Re: Organ transplantation rates in the UK. How to increase deceased organ donors
In January 2017, the former director of the Transplant Organization of Spain (ONT, according to its initials in Spanish) published a minireview on the success of the Spanish transplant model, the keys that define this model’s amazing growth and the Spanish leadership in organ transplantation activities [1].
The authors of that minireview note the following milestones that have defined transplantation activity in Spain:
“(i) promoting the identification and early referral of possible organ donors from outside of the intensive care unit to consider elective non-therapeutic intensive care and incorporate the option of organ donation into end-of-life care;
(ii) facilitating the use of organs from expanded criteria and non–standard risk donors; and
(iii) developing the framework for the practice of donation after circulatory death”.
Those authors then affirm that this article describes the actions undertaken in Spain and their impact on donation and transplantation activities.
However, although (i) + (ii) + (iii) produces a growth in the performance of transplants, this expression is missing a factor that, surprisingly, is omitted whenever the Spanish model of transplantation is promoted by the National Organ Transplant Organization.
Because economic rewards associated with transplantation have already been demonstrated [2], the incentive in euros for professionals involved in transplantation activities plays a substantial role in the Spanish model.
Thus, headlines such as "The Junta spends 8 million in bonuses for transplant professionals" [3] appear.
The most recent example illustrating this phenomenon is that porters of the Andalusian Health Service have claimed their right to partake of the economic benefits derived from transplantation activity [4].
Moreover, no criticisms of this model are observed; instead, there is a lack of transparency in the exposition of the Spanish system.
The key question is why economic rewards to professionals are not discussed in the context of attempts to promote the Spanish model of transplants.
Are economic incentives embarrassing?
Thus, the true answer to the question of “How Spain Reached 40 Deceased Organ Donors per Million Population” is (i) + (ii) + (iii) + (€).
That combination is the complete equation.
References
1 Matesanz R, Domínguez-Gil B, Coll E, Mahíllo B, Marazuela R. How Spain Reached 40 Deceased Organ Donors per Million Population. Am J Transplant. 2017 Jan 9. doi: 10.1111/ajt.14104.
2 Verdu F, Frances F, Castello A. Spanish transplantation model. Don't forget economics. BMJ. 2010 May 18;340:c2520. doi: 10.1136/bmj.c2520.
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Re: Organ transplantation rates in the UK. How to increase deceased organ donors
In January 2017, the former director of the Transplant Organization of Spain (ONT, according to its initials in Spanish) published a minireview on the success of the Spanish transplant model, the keys that define this model’s amazing growth and the Spanish leadership in organ transplantation activities [1].
The authors of that minireview note the following milestones that have defined transplantation activity in Spain:
“(i) promoting the identification and early referral of possible organ donors from outside of the intensive care unit to consider elective non-therapeutic intensive care and incorporate the option of organ donation into end-of-life care;
(ii) facilitating the use of organs from expanded criteria and non–standard risk donors; and
(iii) developing the framework for the practice of donation after circulatory death”.
Those authors then affirm that this article describes the actions undertaken in Spain and their impact on donation and transplantation activities.
However, although (i) + (ii) + (iii) produces a growth in the performance of transplants, this expression is missing a factor that, surprisingly, is omitted whenever the Spanish model of transplantation is promoted by the National Organ Transplant Organization.
Because economic rewards associated with transplantation have already been demonstrated [2], the incentive in euros for professionals involved in transplantation activities plays a substantial role in the Spanish model.
Thus, headlines such as "The Junta spends 8 million in bonuses for transplant professionals" [3] appear.
The most recent example illustrating this phenomenon is that porters of the Andalusian Health Service have claimed their right to partake of the economic benefits derived from transplantation activity [4].
Moreover, no criticisms of this model are observed; instead, there is a lack of transparency in the exposition of the Spanish system.
The key question is why economic rewards to professionals are not discussed in the context of attempts to promote the Spanish model of transplants.
Are economic incentives embarrassing?
Thus, the true answer to the question of “How Spain Reached 40 Deceased Organ Donors per Million Population” is (i) + (ii) + (iii) + (€).
That combination is the complete equation.
References
1 Matesanz R, Domínguez-Gil B, Coll E, Mahíllo B, Marazuela R. How Spain Reached 40 Deceased Organ Donors per Million Population. Am J Transplant. 2017 Jan 9. doi: 10.1111/ajt.14104.
2 Verdu F, Frances F, Castello A. Spanish transplantation model. Don't forget economics. BMJ. 2010 May 18;340:c2520. doi: 10.1136/bmj.c2520.
3 La Junta gasta 8 millones en pluses para profesionales de los trasplantes. Avalaible in http://www.elmundo.es/andalucia/2017/01/14/58793a8622601dfe4a8b45f9.html (accessed on 19.11.17)
4 Los celadores del SAS exigen su plus por participar en los trasplantes Avalaible in http://www.elmundo.es/andalucia/2017/02/06/58978253e2704e8d648b45e3.html (accessed on 19.11.17)
Competing interests: No competing interests