NEWSLETTER
SEPTEMBER 2005
TRANSPLANT
Vol. 10. Nº 1
INTERNATIONAL FIGURES ON ORGAN DONATION AND TRANSPLANTATION - 2004
COUNCIL OF EUROPE
CONSEIL DE L’EUROPE
FUNDACION RENAL I Ñ I G O
A LV A R E Z
D E
T O L E D O
2005
INTERNATIONAL FIGURES ON ORGAN, TISSUE & HEMATOPOIETIC STEM CELL DONATION & TRANSPLANTATION ACTIVITIES. DOCUMENTS PRODUCED BY THE COMMITTEE OF EXPERTS ON THE ORGANISATIONAL ASPECTS OF CO-OPERATION IN ORGAN TRANSPLANTATION (2004) Editors: Rafael Matesanz & Blanca Miranda
NATIONAL DATA PROVIDED BY: – AUSTRALIA Lee Excell – AUSTRIA Guido Persijn (ET) – BELGIUM Guido Persijn (ET) – BULGARIA Yanko Nachkov – CANADA Kim Badovinac – CROATIA Mirela Busic – CYPRUS George Kyriakides – CZECH REPUBLIC Eva Pokorna – DENMARK Frank Pedersen (SKT) – ESTONIA Peeter Dmitriev – EUROTRANSPLANT (ET) Germany, The Netherlands, Austria, Belgium, Slovenia, Luxemburg Guido Persijn (ET) Marjan Slot – FINLAND Frank Pedersen (SKT) – FRANCE Ylana Chalem Philippe Tuppin – GEORGIA Gia Tomadze – GERMANY Guido Persijn (ET) – GREECE Georgia Menoudakou Marianthi Katsani – HUNGARY Peter Borka – ICELAND Frank Pedersen (SKT) – IRELAND Phil Pocock – ISRAEL Sharona Bem Ami
– ITALY Paola di Ciaccio – LATVIA Sergej Trushkov – LITHUANIA Julija Shirokova – LUXEMBURG Guido Persijn (ET) – MALTA Tony Bugeja – NEW ZEALAND Lee Excell – NORWAY Frank Pedersen (SKT) – POLAND Jaroslaw Czerwinski – PORTUGAL Luisa Taveira – ROMANIA Victor Gheorgue Zota – SCANDIATRANSPLANT (SKT) Denmark, Sweden, Norway, Finland, Iceland Frank Pedersen – SLOVAK REPUBLIC Ludovit Laca – SLOVENIA Lea Lamjnet Guido Persijn (ET) – SPAIN Carmen Martin Mª Jose Lopez Carmen Cobo – SWEDEN Frank Pedersen (SKT) – SWITZERLAND Diane Moretti – THE NETHERLANDS Arnoud Sloof Guido Persijn (ET) – TURKEY Altay Köken – UNITED KINGDOM Phil Pocock – UNOS: USA www.unos.org
– ARGENTINA Carlos Alberto Soratti – BOLIVIA www.gpuntacana.org – BRASIL Roberto Soares – CHILE Nelly de Lourdes Alvarado Jose Luis Rojas – COLOMBIA Rafael Romero – CUBA Alexander Marmol – DOMINICANA www.gpuntacana.org – ECUADOR Ignacio Ramirez – EL SALVADOR www.gpuntacana.org – GRUPO PUNTA CANA Argentina, Brasil, Bolivia, Chile, Colombia, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Honduras, México, Panamá, Paraguay, Perú, Puerto Rico, Dominicana R., Uruguay, Venezuela www.gpuntacana.org – GUATEMALA Rudolf A. García-Gallont – MEXICO José Salvador Aburto – PANAMA www.gpuntacana.org – PARAGUAY Eduardo Wilson Martínez – PERU Carmen Fajardo – PUERTO RICO E. Santiago-Delpín – URUGUAY Raul José Mizraji – VENEZUELA Carmen Luisa Lattuf de Milanés
Data recorded & prepared by Organización Nacional de Trasplantes (ONT) – Spain Dr. Rafael Matesanz Dra. Blanca Miranda Ana García Marina Alvarez Foot Note: For the purposes of this Newsletter the following definitions were used: Organ donor: Every potential donor transferred to the operating theatre from whom, at least, one solid organ has been retrieved Multiorgan donor: Every donor from whom, at least, two different solid organs have been retrieved Absolute number: Include all figures corresponding to all donors/patients adults and children Paediatric: Includes only paediatric activity (patients under 15 years old)
2
AULA MÉDICA EDICIONES. Paseo Pintor Rosales, 26. 28008 Madrid (España) Tel. 91 542 09 55. Fax 91 559 51 72. Depósito legal: M-9.990-1996
NEWSLETTER TRANSPLANT 2005 INTRODUCTION FROM EUROPE TO OTHER PARTS OF THE WORLD The outstanding work of the Transplant Committee of the Council of Europe in the field of organ, tissue and cells donation and transplantation for many years is now serving as a model for other International bodies in other parts of the world for setting standards, obtaining accurate data of activity, and implementing new forms of organization. UE has widely used the documents elaborated by this Committee for the tissue and cell directive. WHO is now in the phase of development of the 57th World Health Assembly Resolution about Human Organ and Tissue Transplantation and certainly our experience will serve as a basis for the future work in Latin America or Asia. TRANSPLANT NEWSLETTER is now the only official publication which provides data of organ donation and transplantation of everyday more and more countries all over the world. A wonderful example has been Latino America. Thanks to the cooperation of professionals and authorities of these countries and the coordinators of the GRUPO PUNTACANA, we started to publish their data and now we are the more accurate source of data for this continent. The recent approval of the project of IBEROAMERICAN COUNCIL OF ORGAN DONATION AND TRANSPLANTATION which will serve to harmonize these activities in Spanish and Portuguese speaking countries can be considered as a reflex of this Committee at the other side of Atlantic ocean. Information is an absolute need for taking decisions. It is a simple question of justice thank to all the people who provides these data every year from more and more countries. We all are contributing to provide these therapies everyday to more and more people all over the world. Rafael Matesanz
CONTENTS • INTRODUCTION: FROM EUROPE • INTERNATIONAL
TO OTHER PARTS OF THE WORLD
.......................................................... YEAR 2004 ...............................
5
• INTERNATIONAL DATA ON ORGAN DONATION, TRANSPLANTATION, WAITING LIST AND FAMILY REFUSALS. YEAR 2004 .......................................................................................................................................
23
• INTERNATIONAL
YEAR 2004 ......
39
• DOCUMENTS AND RECOMMENDATION PRODUCED BY THE TRANSPLANT COMMITTEE OF THE COUNCIL OF EUROPE. YEAR 2004 ....................................................................................................................
43
.................................
44
– LINK
TO:
FIGURES ON ORGAN DONATION AND TRANSPLANTATION.
3
DATA ON TISSUE AND HEMATOPOIETIC STEM CELL TRANSPLANT ACTIVITY.
GUIDE
TO SAFETY AND QUALITY ASSURANCE FOR ORGANS, TISSUES AND CELLS
– RECOMMENDATION REC (2004) 19
OF THE
COMMITTEE
OF
MINISTERS
THE AUTHORISATION OF ORGAN TRANSPLANTATION FACILITIES
– RECOMMENDATION REC (2005) 11
OF THE
COMMITTEE
OF
TO MEMBER STATES ON CRITERIA FOR
.....................................................................
MINISTERS
45
TO MEMBER STATES ON THE ROLE AND
TRAINING OF PROFESSIONALS RESPONSIBLE FOR ORGAN DONATION (TRANSPLANT
«DONOR
CO-ORDINATORS»)
.......
