Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness

Danica Avsec; Jana Simenc

doi:doi:10.11648/j.ajhr.20210903.13

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Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness

Danica Avsec, Jana Simenc

Published in American Journal of Health Research (Volume 9, Issue 3)

Received: 29 March 2021 Accepted: 24 April 2021 Published: 21 May 2021

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Abstract

The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.

Published in	American Journal of Health Research (Volume 9, Issue 3)
DOI	10.11648/j.ajhr.20210903.13
Page(s)	82-88
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Deceased Organ Donation, Organizational System, National Competent Authority, Quality

References

[1]	Avsec D, Zupanic Slavec Z (eds). Development of transplant medicine in Slovenia: programmes, guidelines, perspectives. Ljubljana: Slovenija-transplant institute, Celjska Mohorjeva družba; 2016.
[2]	Lusicky P, Avsec D. The role of the Institute of the Republic of Slovenia for the transplantation of organs and tissues Slovenia-transplant in the donor program. Zdr. Vest. 2019; 88 (1-2): 3–20. Available at: https://vestnik.szd.si/index.php/ZdravVest/article/view/2833.
[3]	Primc D, Racki S, Arnol M, Marinovic M, Fucak-Primc A, Muzur A, Hawlina S & Markic D. The beginnings of kidney transplantation in South-East Europe. Acta clinica Croatica. 2020; 59 (1): 135–140. https://doi.org/10.20471/acc.2020.59.01.16.
[4]	Commission Directive (EU) 2015/566 implementing Directive 2004/23/EC as regards the procedures for verifying the equivalent standards of quality and safety of imported tissues and cells. Available at: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2015.093.01.0056.01.ENG.
[5]	Directive 2010/53/EU on standards of quality and safety of human organs intended for transplantation, Available at: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=LEGISSUM:sp0008.
[6]	Directive 2012/25/EU on information procedures for the exchange, between Member States, of human organs intended for transplantation. Available at: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32012L0025.
[7]	Act Regulating the Obtaining and Transplantation of Human Body Parts for the Purposes of Medical Treatment (ZPPDČT), Official Gazette of the Republic of Slovenia, no. 56/2015. Available at: http://www.pisrs.si/Pis.web/pregledPredpisa?id=ZAKO6624.
[8]	Kandus A, Arnol M, Bren F. A. Renal transplantation in Slovenia after joining Eurotransplant, Nephrology Dialysis Transplantation. 2006; 21 (1): 36–39. Available at: https://doi.org/10.1093/ndt/gfi277.
[9]	The Madrid resolution on organ donation and transplantation: National responsibility in meeting the needs of patients, guided by the WHO principles. Transplantation. 2011; 91 (11): 29–31.
[10]	Dominquez-Gil B, Delmonico L F (et al). The critical pathway for deceased donation: reportable uniformity in the approach to deceaed donation. Transplant International. 2011; 24: 373–8.
[11]	Avsec Letonja D, Voncina J (eds). Transplantation: donation programme. (in Slovene). Ljubljana: Slovenija-transplant, 2003.
[12]	Avsec D, Simenc J. Donor programme after circulatory death in Slovenia: Analysis of the views of professional community and future perspectives. Zdrav Vestn. 2020; 89 (5–6): 255–67. Available at: https://vestnik.szd.si/index.php/ZdravVest/article/view/2974.
[13]	Guide to the quality and safety of organs for transplantation. 7th ed. Strasbourg: EDQM, Council of Europe; 2018.
[14]	Lomero M et al. Donation after circulatory death today. An updated overview of the European landscape. Transplant International, 2019. Doi: https://doi.org/10.1111/tri.13506.
[15]	Bouwman R et al. Study on the uptake and impact of the EU Action Plan on Organ Donation and Transplantation (2009-2015) in the EU Member States. Luxemburg, European Union, 2017.
[16]	Avsec D. Donor and transplantation activity in time of Covid-19 epidemic. Isis, June 2020: 27–28.
[17]	Arnol M, Smrkolj T, Avsec D, Gadzijev A, Knezevic I. An increase in kidney transplantation procedures from deceased donors during the Covid-19 epidemic in Slovenia. Transplant International. 7 August 2020, doi https://doi.org/10.1111/tri.13715.
[18]	Donation and transplantation activity in Slovenia in 2020: factsheet and highlights. Available at: https://www.slovenija-transplant.si/?action=viewArticle&articleId=40.
[19]	Berzelak N, Avsec D, Kamin T. Reluctance and willingness for organ donation after death among Slovene general population. Slovenian journal of public health. 2019; 58 (4): 155–163. Available at: https://sciendo.com/article/10.2478/sjph-2019-0020.

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APA Style

Danica Avsec, Jana Simenc. (2021). Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. American Journal of Health Research, 9(3), 82-88. https://doi.org/10.11648/j.ajhr.20210903.13

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ACS Style

Danica Avsec; Jana Simenc. Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. Am. J. Health Res. 2021, 9(3), 82-88. doi: 10.11648/j.ajhr.20210903.13

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AMA Style

Danica Avsec, Jana Simenc. Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. Am J Health Res. 2021;9(3):82-88. doi: 10.11648/j.ajhr.20210903.13

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@article{10.11648/j.ajhr.20210903.13,
  author = {Danica Avsec and Jana Simenc},
  title = {Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness},
  journal = {American Journal of Health Research},
  volume = {9},
  number = {3},
  pages = {82-88},
  doi = {10.11648/j.ajhr.20210903.13},
  url = {https://doi.org/10.11648/j.ajhr.20210903.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20210903.13},
  abstract = {The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.},
 year = {2021}
}

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TY  - JOUR
T1  - Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness
AU  - Danica Avsec
AU  - Jana Simenc
Y1  - 2021/05/21
PY  - 2021
N1  - https://doi.org/10.11648/j.ajhr.20210903.13
DO  - 10.11648/j.ajhr.20210903.13
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 82
EP  - 88
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20210903.13
AB  - The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.
VL  - 9
IS  - 3
ER  -

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Author Information

Danica Avsec

Slovenija-transplant, an Institute of the Republic of Slovenia for Organ and Tissue Transplantation, Ljubljana, Slovenia
Jana Simenc

Slovenija-transplant, an Institute of the Republic of Slovenia for Organ and Tissue Transplantation, Ljubljana, Slovenia

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APA Style

Danica Avsec, Jana Simenc. (2021). Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. American Journal of Health Research, 9(3), 82-88. https://doi.org/10.11648/j.ajhr.20210903.13

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ACS Style

Danica Avsec; Jana Simenc. Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. Am. J. Health Res. 2021, 9(3), 82-88. doi: 10.11648/j.ajhr.20210903.13

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AMA Style

Danica Avsec, Jana Simenc. Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness. Am J Health Res. 2021;9(3):82-88. doi: 10.11648/j.ajhr.20210903.13

Copy | Download

@article{10.11648/j.ajhr.20210903.13,
  author = {Danica Avsec and Jana Simenc},
  title = {Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness},
  journal = {American Journal of Health Research},
  volume = {9},
  number = {3},
  pages = {82-88},
  doi = {10.11648/j.ajhr.20210903.13},
  url = {https://doi.org/10.11648/j.ajhr.20210903.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20210903.13},
  abstract = {The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness
AU  - Danica Avsec
AU  - Jana Simenc
Y1  - 2021/05/21
PY  - 2021
N1  - https://doi.org/10.11648/j.ajhr.20210903.13
DO  - 10.11648/j.ajhr.20210903.13
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 82
EP  - 88
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20210903.13
AB  - The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.
VL  - 9
IS  - 3
ER  -

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