective To investigate the conversion rate, organ procurement rate and influencing factors of organ donation in a single center from Fujian province. Methods Baseline data of 182 potential organ donors of Fujian Medical University Union Hospital from November 2018 to June 2021 were retrospectively analyzed. The conversion rate of organ donation, baseline data of successful organ donors and the causes of failure of organ donors were identified. The organ procurement rate and the influencing factors of the number of organ donations were analyzed. Results Among 182 potential organ donors, 46 cases were successful organ donors with a conversion rate of 25.3%. In addition, 136 cases failed to donate organ. The main causes included disagreement from family members (58.1%), insufficient evaluation time (24.3%) and ineligible for donation criteria (17.6%). A total of 212 large organs and tissues were donated by 46 organ donors, including 88 kidneys, 42 livers, 15 lungs, 19 hearts and 48 corneas, with 4.6 large organs and tissues, and 3.6 large organs for each donor. Age, sex, native place, organ donation area and blood type were the influencing factors of the number of large organ donations. Organ donation area was the influencing factor of the number of tissue donations. Conclusions The conversion rate of organ donation is relatively low in a single center from Fujian province. Disagreement from family members is the main cause. Suitable potential organ donors should be selected for organ donation to improve the conversion rate and organ procurement rate of organ donation.
ABSTRACT
With the reform of organ donation and transplantation in China, the establishment of Organ Procurement Organization (OPO) will become more centralized and enlarged in scale, evolving into the united OPO development stage coordinated by multiple hospitals. How to enhance the operation management and scientific development planning of united OPO has become an urgent and novel issue facing the administrators at all levels. At present, certain constraint factors of united OPO still exist in the integrated management, cost control, service homogenization, cultural integration and discipline layout. To give full play to the large-scale benefits and expand the supply of high-quality organ donation services, the development principle of putting connotation construction first and the appropriate direction of public welfare should be upheld. Leading and driving the development of organ donation services of our province are the responsibility, and discipline construction and talent training serve as the core. The overall development plan should be determined in a scientific pattern and homogeneous management should be implemented according to local conditions, aiming to provide successful experience for establishing a provincial unified OPO.
ABSTRACT
Communication with families of donors is the critical procedure of organ and tissue donation, which is the key to determine the success of donation. Expert Consensus on Communication with Families of Organ and Tissue Donors was formulated by multidisciplinary experts to help the families of potential organ and tissue donors to understand the right of independent decision of organ donation given by law, improve the communication efficiency with families, fully showcase the humanistic care, enable relevant practitioners to maintain professional working status and healthy psychological state in the long term, share and summarize the optimal clinical experiences in different places, and discuss and resolve the difficulties during the communication with families. This expert consensus focuses on the key issues during the communication with families of organ and tissue donors and formulated by multidisciplinary experts after literature review. The expert panel has reached consensus by Delphi method for voting. Eighteen key elements and recommendations for communication with families of potential organ and tissue donors have been proposed, aiming to provide guidance for communication with families of organ and tissue donation. This consensus has been registered both in Chinese and English on International Practice Guidelines Registry Platform.
ABSTRACT
Human organ transplantation is an effective method to treat organ failure and save the life of patients. The practicing qualification certification of human organ transplantation is recognized as an administrative examination and approval item of the national health authority. National health authorities shall organize experts to conduct on-site audit of medical institutions that have applied for practicing qualification certification and have passed preliminary supervision at the provincial level. In this article, the management of on-site audit on the practicing qualification certification of human organ transplantation was illustrated and discussed from the practical significance, principles and highlights of on-site audit, and key points during on-site audit, aiming to provide reference for ensuring high-quality development of organ transplantation and strengthening the management of practicing qualification certification of human organ transplantation in medical institutions.
ABSTRACT
Organ shortage is a common problem in the field of transplantation worldwide. It is urgent to expand the donor pool via different effective and safe approaches. Recently, "the statement from international collaborative on expanding controlled donation after the circulatory determination of death (cDCDD)" has attracted widespread attention from scholars. The statement aims to promote cDCDD in order to increase organ donation rates, with the ultimate goal of achieving self-sufficiency in transplantation. In this article, the key contents mentioned in the statement were summarized, the terminology update and relevant discussion of donation after the circulatory determination of death (DCDD), the development trend of DCDD, the basic part of the clinical pathway of cDCDD and the key factors affecting the implementation of cDCDD were illustrated, and the inspiration drew from this statement to the sustainable development of organ donation program in China was reflected.