47
3
COUNCIL OF EUROPE
CONSEIL DE L’EUROPE
International figures on organ donation and transplantation activity Year 2004
5
6
22,2
34,6
22,1 13,8
21
21,8
12,6
2
15,5
21,1
13
11,9
20,5
13,7
10
13,4
18
22,6
19,6
16
10,2
14,7
6
17,8
0,9
0,5
10,2
13,6
20,9
11,4
2
8,8
CADAVERIC DONORS Annual Rate p.m.p. 2004
16,7
39,2
47,8
36,7
33,9
36,7
24,4
CADAVERIC KIDNEY TRANSPLANT Annual Rate p.m.p. 2004
22,6
20
25,9
30,6
24,1
25
42,4
39,3
25,5
20
24
27,5
37
28,4
18,4
27,3
1,8
0,9
16,5
10,5
1,4
30,9
25
36,8
21,4
3,6
11,9
7
8
2,9
1,4
0,8 7,8
2,7
1,8
11,3
20
15,3
2,4
5,9
9,6
4,6
3,7
15,8
10
1,6
27,5
20,7
1,1
0,4
0,6
6,9
8,2
0,4
8
1,3
1,2
3,6
1
7,8
41,4
10
1,6
LIVING KIDNEY TRANSPLANT Annual Rate p.m.p. 2004
10,2
6,6
2,8
2
6,7
24,3
% LIVING KIDNEY TRANSPLANT / TOTAL KIDNEY TRANSPLANT
100
5,1
31,6
0
37,1
7,1
19,7
27,8
8,6
38,1
36,4
6,1
9,8 0
35,8
3,7
0
2
41,6
88,8
6,55
39,5
86
1,3
12,5
2,5
65,9
68,2
85,1
100
9
10
20,5
24,1
22
15,1
3,6
14,8
11,7
18,2
10,7
7,8
14,8
16,1
8,1
9,7
7,5
9,8
4,3
5,2
2,6
0,1
0,8
9,6
6,7
6,6
11,5
LIVER TRANSPLANT Annual Rate p.m.p. 2004
4,5
6,8
3,1
5,2
7,4
HEART TRANSPLANT Heart - Lung Transp. Included Annual Rate p.m.p. 2004
4
2
6,2
5
4,5
3,4
7,8
4,7
1,8
1,5
7,4
1
2
2,7
0,5
0,1
0,2
0,4
4
0,4
2,5
11
12
0,1
3,3
2,8
6,1
5
3,3
1,5
2,9
5,2
2,4
9,5
0,7
2,9
0,4
0,03
1,9
0,02
4,3
2,3
LUNG TRANSPLANT Single + Double Lung Heart - Lung Transp. Included Annual Rate p.m.p. 2004
1,2
1,7
1 1,3
1,7
4
PANCREAS TRANSPLANT –included all the combinations– Annual Rate p.m.p. 2004
1,5
1,3
1,6
2,3
2,2
5
2,4
0,9
1,2
0,4
2,5
0,1
0,5
1,3
13
14
1,2
1,4
1,2
1,4
1,7
1,4
1,1
1
1,9
1,7
3,6
1,6
0,6
1,2
0,4
2,5
0,1
0,3
1,3
1
KIDNEY-PANCREAS TRANSPLANT Annual Rate p.m.p. 2004
POPULATION: 31,9 millions Cadaveric donors Cadaveric Kidney Transplant Living Kidney Transplant Liver Transplant Heart Transplant Heart - Lung Transplant S. Lung + D. Lung Transp. Pancreas Transplant
CANADÁ
7.150 9.354 6.647 6.168 2.055 39 1.173 1.484
(pmp) (13),0 (18,9) (12,9) (13,2) 0(4,6) 0(0,1) 0(4,2) 0(1,9)
POPULATION: 20,1/4,1 millions Cadaveric donors (pmp) Cadaveric Kidney Transplant Living Kidney Transplant Liver Transplant Heart Transplant Heart - Lung Transplant S. Lung + D. Lung Transp. Pancreas Transplant
USA
POPULATION: 297 millions Cadaveric donors Cadaveric Kidney Transplant Living Kidney Transplant Liver Transplant Heart Transplant Heart - Lung Transplant S. Lung + D. Lung Transp. Pancreas Transplant
414 603 413 420 146 3 135 61
(pmp) (24,1) (31,5) (22,4) (20,8) 0(6,9) 0(0,1) 0(3,9) 0(5),0
Australia N. Zealand 218 (10,8) 40 0(9,8) 405 (20,1) 58 (14,2) 246 (12,2) 48 (11,8) 177 0(8,8) 36 0(8,8) 78 0(3,8) 6 0(1,4) 6 0(0,2) –0000–0 98 0(4,8) 12 0(2,9) 31 0(1,5) 2 0(0,4)
AUSTRALIA
NEW ZEALAND
Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by 2004, 31st Dec. 2.975 667 129 181 154 Patients dead while on the WL during 2004 0.058 096 026 043 003
CANADÁ Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by 2004, 31st Dec. 1.399 104 45 87 30 Patients dead while on the WL during 2004 – – – – –
USA
Kidney Liver Heart Patients admitted to the waiting list during 2004 27.298 10.180 2.908 Patients awaiting for a transplant by 2004, 31st Dec. 61.924 17.336 3.309 Patients dead while on the WL during 2004 21.548 09.537 3.150
Lung Pancreas
AUSTRALIA
1.964 2.788
3.659 4.159
1.882 2.604
Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by 2004, 31st Dec.
301
12
10
7
4
NEW ZEALAND
15
CADAVERIC DONORS Annual Rate p.m.p. 2004 3,1 14,1 21,8 0,3 1,9
6,8 6 3,2
7,7 1 0,3 0,2
8,9 10,8
16
19,2
CADAVERIC KIDNEY TRANSPLANT & / LIVING KIDNEY TRANSPLANT Annual Rate p.m.p. 2004
16,5 0
1,5 1,4 0 2,8
0,5 5,5 10 2,1
16 6,1
3,6 4,21 8,9 1,9
3,2 2,6
10,2 7,3
1,6 0,9 0 1,2
15,6 2,2
15,3 5
26,3 0
17
% LIVING KIDNEY TRANSPLANTS / TOTAL KIDNEY TRANSPLANTS 0 8,6 27,9 100 92 53,4
17,9 17,5 44,4
41,7 36,1 100
12,3 2,7
18
0
LIVER TRANSPLANT Annual Rate p.m.p. 2004 1 2,3 17,9
2 3
5,3 0,2
0,4
4,7 6,6
19
HEART TRANSPLANT Heart - Lung Transp. Included Annual Rate p.m.p. 2004 0,2 0,3 4,6
1,1
0,2
1,4 1,9
20
3,1
LUNG TRANSPLANT Single + Double Lung Heart - Lung Transp. Included Annual Rate p.m.p. 2004 0,3 1,8
0,1
0,2
0,4 0,8
0,3
21
PANCREAS TRANSPLANT –included all the combinations– Annual Rate p.m.p. 2004
2,8
0,4
0,1 0,2
22
1,6
COUNCIL OF EUROPE
CONSEIL DE L’EUROPE
International data on organ donation and transplantation activity, waiting list and family refusals Year 2004
23
24
185 (22’56) 3 (0,37) 76’8
Cadaveric D. - included NHBD (Rate - pmp -) NHB Donors (pmp) % Multiorgan donors
48 (4’7)
1 (0’1)
83 (8’1) 3
38 (3’7) 2 (0’2)
442 (43) 8.6 8 404 (39’3) 404 (39’3)
86 (1’4) 17 (0’3)
103 (1’7)
167 (2’8) 2 47 (0’7) 120 (2)
22 (0’4)
339 (5’6) 8
931 (15’1) 51 56 (0’9) 12 (0’2) 48 (0’8)
2423 (39’4) 6.7 68 2259 (36’7) 2226 (36’2) 33 (0’5) 164 (2’7)
96
1291 (21)
61’5
FRANCIA
49 (0’8)
3 (0’6) 7 (1’3)
10 (1’9)
2 (0’4)
21 (4) 3
50 (9’6) 4
5 (1)
197 (37’4) 2.5 8 192 (36’8)
56
109 (20’9)
5’2
FINLAND
MULTIVISCERAL (pmp)
17 (1’6) 8 (0’8)
5 (3’6)
35 (25) 35 (25)
40 (28’6) 12.5
10
19 (13’6)
1’4
ESTONIA
7 (0’1) 7 1 (0’02) 6 (0’1)
11 (2.5)
22 (4’1) 6 (1’1)
28 (5’2)
1 (0’2)
24 (4’5)
1 (0’2)
42 (7’8) 11
52 (9’6)
187 (34’6) 27.8 10 135 (25)
65’6
64 (11’9)
5’4
DENMARK
SMALL BOWEL TX – included all the combinations - (pmp) Paediatric <15 years -Liver + Small Bowel (pmp) -S. B. TX Alone (pmp)
18 (1’73) 5 (0’48)
30 (3’66) 5 (0’61)
25 (2’4)
3 (0’3) 4 (0’4)
44 (62.8) 65.9 1 15 (21.4) 1 (1.4) 7 (10) 29 (41.4)
TRANSPLANTATION
211 (20’5) 2 (0’19) 54
28 (2’7) 35 (3’4)
8 (1.8)
43 (9.7)
7 (1.59)
10’3
CZECH R.
