J Korean Soc Transplant.  2008 Jun;22(1):109-119.

Development of Korean Model for Independent Organ Procurement Organization

Affiliations
  • 1Department of Surgery, Keimyung University School of Medicine, Daegu, Korea. wh51cho@dsmc.or.kr
  • 2Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
  • 3Department of Neurosurgery, Keimyung University School of Medicine, Daegu, Korea.
  • 4Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine, Daegu, Korea.
  • 5Department of Medical Information, Keimyung University School of Medicine, Daegu, Korea.
  • 6Transplant Coordinator, Keimyung University School of Medicine, Daegu, Korea.

Abstract

PURPOSE: The aims of this project were to increase organ donation by developing potential brain dead donor actively and to provide basic data to settle up independent Organ Procurement Organization (OPO) in Korea.
METHODS
Hospital based Organ Procurement Organization (HOPO) of Keimyung university worked as a regional OPO and all the reported potential brain dead patient were treated by OPO team during May through October, 2007. Every reported and confirmed brain dead patient was evaluated for their eligibility of organ donation and these organs were allocated by Korean Network for Organ Sharing (KONOS). In order to increase the development of organ donation, campaign was done for public and medical personnels. To estimate the capacity of brain death donor pool, medical records of the dead patients with brain injury were evaluated. Accommodations and educations to the care-giver to the potential donor, neurosurgeon, neurologist and emergency department physicians were also done. For standardization of potential donor care, frame a clinical pathway of the care of the potential donor from the data of computerized records. The cash flow of whole process from developing potential donor to final procurement of organs were calculated to provide minimum expenses for operating Independent OPO in our environment.
RESULTS
Total 33 solid organs were procured from 11 brain dead donor during the experimental period. Twelve more organs were possible to donate but not procured because there were no matched recipient at that time. The reported number of potential donor was increased 2.5 times, compare to the same period of previous year (19 from 5 hospital in 2006 but 47 from 14 collaborating hospitals in 2007). Among 47 notified potential donor, only 11 were succeeded to procure. The reasons of failure for procurement in 36 patients were no familial consent in 12, poor patient condition to donate in 9, not in brain death criteria in 15. These results mean that we have at least 21 more potential donors if we can get familial consent and use marginal donor, and early notification. Mean medical expenses were 3 million won for individual expense beside insurance coverage and 5 million won for management expense of donor care from the detection to organ procurement.
CONCLUSION
Our results showed the number of the potential donor and actual organ donation can be increased by continued active relationship with regional hospital and adequate care of the donor. The big gap between the profit from our donor care and calculated donor management expenses of IOPO can be progressively covered by increasing number of brain dead donor, increasing procurement rate and increasing organ fee paid by recipient. But for a certain periods, financial support is necessary to settle up IOPO. Our result can be used as a basic data for management plan of IOPO in the future.

Keyword

Organ procurement organization; Activation of transplantation; Latent deceased donor

MeSH Terms

Brain Death
Brain Injuries
Critical Pathways
Emergencies
Fees and Charges
Financial Support
Humans
Insurance Coverage
Korea
Medical Records
Tissue and Organ Procurement
Tissue Donors
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