Korean J Transplant.  2022 Nov;36(Supple 1):S132. 10.4285/ATW2022.F-2516.

Effects of policy on promotion of organ donation and Donation Improvement Program on donation

• Park J
• Park H
• Min J
• Kang H
• Lee J
• Moon I

• KMID: 2535648
• DOI: http://doi.org/10.4285/ATW2022.F-2516

Abstract

Background
In Korea, after the establishment of the organ procurement organization (Korea Organ Donation Agency, KODA) in 2009, institutional framework for designation of organ procurement organization and implementation of the reporting system for potential brain death donors has been prepared through amendment of the Organs Transplant Act in 2011. In addition, although a donation activation program is being implemented at medical institutions that have entered into an agreement with the organ procurement organization, the organ donation is in gridlock due to various factors including new infectious disease such as the recent COVID-19, and lack of a national consensus, etc. Therefore, improvements should be made to approaches to institutions and social system that allow excavation of potential brain death donors, face-to-face talk with the donors, and their donations. As such, this paper aims to present the direction of its development in the future.
Methods
We have analyzed 79 hospitals across the country that entered into an agreement with KODA for using the Donation Improvement Program (DIP) between 2012–2021 and compared the number of brain death donors per million population (PMP) in countries (EU nations) that applied the Organ Donation European Quality System (ODEQUS) of Europe with the number of do-nors prior to its application.
Results
The number of brain death donors per million population (PMP) in Korea was found to be 8.35 in 2012 and 8.56 in 2021, which did not show any significant change in donation rate during the past 10 years. However, it was confirmed that there were changes in recognition rate and donation rate at hospitals that entered into an agreement for using the Donation Improvement Program. According to change in recognition rate based on the agreement period, it was 26.5% 6 months prior to agreement. However, it was increased up to 66.9% 2–3 years after the agreement. As for the donation rate, while it was 6.5% 6 months prior to agreement, it was increased up to 16.0% 2–3 years after the agreement. Among the top 10 countries showing the high dona-tion rate (PMP) in the world in 2021, seven of them were EU nations which enforced ‘ODEQUS’. When comparing PMP between 2009 and 2021 in major cooperative countries for the initial project for ODEQUS, it was increased from 34.4 to 40.2 in Spain, 17.4 to 29.5 in Croatia, 21.3 to 24.4 in Italy, and 13.8 to 18.39 in Sweden.
Conclusions
In order to achieve donation activation, overall social systems should be able to be managed together in an organic way. At the level of medical institution, each hospital should introduce the DIP, and need to have a systematic training system for donation-related medical staffs and coordinators for promoting active excavation activities through connections with medical staffs and increasing their capacity. Moreover, a systematic media campaign should be made for the public for improving their positive social recognition, and a proper compensation system for medical institutions’ donation activities should be introduced.