DONATION 8 (11.4)
0.7
CYPRUS
7 (0’7)
11 (2.5)
1 (0.13)
1 (0.13)
1 (0.13) 1 (0.13)
10 (1.3)
14 (1.8)
113 (25.7) 6.1 2 106 (24) 95 (21.59)
83
57
24 (3) 41.6
59 (13.4)
4.4
7 (0.9)
7.8
CROATIA
63 (6’06)
42 (4’04)
78 (9’51) 1 20 (2’4) 58 (7’1)
LUNG TX – included all the combinations - (pmp) Paediatric <15 years -Single (pmp) -Double - included Heart/ Lung TX - (pmp) NHB – double + single - Lung TX (pmp)
3 (0’29)
77 (7’4) 2
41 (5)
1 (0’12)
HEART-LUNG Transplants (pmp) Paediatric <15 years
PANCREAS TX – included all the combinations - (pmp) Paediatric <15 years -Kidney - Pancreas TX (pmp) -Pancreas TX Alone (pmp)
64 (7’8)
6 (0’73)
229 (22’02) 31 20 (1’92) 1 (0’10) 25 (2’40) 5 (0’48)
19 (1’8) 7 (0’67)
38 (4’6) 13 (1’59)
132 (16’10) 8 8 (0’98)
372 (35’77) 5.1 16 353 (33’94)
386 (47’07) 9.8 14 348 (42’44)
HEART TX-included Heart-lung transplant- (pmp) Paediatric <15 years
LIVER TX – included all the combinations - (pmp) Paediatric <15 years -Split Liver TX (pmp) -Domino Liver TX (pmp) Living Liver TX (pmp) NHB Liver TX (pmp)
KIDNEY TX – included all the combinations - (pmp) % (Living TX/ Total TX) Paediatric <15 years Cadaveric TX (pmp) -Single TX (pmp) -Double TX (pmp) Living TX (pmp) NHB kidney TX (pmp)
10’4
8’2
BULGARIA
8 (1’6)
8 (1’6) 100
5
GEORGIA 11
GREECE
163b (1’98) 20 (0’24)
192 (2’33)
240 (2’91) 3 44 (0’5) 196 (2’4)
14 (0’17) 1
412 (5) 31
881 (10’69) 91 117 (1’42) 7 (0’08) 64 (0’78)
6 (0’54)
29 (2’6)
2478 (30’07) 192 (17’4) 19.7 39.5 78 1989 (24’14) 116 (10’5) 114 (10’4) 2 (0’18) 489 (5’9) 76 (6’9)
76’7
1075 (13’05) 66 (6)
8’4
GERMANY
227 (21’83) 5 (0’48) 83’7
BELGIUM
AUSTRIA
COUNTRIES Population (million inhabitants)
3 (10’2)
11 (1’1)
7 (0’1)
1 (0’02)
9 (1’32)
94 (1’6) 1 55 (1) 39 (0’6)
MULTIVISCERAL (pmp)
4 (1)
12 (1’2)
9 (1’32)
85 (1’5) 4 40 (0’7) 45 (0’8)
3 (0’1) 1
353 (6’2) 14
19 (0’3)
1881 (33) 7.1 40 1746 (30’6) 1564 (27’4) 101 (1’8) 135 (2’4)
6 (0’88)
29 (4’26) 1 23 (3’38) 6 (0’88)
41 (17’83) 15 (6’53) 2’44
1 (0’44)
1 (0’44) 24 (10’44)
72 (31’31) 1.3 1 71 (30’87) 71 (30’87)
TRANSPLANTATION
83’7
1203 (21’1)
1035 (18’2) 61 94 (1’6)
17 (2’5) 2
2’3
LATVIA
DONATION
56.9
ITALY
45 (6’61) 6 2 (0’29)
69 (10) 2 (0’29)
81 (11’9) 85.1 14 81 (11’9) 70 (10’29)
60 (8’82) 1 (0’14) 75
6’8
ISRAEL
6 (0’1)
4 (1)
45 (11’5)
146 (37’4) 2 10 143 (36’7) 138 (35’4) 5 (1’3) 3 (0’8)
86 (22’1)
3’9
IRELAND
12 (1’2)
4 (0’4)
4 (0’4)
10 (1’0)
43 (4’3) 6
3 (10’2) 100
80
45
295 (29’5) 3.7 13 284 (28’4) 284 (28’4)
58 (16’7)
0’3
10
160 (16)
ICELAND
HUNGARY
SMALL BOWEL TX – included all the combinations - (pmp) Paediatric <15 years -Liver + Small Bowel (pmp) -S. B. TX Alone (pmp)
PANCREAS TX – included all the combinations - (pmp) Paediatric <15 years -Kidney - Pancreas TX (pmp) -Pancreas TX Alone (pmp)
LUNG TX – included all the combinations - (pmp) Paediatric <15 years -Single (pmp) -Double - included Heart/ Lung TX - (pmp) NHB – double + single - Lung TX (pmp)
HEART-LUNG Transplants (pmp) Paediatric <15 years
HEART TX-included Heart-lung transplant- (pmp) Paediatric <15 years
LIVER TX – included all the combinations - (pmp) Paediatric <15 years -Split Liver TX (pmp) -Domino Liver TX(pmp) Living Liver TX (pmp) NHB Liver TX (pmp)
KIDNEY TX – included all the combinations - (pmp) % (Living TX/ Total TX) Paediatric <15 years Cadaveric TX (pmp) -Single TX (pmp) -Double TX (pmp) Living TX (pmp) NHB kidney TX (pmp)
Cadaveric D. - included NHBD (Rate - pmp -) NHB Donors (pmp) % Multiorgan donors
COUNTRIES Population (million inhabitants)
10 (20)
57 (16.5) 57 (16.5) 4 (1.2)
10 (20) 0
100
1 (2)
0’5
61 (17.7) 6.55
17.1
35 (10.2)
3.4
4 (10)
1 8 (20) 8 (20)
11 (27.5)
100
4 (10)
0.4
LITHUANIA LUXEMBURGO MALTA
8 (1’7) 2 (0’4)
10 (2’2)
11 (2’4)
11 (2’4)
34 (7’4) 1
45 (9’8) 5 1 (0’2)
95 (20’7)
265 (57’6) 35.8 9 170 (37)
90
90 (19’6)
4’6
NORWAY
15 (0’4) 1 (0’03)
12 (1’2)
12 (1’2)
10 (0’1)
1 (0’03)
16 (0’4)
10 (0’1)
45 (4’5) 1
205 (20’5) 11 3 (0’3) 46 (4’6) 5 (0’5)
436 (43’6) 6.6 10 392 (39’2) 391 (39’1) 1 (0’1) 29 (2’9)
79’7
222 (22’2)
10
2 (0’1)
2 (0’1)
4 (0’19)
9 (0’43)
16 (0’76) 2
168 (8)
189 (9) 88.8 7 19 (0’9)
80
10 (0’48)
21
PORTUGAL ROMANIA
1 (0’03)
1 (0’03)
105 (2’7) 2
18 (0’5)
199 (5’2) 33
22 (0’6)
1067 (27’9) 2 31 1045 (27’3) 1045 (27’3)
39
562 (14’7)
38’2
POLAND
25
26 133 (14’8) 13
142 (15’8)
2 (0’2)
7 (0’2) 5 4 (0’1) 3 (0’1)
SMALL BOWEL TX – included all the combinations - (pmp) Paediatric <15 years -Liver + Small Bowel (pmp) -S. B. TX Alone (pmp)
MULTIVISCERAL (pmp)
5 (0’6) 3 (0’3)
19 (2’1) 7 (0’8)
26 (2’9)
31 (3’4) 2
6 (0’7) 9 (1)
91 (12’6) 6 (0’8) 80
DONATION
7’2
SWIZERLAND
247 (15’5) 111 (6’81) 53
16’3
10 (1’4) 1 (0’1)
11 (1’5)
36 (5) 1 2 (0’3) 34 (4’7)
29 (4)
