Consultancy in organ donation

SEUSA: Global approach for transplant systems

SEUSA is a consultancy program addressed to countries, regions or local institutions to ensure self-sufficient transplant systems. It is based on a comprehensive model that combines the best practices of the Spanish, European and USA models.

Its aim is to provide a full approach to understand the major challenges to be met while analyzing how to carry out organ donation and transplantation programs.

This dynamic program has been designed to be adapted to the local needs allowing a complete or modular implementation of its steps.

1. Diagnosis study

Data collection and analysis of the current situation.

The diagnostic study aims at identifying organizational, structural and educational needs to be analyzed and foreseeing solutions that can be implemented in different phases.

The analysis of the organ donation and transplantation system is done in four levels: National agencies, Regional organizations, Hospital managers and Critical care unit primary.

The donation and transplantation activity is evaluated in terms of the current medical practice, procedures and structure (human and material resources) to achieve a comprehensive study of the situation.

Data collection is done by means of the application of the Organ Donation Diagnostic Surveys (ODDS) and personal interviews with the stakeholders of the four assessed levels.

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2. Organizational framework

People, processes and financial management.

This analysis aims at improving efficiency and effectiveness of the system, focusing on the professionals’ involvement and management factors.

Clear medical activities, responsibilities and suitable professional roles are crucial to foster organizations sustainability and development. Counselling on improvement and strategic planning is settled in close collaboration with the local partner.

Customized training is designed for healthcare professionals according with the educational needs identified in alignment with the donor critical pathway.

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Cooperacion_Internacional

TPM Training Course in Trinidad and Tobago and hospitals internships in Spain.

 

3. Donor detection maximization

Identification and early potential donors’ report.

One of the main reasons of lack of donors is the deficiency in reporting any potential donor to the donor coordinator responsible. The Deceased Alert System (DAS) is an IT system that allows to report 100% of potential DBD (Donor after Brain Death) and DCD (Donor after cardio-circulatory Death) cases from an early stage (GCS<5).

This warning system can be set up in the hospitals to monitor the donor potentiality and foreseeing the outcomes. Professionals should be trained for its appropriate use.

DAS-2

4. Health professionals awareness

Basics knowledge on organ donation.

To nurture donation positive attitude towards donation, professional motivation to contribute to the process accomplishment and self-confidence to collaborate in any step of the process among health care professionals of the institutions, an elementary level training program on organ donation is conducted by the local responsible of organ donation activity. Essential in Organ Donation (EOD) is the training program that provides basic knowledge on the donation and transplantation process.

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Dr. Manyalich, Dr. Gomez and Dr. Gunderson with EOD participants in Trinidad and Tobago. Dr. Wolf with EOD participants in Lebanon.

5. Hospital audits

Evaluation, improvement, organization.

Its aim is to check the accuracy of the application of corrective SEUSA actions. International and national experts visit the institutions involved to review retrospectively the cases and potential loses and interview the stakeholders of the process. An auditing report is provided with improvement recommendations.

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Hospital Audits in Trinidad and Tobago and Lebanon

 

6. Combined program

Diagnosis study and TPM professional training.

This program combines the analysis of the organ donation program development at hospitals providing recommendations for improvement (Diagnosis study) and the professional training according to the local educational needs identified.

The ODDS set of surveys is distributed among donation professionals before the hospital visits take place. The analysis of the results obtained from the survey will serve as a basis to identify the key points for improvement of the system. Afterwards, official visits to the hospitals units and interviews with authorities are carried out. Finally a comprehensive report with conclusions and recommendations is provided.

VISITS-XINATPM-XINA

Hospital assesment visits and TPM Intermediate Course in Kunming, China.

Examples of succes

Trinidad and Tobago 2010-2015

Since 2010 DTI Foundation, with the financial support of Repsol Foundation, is collaborating to achieve a self-sufficient system in local transplants in T&T.

T&T-example

Dr. Balleste and Dr. Gunderson with Sant Fernado Hospital team from T&T

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RESULTS

Renal transplant of 74 patients from 2010 to 2014 (59 from living donor and 15 from deceased donor).

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LEBANON

Since 2000, DTI Foundation is involved in different projects that has as main objective to consolidate a model of organ donation and transplantation in Lebanon, to ensure that the Lebanese population to equal access to a secure, efficient and quality system of donation and transplantation. In order to achieve it, a series of actions aimed at increasing organ donation rates. During the period of 2010-2012 DTI develop a SEUSA program  thanks to the Spanish Agency for International Cooperation for Development (AECID) a public entity under the Spanish Ministry of Foreign Affairs and Cooperation.

lebanon-example

The results of the project was an increasing the number of potential donors alerts, from 116 in the last nine years (2000-2009) to an average of 1500 alerts during the project. Moreover, it was increased in the number of donors from 0 in 2009 to 10 in 2012.

lebanon_table

 

ITALIA: PUGLIA REGION.

Since the beginning of the 90s the donation rate of Puglia (Italy) has been increasing in parallel with the Italian average. However, since 2003, the national rate has continued to grow while the regional rate has steadily declined. Therefore, DTI Foundation has worked through the program SEUSA in the implementation of a more effective donation system to increase the rate of donation and transplant accordingly so they can save more lives.

As a result of its collaboration the evolution by provinces shows notable differences however, not only in absolute terms but also in its evolution. Total donor used per year increased from 89 in the 2005-2007 to 131 in 2008-2010, representing an increase of 47%.

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