ABSTRACT
PURPOSE: To reflect on the implementation of the concept of 'Donation Medicine' as a substitute for 'Procurement' to describe the Foundation's activities in the procurement of ocular tissue and donor selection, considering that the prevailing connotation of procurement (the action of obtaining materials, goods and services necessary to the functioning of a productive activity) did not express satisfactorily all the social, human and medical implications of a programme aimed at promoting ocular tissue donation and recovery. Moreover, in medicine the term 'Procurement' is generally associated with the worst therapeutic outcome, which is the end of a human life. METHODS: A retrospective evaluation of the main indicators pertaining to activities in 2021 was performed, with particular regard to donor screening ,tissue recovery, and the human and professional relations with donor families and hospital staff. The results were assessed by an interdisciplinary team, composed of eye bank and healthcare personnel, regulators and experts in medical humanities. RESULTS: In 2021, in light of 2944 non-oppositions to donation (opting out system), 891 consultations of the national SIT donor registry were performed (Sistema Informativo Trapianti), with 2551 clinical charts reviewed, 4332 related phone consultations performed, and 2032 nasopharyngeal swabs for SARS-CoV-2 nucleic acid tested; as a consequence, 2213 condolence and gratitude letters were sent to donor families, of which 57%(1269) conveyed the outcome of donation, along with 115 gratitude letters sent in instances of the non-recovery. 24 families requested, and were granted, the opportunity to visit the eye bank. CONCLUSION: A consensus was reached on the evidence that the term 'Procurement' has obvious limitations in the long term nurturing and maintenance of the motivation of the eye bank and healthcare personnel. As a consequence, the concept of 'Donation Medicine' was implemented to define and develop the activities related to the promotion of donation, the recovery of ocular tissues for transplantation, and internal/external relations with healthcare personnel, thus changing the meaning of 'Procurement', from a process at the end of a life to the realization of a new pathway of care that takes into account both donor families and recipients. Donation medicine begins with the re-opening of the donor clinical chart, the interaction with donor relatives and the recovery of a precious gift for use in the restoration of sight of patients.