84 (11’7) 5 2 (0’3) 2 (0’3) 4 (0’6)
256 (35’5) 31.6 6 163 (22’6) 160 (22’2) 3 (0’4) 81 (11’3) 12 (1’6)
18 (1’10) 4 (0’25)
22 (1’35)
54 (3’31) 1 7 (0’4) 47 (2’9)
32 (1’96)
3 (0’18) 8 (0’49)
109 (6’69) 11 6 (0’37)
250 (15’3) 171 (10’49)
673 (41’29) 37.1 38 423 (25’95)
1 (0’01)
1 (0’01)
21 (0’3) 16 (0’2)
37 (0’5)
2 (0’02)
2 (0’02)
33 (0’4) 1
133 (1’9)
2 (0’02)
245 (3’6)
246 (3’6) 243 (3’5) 3 (0’04) 529 (7’8) 1 (0’01)
775 (11’4) 68.2
136 (2) 1 (0’01) 17
67’8
T. NETHERLANDS TURKEY
TRANSPLANTATION 372 (41’3) 38.1 14 230 (25’5)
61 (1’4) 12 80’3)
143 (3’3) 7 41 (0’9) 102 (2’4) 7 (0’2)
7 (0’2)
294 (6’8) 20
1040 (24’1) 58 14 (0’3) 7 (0’2) 18 (0’4) 5 (0’1)
2125 (49’2) 2.8 68 2064 (47’8) 2025 (46’9) 39 (0’9) 61 (1’4) 92 (2’1)
8 (0’9)
3 (1’50)
15 (7’50)
55 (27’50) 55 (27’50)
55 (27’50) 0
88’6
123 (13’7)
9
SWEDEN
74 (1’7)
11 (2’04)
2 (0’4)
99 (18’4) 0 1 99 (18’4)
64
32’73
1495 (34’6) 71 83.5
43’2
SPAIN
PANCREAS TX – included all the combinations - (pmp) Paediatric <15 years -Kidney - Pancreas TX (pmp) -Pancreas TX Alone (pmp)
LUNG TX – included all the combinations - (pmp) Paediatric <15 years -Single (pmp) -Double - included Heart/ Lung TX - (pmp) NHB – double + single - Lung TX (pmp)
HEART-LUNG Transplants (pmp) Paediatric <15 years
HEART TX-included Heart-lung transplant- (pmp) Paediatric <15 years
LIVER TX – included all the combinations - (pmp) Paediatric <15 years -Split Liver TX (pmp) -Domino Liver TX (pmp) Living Liver TX (pmp) NHB Liver TX (pmp)
KIDNEY TX – included all the combinations - (pmp) % (Living TX/ Total TX) Paediatric <15 years Cadaveric TX (pmp) -Single TX (pmp) -Double TX (pmp) Living TX (pmp) NHB kidney TX (pmp)
36 (18)
2
5’4
55 (10’22)
SLOVENIA
SLOVAK R.
7 (80’1) 7 6 (0’1) 1 (0’02)
69 (1’2) 10 (80’2)
79 (1’3)
134 (2’3) 5 37 (0’6) 97 (1’6) 2 (0’03)
15 (0’3) 4
180 (3’1) 24
731 (12’4) 83 60 (1) 2 (0’03) 10 (0’2) 28 (0’5)
1905 (32’3) 24.3 86 1442 (24’4) 1358 (23) 8 (0’1) 463 (7’8) 147 (2’5)
813 (13’8) 87 (1’5) 84
59
U. K.
31 (1’5) 1 23 (1’1) 5 (0’2)
98 (4’8) 4 11 (0’5) 87 (4’3)
6 (0’2)
78 (3’8) 1
1 (0’04)
177 (8’8) 6 28 (1’3)
651 (32’3) 37.8 8 405 (20’1) 402 (19’9) 3 (0’1) 246 (12’2) 8 (0’4)
218 (10’8) 4 (0’2) 84
20’1
1 (0’03)
1 (0’03)
45 (1’4) 16 (0’5)
61 (1’9)
135 (4’2) 6 29 (0’9) 106 (3’3)
3 (0’09)
146 (4’6) 32
53 (1’7)
420 (13’2) 10 10 (0’3)
603 (18’9) 589 (18’4) 14 (0’4) 413 (12’9)
1061 (33’2) 38.9
85
414 (13)
31’9
AUSTRALIA CANADA
2 (0’4)
2 (0’4)
2 (0’4) 10 (2’4)
12 (2’9)
6 (1’4)
36 (8’8) 1 2 (0’4)
58 (14’2) 54 (13’2) 4 (0’9) 48 (11’8)
106 (26’1) 45.2
80
40 (9’8)
4’1
152 (0’5)
152 (0’5) 92
880 (3) 604 (2)
1484 (5)
1173 (3’9) 54
39 (0’1) 6
2055 (6’9) 297
323 (1’1)
6168 (20’8) 580
6647 (22’4)
16001 (54) 41.5 764 9354 (31’5)
7150 (24’1)
297
N. ZEALAND USA
Cadaveric D. - included NHBD (Rate - pmp -) NHB Donors (pmp) % Multiorgan donors
COUNTRIES Population (million inhabitants)
MULTIVISCERAL (pmp)
SMALL BOWEL TX – included all the combinations - (pmp) Paediatric <15 years -Liver + Small Bowel (pmp) -S. B. TX Alone (pmp)
5
9 (0.2)
9 (0.2)
31 (0.83) 2 (<18) 26 (0.7) 5 (0.1)
LUNG TX – included all the combinations - (pmp) Paediatric <15 years -Single (pmp) -Double - included Heart/ Lung TX - (pmp) NHB – double + single - Lung TX (pmp)
PANCREAS TX – included all the combinations - (pmp) Paediatric <15 years -Kidney - Pancreas TX (pmp) -Pancreas TX Alone (pmp)
5 (0.1)
73 (1.95) 14 (<18)
1 (0.005)
100 (0.37)
43 (0.24)
195 (1.07)
180 (0.99)
50 (1.3)
1 (0.066)
1 (0.066)
1 (0.066)
1 (0.066)
6 (0.4)
21 (1.4)
3 (0.2)
2 (0.13)
70 (4.66)
33 (2.2)
234 (15.6) 234 (15.6)
1846 (10.17)
1322 (7.28)
267 (17.8) 12.3
TRANSPLANTATION
55
134 (8.9)
DONATION
15
CHILI
3168 (17.45) 41.7
960 (5.29)
11 (1.2)
11 (1.2) 100
1408 (7.75)
181.6
BRASIL
247 (6.6) 76 (<18)
761 (20.3) 24.7 111 (<18) 573 (15.3) 563 (15) 10 (0.3) 188 (5)
50.62
3 (0.3)
9.2
37.4
403 (10.8)
BOLIVIA
ARGENTINA
HEART-LUNG Transplants (pmp) Paediatric <15 years
HEART TX-included Heart-lung transplant- (pmp) Paediatric <15 years
LIVER TX – included all the combinations - (pmp) Paediatric <15 years -Split Liver TX (pmp) -Domino Liver TX (pmp) Living Liver TX (pmp) NHB Liver TX (pmp)
KIDNEY TX – included all the combinations - (pmp) % (Living TX/ Total TX) Paediatric <15 years Cadaveric TX (pmp) -Single TX (pmp) -Double TX (pmp) Living TX (pmp) NHB kidney TX (pmp)
Cadaveric D. - included NHBD (Rate - pmp -) NHB Donors (pmp) % Multiorgan donors
COUNTRIES Population (million inhabitants)
2 (0.04)
4 (0.09)
27 (0.62)
6 (0.1)
131 (3)
82 (1.9)
384 (8.9)
466 (10.8) 17.51
85
258 (6)
43
COLOMBIA
3 (0.3)
26 (2.3)
16 (1.4)
169 (15.1)
85 (16.5) 8.6
159 (14.1)
11.2
CUBA
25 (2.8)
25 (2.8) 100
8.9
DOMINICAN R.
