Coordination and donation

Abstract

The progressive incorporation of organ transplants as a therapeutic resource resulted in organisational adaptation and overall transplant management, leading to the emergence of the figure of the transplant coordinator in the mid-1980s. In Spain, the National Organisation of Transplants (Organización Nacional de Transplantes – ONT) was created, establishing a system – called the “Spanish model” – based on a network of coordinators at three levels: national, the autonomous community and the hospital. This organisational structure is a point of reference at the world level. The prevalence of the Intensive Medicine specialisation amongst hospital transplant coordinators is remarkable. The majority of organs proceed from brain-dead patients with beating hearts and this requires the infrastructure offered by intensive care units. The functions of the coordinator can be summarised in guaranteeing a synchrony of all the elements and teams that come together in an organisational chain that has come to be called the “process of donation”. Schematically, the crucial points that the hospital coordinator develops are the following: – Detection of the potential donor. – Maintenance of the donor. – Diagnosis of brain death. – Family consent. – Preparation of the hospital logistics. – Helping the relatives. – Direct involvement in the Program of Guarantee of Quality. – Person of reference in any activity related to the transplant. It would be desirable to achieve the creation of transplant coordination teams, with univocal messages, professionalism and a permanent input of the so-called “human factor”, which is so necessary and also so close to the transplant world.