ABSTRACT
Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.
ABSTRACT
Quality assurance is the responsibility of Organ Procurement Organization (OPO). The establishment of OPO quality management system is a novel task for implementing high-quality human organ donation. At present, the quality management of OPO still has certain problems, such as lack of comprehensive management organization, standardized management process, scientific evaluation index, qualified professionals and strong safety culture atmosphere, etc. It is necessary to deliver top-level design from three perspectives of ideological concept change, quality management system construction and process implementation management in combination with the actual situation of OPO and reference to the criteria of international general quality management system. More importantly, the managers of OPO should play a leading role in ensuring the efficient operation of OPO in the persistent improvement of quality management system.
ABSTRACT
In recent years, the fields of donation after citizen's death and organ transplantation in China have developed rapidly with remarkable achievements and revolutionary changes in the source of transplant organs.How to transform the development of organ donation and transplantation from high-speed to high-quality growth mode?It is extremely urgent to establish the expenditure and management system of organ donation and transplantation.In this article, the establishment and management of clinical use price of organs from donation after citizen's death were investigated from the perspectives of policy basis, accounting items, accounting methods, price formation and price management, aiming to provide reference for resolving the problem of cost accounting and price determination of clinical use of donated organs.
ABSTRACT
The pilot work of organ donation after citizen's death has been implemented in China for 10 years. The number of organ donations was significantly increased from 34 cases in 2010 to more than 6 300 cases in 2018, accounting for over 15% of the global quantity of organ donations. China has established an organ donation and transplantation system that follows the international ethical standards, and conforms to our own social development stage and cultural tradition. Organ donation is a novel discipline created by multi-disciplinary integration in the new era of China, the process of which was reviewed from the perspectives of legal supervision, workflow, management mode, training and education mode, quality management and control system, organ donation in the epidemic of noval coronavirus pneumonia and application of innovative technologies, etc.
ABSTRACT
Objective To get a knowledge of the current status of organ donation and utilization after citizen's death in Wuxi District, and thereby provide ideas and basis for further development of organ donation work in local areas. Methods Clinical data from 151 organ donors, included 37 successful donors and 114 potential donors, were retrospectively analyzed. The reasons for donation failure of potential donors were analyzed. The general information for successful donors was collected. And the information on organ donation and organ utilization in successful donors were analyzed. Results Among the 151 organ donors, 37 were successful donors, with the conversion rate reaching 24.5%. For the 114 donors with failed organ donation, the reasons for failure included family disagreement, failure to meet donation status criteria, insufficient evaluation time, and unresolved work injury disputes. The categories for organ donation included 34 cases of donation after brain death followed by cardiac death (DBCD), 3 cases of donation after brain death (DBD), and no case of donation after cardiac death (DCD). The reasons for death of donors includes 19 cases of craniocerebral trauma, 14 cases of stroke and 4 cases of others. Among the 37 cases of successful donors, the majority were floating population. A total of 154 major organs and tissues were donated, of which 124 were major organs. The number of major organs and tissues donated per citizen was (4.2± 1.6) and the number of major organs donated per citizen was (3.4± 1.1). The utilization rate of the 154 donated organs reached 96.7% (149/154), with Nanjing, Wuxi, Suzhou and Changzhou ranking the top 4 of organ distribution. Conclusions The rate for successful organ donation and conversion after citizen's death is low in Wuxi District. The organ donation work networks in local areas should be established. And organ donation promotion efforts and skills training for coordinators should be developed.
ABSTRACT
Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.
ABSTRACT
The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.
ABSTRACT
As China enters the era of organ donation after the citizen's death, the organ donation cases with potential malignant tumor history increase gradually. Guide to the Quality and Safety of Organs for Transplantation (6th Edition) by European Committee was translated into Chinese in 2019. This article interprets Chapter 9 of the guideline "Risk of Malignant Tumor Transmission" to assist organ donation coordinator and transplant team in screening donors at risk of malignant tumor transmission in our country and to reduce the risk of donor-derived tumor transmission.
ABSTRACT
Organ shortage is one of the important factors restricting the development of human organ transplantation. The identification and referral of potential donors determine the total scale of organ donation. Whether potential donors can be identified and referred is the most important reason for the difference of organ donation rates in different regions. This paper interprets the chapter of the identification and referral of potential donors in the Guide to the Quality and Safety of Organs for Transplantation (6th edition) issued by European Union in order to provide reference for the staff of organ procurement organization and related medical personnel in China and improve the organ donation rate in China.