32 (2.6)
40 (3.2) 40 (3.2)
72 (5.8) 44.4
40 (3.2)
12.5
ECUADOR 6.6
EL SALVADOR
27
28
MULTIVISCERAL (pmp)
SMALL BOWEL TX – included all the combinations - (pmp) Paediatric <15 years -Liver + Small Bowel (pmp) -S. B. TX Alone (pmp)
PANCREAS TX – included all the combinations - (pmp) Paediatric <15 years -Kidney - Pancreas TX (pmp) -Pancreas TX Alone (pmp)
LUNG TX – included all the combinations - (pmp) Paediatric <15 years -Single (pmp) -Double - included Heart/ Lung TX - (pmp) NHB – double + single - Lung TX (pmp)
HEART-LUNG Transplants (pmp) Paediatric <15 years
HEART TX-included Heart-lung transplant- (pmp) Paediatric <15 years
LIVER TX – included all the combinations - (pmp) Paediatric <15 years -Split Liver TX (pmp) -Domino Liver TX (pmp) Living Liver TX (pmp) NHB Liver TX (pmp)
KIDNEY TX – included all the combinations - (pmp) % (Living TX/ Total TX) Paediatric <15 years Cadaveric TX (pmp) -Single TX (pmp) -Double TX (pmp) Living TX (pmp) NHB kidney TX (pmp) 1253 (12.05)
69 (5.5)
3 (0.3)
3 (0.3)
20 (0.2)
3 (0.03)
100 (1)
1724 (16.6) 0 471 (4.5) 1716 (16.5) 4 (0.04)
75 (6) 92 6 6 (0.5) 6 (0.5)
330 (3.1)
104
12
3 (0.25)
MEXICO
GUATEMALA
1 (0.2)
DONATION
5.5
PARAGUAY
7 (2.1)
32 (10)
39 (12.1) 17.9
1 (0.2)
2 (0.4)
TRANSPLANTATION
6.8 (2.1)
3.2
PANAMÁ
7 (0.2)
2 26 (0.9)
72 (2.5) 36.1 4 46 (1.6)
7
29 (1)
27.9
PERU
7 (1.8)
11 (2.8)
7 (1.8)
18 (4.6)
70 (17.9)
24 (6.1)
62 (16)
86 (22.05) 27.9
85 (21.8)
3.9
PUERTO RICO
5 (1.6) 5 (1.6)
1 (0.31)
10 (3.12)
84 (26.3) 84 (26.3)
89 (27.8) 0
22
61 (19.2)
3.2
URUGUAY
2
108 (4.1)
202 (7.7) 53.4 20 94 (3.6) 94 (3.6)
3.9
51 (1.96)
26
VENEZUELA
Cadaveric D. - included NHBD (Rate - pmp -) NHB Donors (pmp) % Multiorgan donors
COUNTRIES Population (million inhabitants)
SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
37 53 5
1 5 6
5 13
1 9 4 1
26 429 277 87
24 1160 474 103
45 3032 5626 115
1 3 4
8 111 181 8
38 36 1
1 45 41 8
1 23 4 4
1 50 2
1 224 244 5
PANCREAS NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
1 16 22 3
1 40 23 3
61.53
FRANCIA
12 176 144 44
66 46 11
2 33 18 2
1 52 16 2
4 257 403 3
5.2
FINLAND
100 57 13
2 75 74 16
1.4
ESTONIA
WAITING LIST
5.4
DENMARK
LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
93 34 12
2 93 46 7
1 20 100 5 240
0.7
CYPRUS
9 29 39 18
95 75 19
HEART NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
308 243 26
7 440 608 44 4504
10.29
CZECH R.
HEART-LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
183 108 52
452 936 31
10.4
8.2
402 805 44
BELGIUM
AUSTRIA
LIVER NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
KIDNEY NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004 ESRD on dialysis treatment during 2004
COUNTRIES Population (million inhabitants)
408
2
5
GEORGIA
213 158 14
405 457 108
756 613 172
1427 1525 288
2833 9270 482
82.4
GERMANY
2
1
1 9 18 2
1
847
4
11
GREECE
2 13 14 1
9 4
1 21 22 13
1 81 47 15
4 371 1021 43 4600
4
HUNGARY
29
30
SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
PANCREAS NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
HEART-LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
HEART NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
LIVER NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
7
1
21
1
171
1
3.9
0.3
1
IRELAND
ICELAND
3
2 41 44 10
3 68 121 24
3 118 130 27
6 220 497 29
6.8
ISRAEL
1 8 22
17 126 205 7
14 186 238 66
18 498 640 93
20 1359 1457 137
39 2604 6561 188
56.99
ITALY 3.4
LITHUANIA
6 6 6 1
1 52 375 12
2 61 434 4
WAITING LIST
2.3
LATVIA
3 14
0.5
190
1 25 85
0.4
LUXEMBURGO MALTA
1 14 14
1 32 45 9
1 35 4 1
1 53 4 5
1 192 169 13
4.6
NORWAY
4 30 25 2
1 7 8
2 18 14 7
4 213 178 42
6 290 105 25
18 1190 1201 38 15340
38.23
POLAND 10
PORTUGAL
1
2 35 72 8
1 234 290 36
5 432 1626 73
21
ROMANIA
KIDNEY NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004 ESRD on dialysis treatment during 2004
COUNTRIES Population (million inhabitants)
SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
PANCREAS NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
1
2 9 3 1
HEART NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
HEART-LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
1 3 7 1
1
1 1
1 9 16 5
1 12 6 1
1 38 108 1 1225
2
5.38
4 224 759 70
SLOVENIA
SLOVAK R.
LIVER NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
KIDNEY NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004 ESRD on dialysis treatment during 2004
COUNTRIES Population (million inhabitants)
2 8 6
10 98 79 3
8 209 145 26
17 394 113 36
24 1460 701 163
21031
4231
42
43.2
SPAIN
1
3
2 38 31 6
3 36 16 2
3 130 17 6
4 357 350 6
9
SWEDEN 16.3
1 2 1
2 12 6 1
2 41 17 3
4 45 18 6
3 115 86 15
6 282 488 18
39 34 2
88 86 14
59 45 16
154 155 21
832 116 111
25 5 35
12 1 1
12 24 182
17 631 737
34262
25 1403 7904
67.8
T. NETHERLANDS TURKEY
WAITING LIST
7.2
SWIZERLAND
3 14 6 2
9 26 36 1
6 205 272 46
7 206 111 17
7 875 253 62
25 2808 5299 273
59
U. K.
30
2
87
4
45
4
104
8
1399
20
20.11
1 1
3
154 3
7
181 43
5
129 26
12
667 96
9
2975 58
24
31.94
AUSTRALIA CANADA
4
1
7
1
10
1
12
1
301
3
4.06
18 244 195 219
141 2788 4159 2604
67 1964 3659 1882
131 2908 3309 3150
117 10180 17336 9573
250 27298 61924 21548
297
NEW ZEALAND USA
31
32
23 132 127 32
HEART NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
PANCREAS NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
1
4 7 19
8 57 70 20
14 380 289 79
LIVER NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
HEART-LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004
22829
37
299
104
256
62
6288
56
29389
183
181.6
37.4
47 1205 5185
BRASIL
ARGENTINA
1
4
5
7
21
15
CHILI
9 1246 985 490 1666
3 30 25
1 10 7 3
2 40 25
12.5
ECUADOR
2
1
1 1
2
1300
11
WAITING LIST
11.2
CUBA
1900
300
2
12
2
3
2
54
10
273
14
30000
3072
133
104
GUATEMALA MEXICO
4 4 77 8 491
5.5
PARAGUAY
1 176 443 31 442
3.9
1 8 13
2 1 1
3 18 29 6
4 104 546 4 2600
3.2
PUERTO RICO URUGUAY
1 6 4 1
14 123 295 10 8000
26
VENEZUELA
KIDNEY NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31st Dec Patients dead while on the WL during 2004 ESRD on dialysis treatment during 2004
COUNTRIES Population (million inhabitants)
ROMANIA
COUNTRIES
21
12
2 (17)
(million inhabitants)
Number of interviews, asking for consent to donation
Number of family refusals (%)
36 (77)
47
2
SLOVENIA
17 (47)
Population
36
13
1.4
ESTONIA
Number of family refusals (%)
10.29
CZECH R.
