Newsletter Europe 2005

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