Strengthening the Donation Process

Abstract

The donation process must be strengthened by the use of expanded criteria donors, continued education procedures to improve family support, detailed attention to financial viability, setting up a network of histocompatibility laboratories, and development of awareness campaigns. These steps helped the overall system expansion throughout 2010–2020 in Paraná State. Actions to shift the paradigm regarding the use of extended criteria donors – with a 33.7% increase in donors’ numbers within the 50–64 age group and a 91.58% increase in the 65–79 age group – resulted in a ratio drop of transplant/actual donor (2.54–1.55) but with increased ratio of transplants performed by million population (27–67.9 pmp). Continuing education programs, shaped by the different realities of the state’s OPOS and CIHDOTTs about the brain death diagnosis and family approach, support intensive care physicians regarding the donor’s maintenance steps, with efforts to train instructors in all regional health authorities. Financial incentive through a governmental funding program (HOSPSUS) implemented metrics that, according to their fulfilment, linked funds’ transfer from the program. Awareness campaigns were conducted in partnership with the private system, aiming not to spend public budget on this matter. As always limited, public resources should be directed to active search, diagnosis, and family welcoming activities.