Number of interviews, asking for consent to donation
(million inhabitants)
Population
COUNTRIES
351 (18)
1974
43.2
SPAIN
488
61.53
FRANCE
76 (34)
220
67.8
TURKEY
16 (7)
229
10
HUNGARY
442 (37)
1183
59
U.K.
2 (29)
7
0.3
ICELAND
FAMILY REFUSALS
515 (55)
933
37.4
ARGENTINA
87 (56)
154
6.8
ISRAEL
78 (37)
212
15
CHILI
594 (29)
2027
56.99
ITALY
22 (10)
221
11.2
CUBA
11 (29)
38
2.3
LATVIA
17 (27)
62
3.2
URUGUAY
31 (25)
122
4.6
NORWAY
52 (50)
103
26
VENEZUELA
73 (10)
696
38.23
POLAND
33
34
7/1(RL)
1
1
4
1
18
1
19
2
20
4
1
22
1
24
1
25
26
75
34
TOTAL IMPORTED
3
1
1
1
1
1
1
26. U.K.
1
5
10
1
25. Switzerland
8
0
24. Sweden
6
23. Spain
1
3
0
22. Slovak R.
8
6
21. Slovenia
1
0
20. Portugal
38
17. Netherlands
0
0
16. Malta
19. Poland
0
15. SKT
0
0
14. Luxembourg
18. Norway
0
13. Latvia
16
1
2
1
23
12. Italy
4
12
3
1
21
0 4
36
12
2
17
11. Hungary
10. Greece
30
1
16
143
1
15
9. Germany
14
0
13
8. France 1
12
0
11
7. Finland
2
1
10
0
49
23
9
6. ET
1
8
0
7
5. Denmark
52
6
0
5
4. Cyprus
31
4
0
7
3
3. Croatia
2. Belgium
6
2
1. Austria
IMPORTED
1
DATA ON ORGAN EXCHANGE IN EUROPE LIVER (WHOLE) / RIGHT LIVER LOBE (RL) (IMPORTED AND GRAFTED)
1
2
13
14
1
15
16
17
19
20
1
21
23
6
24
25
1
26
27
103
92
TOTAL IMPORTED
2
1
0 0 0
26. Switzerland
27. U.K.
1
24. Spain
25. Sweden
0
23. Slovak R.
38
22. Slovenia
28
0
21. Portugal
3
0
20. Poland
4
0
19. Norway
77
18
18. Netherlands
8
0
17. Malta
10 0
10
16. SKT
15. Luxembourg
1
1
13. Italy
14. Latvia
0
12. Hungary 1
0
11. Greece
0 234
35
4
10
22
9. France 47
6
14
18
10. Germany
50
12
0
1
11
8. Finland
80
51
10
0
9
7. ET
8
0
7
6. Estonia
79
6
0
5
5. Denmark
4
0
3
4. Cyprus
65
17
2
0
11
1
3. Croatia
2. Belgium
1. Austria
IMPORTED
KIDNEY (IMPORTED AND GRAFTED)
DATA ON ORGAN EXCHANGE IN EUROPE
35
36
5
1
5
1
6
7
1
8
9
1
24
25
2
26
4
6
TOTAL IMPORTED
2
1
26. U.K.
1
1
3
2
1
2
23. Spain
25. Switzerland
0
22. Slovak R.
0
0
21. Slovenia
24. Sweden
0
20. Portugal
2
17. Netherlands
0
0
16. Malta
19. Poland
0
15. SKT
0
0
14. Luxembourg
18. Norway
0
13. Latvia
11
12. Italy
6
0
1
11. Hungary
10. Greece
1
1
1
23
51
2
22
9. Germany
4
21
0 1
20
8. France 1
19
0
9
18
7. Finland
3
17
0
16
6. ET
15
0
14
5. Denmark
13
0
3
12
4. Cyprus
11
0
10
10
3. Croatia
2
1
4
2. Belgium
14
3
4
2
2
1. Austria
IMPORTED
1
HEART (IMPORTED AND GRAFTED)
DATA ON ORGAN EXCHANGE IN EUROPE
15
16
2
17
18
4
19
20
4
21
4
22
23
24
25
26
3
53
TOTAL IMPORTED
0 0 0 2
21. Slovenia
22. Slovak R.
23. Spain
24. Sweden
26. U.K.
0
1
0
20. Portugal
25. Switzerland
0
19. Poland
1
1
0
1
16. Malta
18. Norway
0
15. SKT
0
0
14. Luxembourg
17. Netherlands
0
5
12. Italy
13. Latvia
0
1
11. Hungary
10. Greece
0
14
9. Germany
13
0
1 (SB)
12
8. France
1
30
11
0
3
3
10
7. Finland
6
9
0
2
8
6. ET
7
0
6
5. Denmark
5
0
4
4. Cyprus
3
3
0
2
3. Croatia
2. Belgium
1. Austria
IMPORTED
1
DATA ON ORGAN EXCHANGE IN EUROPE LUNG / SMALL BOWEL (SB) (IMPORTED AND GRAFTED)
37
38
5
16
18
19
20
1
22
13
23
24
25
26
41
14
TOTAL IMPORTED
0 0 0 0 0 0 0
20. Portugal
21. Slovenia
22. Slovak R.
23. Spain
24. Sweden
25. Switzerland
26. U.K.
28
17. Netherlands
0
0
16. Malta
19. Poland
0
15. SKT
0
0
14. Luxembourg
18. Norway
0
13. Latvia
9
0
12. Italy
5
0
11. Hungary
1
0
1
1
3
21
10. Greece
3
11
2
17
18
8
15
9. Germany
14
0
13
8. France
12
0
11
7. Finland
10
0
24
7
9
6. ET
8
0
5
7
5. Denmark
6
0
5
4. Cyprus
4
0
3
3. Croatia
2. Belgium
2
2
1. Austria
IMPORTED
1
PANCREAS (IMPORTED AND GRAFTED)
DATA ON ORGAN EXCHANGE IN EUROPE
COUNCIL OF EUROPE
CONSEIL DE Lâ&#x20AC;&#x2122;EUROPE
International data on tissue and hematopoietic stem cell transplant activity Year 2004
39
40
644 (82.6)
7015 (899.3)
Nº Grafted Patients (pmp)
Nº Bank Processed Pieces (pmp)
91 (11.7)
132 (16.9)
174 (22.3)
76
Nº Cadaveric donors (pmp)
Nº Grafted Patients (pmp)
Nº Bank Processed Pieces (pmp)
Percentage of Desestimation
Types of Tissues Distributed: Tendon %
Types of Tissues Distributed: Bone % (frozen/freeze-dry/ demineralizated)
Percentage of Desestimation
106 (13.6)
Nº Living D. (pmp)
141 (12.8)
46 (4.2)
11
7.8
478 (61.3)
GREECE
BULGARIA
250 (37)
14 (2.1)
6.8
ISRAEL
11953 (209.7)
4953 (86.9)
6471 (113.5)
7513 (131.8)
3380 (59.3)
2207 (38.7)
191 (3.4)
56.99
ITALY 38.23
10
21
PORTUGAL ROMANIA
12 (3.5)
28 (8.2) 178 (4.7)
716 (18.7)
15
556 (55.6)
356 (35.6)
Corneas
11944 (312.4)
73 (3.47)
7 (0.33)
31
69
26 (1.23)
18 (0.85)
4 (0.19)
Musculo Skeletal Tissue
TISSUE ACTIVITY INDICATORS
15 (4.4)
3.4
LITHUANIA POLAND
76 (38)
2
SLOVENIA
14
4316 (99.9)
2961 (68.5)
2268 (52.5)
9.8
90.2 (61.3/ 38.7)
8192 (200.2)
5970 (138.2)
2829 (65.5)
506 (11.7)
43.2
SPAIN
45 (6.25)
7.2
SWIZERLAND
1533 (95.8)
848 (53)
1726 (107.9)
6
94 (22/19/53)
5665 (354.1)
1068 (66.7)
1996 (124.7)
101 (6.3)
16
1666 (24.5)
2043 (30)
2043 (30)
67.8
T. NETHERLANDS TURKEY
2454 (41.6)
1903 (32.3)
59
U. K.
Nº Cadaveric donors (pmp)
COUNTRIES Population (million inhabitants)
21
Valves
Types of Tissues Distributed: Tricuspid/ Mitral %
40/ 60
41.1/ 58.9
299 (6.9)
Types of Tissues Distributed: Aortic/ Pulmonary %
287 (7.5)
154 (3.5)
175 (4.05)
29.7
512 (9)
Nº Bank Processed Pieces (pmp)
3 (0.86)
10 (2.9)
Percentage of Desestimation
119 (2.1)
265 (4.6)
Nº Grafted Patients (pmp)
Nº Living Donors (pmp)
Nº Cadaveric Donors (pmp)
41.05
Types of Tissues Distributed: Vein 4.8
95.2
58.95
147 (3.4)
99 (2.3)
176 (4.07)
43.2
SPAIN
Types of Tissues Distributed: Artery
176 (4.6)
11 (0.3)
Vascular Tissue
2
SLOVENIA
20.9
47 (7)
7 (2.1)
7
38.23
PORTUGAL ROMANIA
TISSUE ACTIVITY INDICATORS
10 (2.9)
3.4
LITHUANIA POLAND
Percentage of Desestimation
972 (17.1)
Nº Bank Processed Pieces (pmp)
56.9
166 (2.9)
6.8
ITALY
Nº Grafted Patients (pmp)
11
7.8
ISRAEL
168 (2.9)
GREECE
BULGARIA
Nº Cadaveric donors (pmp)
COUNTRIES Population (million inhabitants)
17 (2.36)
7.2
SWIZERLAND
12 (0.75)
342 (21.4)
16
7 (0.1)
7 (0.1)
67.8
T. NETHERLANDS TURKEY 59
U. K.
41
42
11
7.8
GREECE
HUNGARY
99 (2.6)
Nº bank Processed Pieces (pmp)
4.4
7.8
12 3 – 15
Autologous Allogeneic related Allogeneic unrelated Total
115 17 4 136
CROATIA
BULGARIA
COUNTRIES Population (million inhabitants)
Types of Tissues Distributed: Other %
3176 671 311 4158
61.5
120 44 22 186
11
56.99
3.4
38.23
10
147 36 21 204
3209 886 387 4482
26 12 – 38
465 169 134 768
178 74 27 279
10 7 – 17
21
PORTUGAL ROMANIA
HEMATOPOIETIC STEM CELL TRANSPLANTS
10
ITALY
64
Types of Tissues Distributed: Keretinocytes %
147 (3.4)
83 (1.92)
2
159210 (3365.3)
55 (1.2)
68 (1.5)
43.2
SPAIN
36
LITHUANIA POLAND
14 (0.66)
8 (0.38)
6 (0.28)
2
SLOVENIA
Types of Tissues Distributed: Chondrocytes
14
Skin
Cell Cultures
52 (1.4)
14 (0.4)
Percentage of Desestimation
21
PORTUGAL ROMANIA
TISSUE ACTIVITY INDICATORS
38.23
LITHUANIA POLAND
Nº Grafted Patients (pmp)
Nº Living Donors (pmp)
FRANCE
81
Percentage of Desestimation
Nº Cadaveric donors (pmp)
308 (39.5)
Nº Bank Processed Pieces (pmp)
413939 (6916.8)
1122 (19.7)
296 (38)
Nº grafted patients (pmp)
217 (3.8)
56.9
ITALY
28 (0.5)
151 (22.5)
6.8
ISRAEL
Nº living donors (pmp)
352 (45.1)
GREECE
BULGARIA
50 12 8 70
2
SLOVENIA
58.6
12 (1.66)
29 (4.03)
7.2
SWIZERLAND
1429 413 131 1973
43.2
SPAIN
346 (21.6)
16
59
U. K.
309 122 41 472
7.2
264 – – 460
67.8
SWITZERLAND TURKEY
67.8
T. NETHERLANDS TURKEY
Nº Cadaveric donors (pmp)
COUNTRIES Population (million inhabitants)
COUNCIL OF EUROPE
CONSEIL DE Lâ&#x20AC;&#x2122;EUROPE
Documents produced by the Transplant Committee of the Council of Europe Year 2004
43
GUIDE TO SAFETY AND QUALITY ASSURANCE FOR ORGANS, TISSUES AND CELLS - 2nd Edition (2004)
This Guide includes standards for procurements, preservation, processing and distribution of organs, tissues and cells. It is the first international text on this topic adopted by Health Authorities. ISBN: 92-871-5518-6 Format: 16 x 24 cm No. of pages: 95
SYNOPSIS The purpose of this guide is to provide guidance for all those involved in the transplantation to maximise the quality, and thereby the success rate, of transplants, and to minimise the risks to all involved in this complex procedure. It includes safety and quality standards for procurement, preservation, processing, and distribution of organs, tissues and cells of human origin (allogeneic and autologous) used for transplantation purposes. As the European Union Directive on Tissues and Cells (2004/23/EC) was recently adopted, the European Commission will build on the Council of Europeâ&#x20AC;&#x2122;s guide when establishing technical standards under the directive. This co-operation will ensure that the same standards are applied throughout Europe.
CONTENTS 1. Introduction. 2. Quality management: principles for ensuring the quality of organs, tissues and cells. 3. Selection of donors. 4. Organ procurement and preservation. 5. Tissue and cell procurement. 6. Tissue establishments. 7. Transplantation practices. Appendices.
http://www.coe.int/T/E/Social_Cohesion/Health/Activities/Organ_transplantation/ 44
RECOMMENDATION REC(2004)19 OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON CRITERIA FOR THE AUTHORISATION OF ORGAN TRANSPLANTATION FACILITIES Adopted by the Committee of Ministers on 15 December 2004 at the 909th meeting of the Ministers’ Deputies
The Committee of Ministers, under the terms of Article 15.b of the Statute of the Council of Europe, Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued inter alia by the adoption of common action in the health field; Taking into account Resolution No. R (78) 29 on harmonisation of legislation of member states relating to removal, grafting and transplantation of human substances, the final text of the 3rd Conference of European Health Ministers (Paris, 16-17 November 1987); Articles 19 and 20 of the Convention of Human Rights and Biomedicine, and Articles 3 and 4 of the Additional Protocol to the Convention on Human Rights and Biomedicine, on Transplantation of Organs and Tissues of Human Origin;
– member states should therefore provide highquality transplant services for the benefit of their citizens. Considering the limited organ supply, all necessary steps should be taken to make sure all available organs are properly safeguarded and used so as to maximise the benefit to patients; – the highest professional standards are to be maintained in the area of organ transplantation, Recommends that the governments of member states take all necessary measures to ensure the following: 1. An appropriate mechanism for the authorisation 1 of health care facilities carrying out organ transplantations 2 should be set up. In order to obtain authorisation these facilities should meet the following criteria:
Considering that:
– feasibility of programme, based on clinical need assessment and a documented estimate of organ supply, to ensure that projected activity levels are sufficient to maintain clinical expertise and programme quality;
– organ transplantation is a well-established, lifesaving, and effective treatment: a successful organ transplantation may be the only treatment available for some forms of end stage organ failure and is the most clinically and cost effective treatment for chronic renal failure; 1
– organ exchange and circulation of recipients among member states is becoming a more frequent phenomenon, and that a minimum common standard should be guaranteed to the citizens;
For the purpose of this Recommendation, the term «authorisation» refers to any appropriate mechanism for designating, authorising, accrediting or licensing health care facilities carrying out organ transplantations. 2 This Recommendation refers to the facilities where organs are being «implanted».
45
â&#x20AC;&#x201C; standards of vocational training of team members, and infrastructural conditions relating to availability of beds, intensive care facilities, and diagnostic and therapeutic back-up services (radiology, microbiology, immunology services, etc.), and to care provided by nursing, physiotherapy, social services and related medical professionals.
2. Medical professionals forming part of an organ transplant team should be properly qualified and their previous training in the field of transplantation should be documented and personalised. 3. A quality-management system should be put in place to evaluate performance against established national and/or international standards as applicable, and to ensure the quality of the process of organ procurement and transplantation, following the principles described in the Council of Europeâ&#x20AC;&#x2122;s Guide to safety and quality assurance for organs, tissues and cells. 4. Authorisations should be regularly reviewed against agreed quality criteria and standards, as well as against audit results. 5. Outcome results for each type of transplant should be within the margins of internatio-
46
nal registers, at an equivalent degree of complexity of patients. In order to guarantee clinical results and cost-effective performance, minimal yearly activity standards shall be established in order to maintain an active programme. 6. These minimal activity standards, required to keep active each kind of transplant programme, should be related to the mean number of cadaveric organs available to the transplant team in recent years. 7. Any transplant centre which, after several warnings, continues to fail to meet activity or outcome criteria may have its authorisation withdrawn. 8. No new transplant centre may be authorised if there are not enough organs available to enable a new centre to reach the required standards. 9. Any new transplant centre should be authorised, accredited or licensed on the basis of agreed criteria and initially should be limited in time. If, within an agreed timescale, the new centre does not achieve the required standards, authorisation shall be withdrawn.
RECOMMENDATION REC(2005)11 OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON THE ROLE AND TRAINING OF PROFESSIONALS RESPONSIBLE FOR ORGAN DONATION (TRANSPLANT «DONOR CO-ORDINATORS») Adopted by the Committee of Ministers on 15 June 2005 at the 930th meeting of the Ministers’ Deputies
The Committee of Ministers, under the terms of Article 15.b of the Statute of the Council of Europe, Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued, inter alia, by the adoption of common action in the health field; Taking into account Resolution (78) 29 on the harmonisation of legislation of member states relating to removal, grafting and transplantation of human substances, the final text of the 3rd Conference of European Health Ministers (Paris, 16 and 17 November 1987); Articles 19 and 20 of the Convention on Human Rights and Biomedicine, and Articles 3 and 4 of the Additional Protocol to the Convention on Human Rights and Biomedicine concerning Transplantation of Organs and Tissues of Human Origin, and principles established in the 1998 Council of Europe consensus document entitled «Meeting the organ shortage»; Considering that organ transplantation is a well-established, life-saving, and effective treatment: a successful organ transplant may be the only treatment available for some forms of end stage organ failure and is the most clinically effective and cost-effective treatment for chronic renal failure; Considering the universal shortage of organs for transplantation;
Considering that the transplant process is complex, involves various services and therefore requires effective organisation and co-ordination of health care professionals; Bearing in mind that in many member states the training and employment of health care professionals responsible for detecting potential deceased organ donors and organising the donation process has increased the efficiency of the procurement of organs and improved the functioning of local and national transplant systems; and that such professionals can also increase the rate of donation of tissues for transplantation, Recommends that the governments of member states take the measures contained in the appendix to this recommendation as regards the role and training of professionals responsible for organ donation (transplant «donor co-ordinators»).
APPENDIX TO RECOMMENDATION REC(2005)11 1. A professional responsible for the identification of potential deceased organ and/or tissue donors should be appointed in every hospital with an intensive care unit. This professional should have appropriate training and experience, be independent of any transplant teams, and have 47
clearly defined responsibilities for the establishment, management and audit of a hospital-based system for potential deceased donor identification and organ/tissue procurement. The person should also be responsible for monitoring the donation and procurement process and for identifying and implementing improvements. For the purposes of this recommendation, the professional will be termed a transplant ÂŤdonor coordinatorÂť. 2. Donor co-ordinators should be properly accountable to senior management of the relevant health institution and to any regional or national
48
transplant organisations. Donor co-ordinators may be complemented by, or responsible to, other transplant co-ordinators at regional or national level. 3. Donor co-ordinators, and any other transplant co-ordinators should have a high standard of professional training consistent with internationally recognised standards, to ensure the highest possible professional and ethical standards in organ donation and procurement. Member states should establish formal national or international accreditation for donor co-ordination activities/donor co-ordinators.
MEMBERS OF THE TRANSPLANT COMMITTEE OF THE COUNCIL OF EUROPE AUSTRIA Ferdinand Mühlbacher BELGIUM Ludo Muylle Jean-Paul Squifflet BOSNIA AND HERZEGOVINA Marina Bera BULGARIA Yanko Nachkov CROATIA Mirela Busic CYPRUS George Kyriakides CZECH REPUBLIC Premysl Fryda Sylva Dusilova-Sulkova DENMARK Jorn Carlsen ESTONIA Peeter Dmitriev EUROTRANSPLANT Germany, The Netherlands, Austria, Belgium, Slovenia, Luxemburg Guido Persijn Bernard Cohen FINLAND Kaija Salmela FRANCE Bernard Loty GEORGIA Gia Tomadze GERMANY Günter Kirste GREECE Ioannis Boletis HUNGARY Jozsef Borsi Ferenc Perner IRELAND David P HicKey ISRAEL Tamar Ashkenazi Alain Berrebi ITALY Alessandro Nanni Costa Giuseppe Piccolo LATVIA Rafail Rozental
LITHUANIA Julija Shirokova MALTA Peter Cauchi NORWAY Per Pfeffer POLAND Janusz Walaszewski POTUGAL Manuel M. Abecasis Luisa Taveira RUSSIAN FEDERATION Nikolay V. TarabarKo ROMANIA Irinel Popescu SCANDIATRANSPLANTSLOVENIA Denmark, Sweden, Norway, Finland, Iceland Per Pfeffer Arnt Jakobsen SERBIA AND MONTENEGRO Sinisa Gradinac SLOVAK REPUBLIC Ludovit Laca SLOVENIA Danica Avsec- Letonja SPAIN Rafael Matesanz SWEDEN Hakan Gabel SWITZERLAND Philippe Morel TURKEY Bekir Keskinkilic THE NETHERLANDS Bernadette Haase-Kromwijk UNITED KINGDOM Chris Rudge Stephen Powis COUNCIL OF EUROPE (Secretariat) Alina Tatarenko Sophie-Marie Le Guilloux Jacqueline Lostao EUROPEAN COMMISSION Eduardo Fernandez-Zincke WHO Luc Nöel
49
A
G I F T
F O R
L I F E
14 October 2005 Palexpo, Geneva, Switzerland Council of Europe 7th European Day for Organ Donation and Transplantation 1st World Day for Organ Donation and Transplantation With the participation of the World Health Organization
Preliminary Program Morning:
Council of Europeâ&#x20AC;&#x2122;s 7th European day for organ donation and transplantation with participation of the Council of Europe Committee of Experts on Transplantation (SP-CTO)
10:00-10:55
Welcome from local, national and international representatives Council of Europe Role in Transplantation and Organ Donation
11:00 â&#x20AC;&#x201C; 11:45
Round table I: Quality of life after organ transplantation
11:55-12:40
Round Table II: Organ Donation: Ethical and religious aspects Handing the vase over to Turkey, which will host the 8th European Day in Istanbul
12:40-14:00
Lunch
Afternoon:
1st World day for organ donation and transplantation With the participation of the World Health Organisation (WHO)
14:00-14:45
Resolution WHA 57.18 of the 57th World Health Assembly (organ and tissue transplantation) will be brought by a transplanted sport-person from the WHO headquarters to Palexpo. The content of the resolution will be presented
14:50-15:35
Round Table III: Economical aspects of organ donation and transplantation
15:45-16:30
Round table IV: Access to organ transplantation worldwide
16:40-18:00
Closing ceremony: Launch of an international donor card Passage of the baton to the organizers of the 2nd World day for organ donation and transplantation (Argentina) Human chain of solidarity
18:00 Onwards:
Festive evening (concert, films)
A
G I F T
F O R
L I F E
14 October 2005 Palexpo, Geneva, Switzerland
Council of Europe 7th European Day for Organ Donation and Transplantation
1st World Day for Organ Donation and Transplantation With the participation of the World Health Organization
COUNCIL OF EUROPE
CONSEIL DE Lâ&#x20AC;&#x2122;EUROPE