Organ donation and transplantation in Slovenia Role of ET

1. Organ donation and transplantation in SloveniaRole of ET Valentin Sojar, MD, FEBS, MBA, University Medical Center Ljubljana President, Slovenian Transplant Society

2. Challanges in transplantation • Small • Difficult match • HU impossible • Small • Easy to manage

3. Slovenia transplant • Competent authority • organs, tissues and cells • Central TX coordination • Mobile teams • brain death • surgical team

4. Donation

5. Transplantation

6. Actual situation

7. Kidney • 1300 pts EKD, • 650/PMP • 53 pts on waiting list • 22 PMPB – 73 PMP • 55 – 60 tx/y, • 27 – 30 PMPB – 38 PMP • No living donors B – 10 % • ????

8. Results • Results of treatment comparable • Smallnumberoftransplantations • Not enoughpts. on waitinglists • Exception

9. Heart • No. TX • Highest (9) / pmp • Long waiting list • New organization • Dept. for advanced heart failure in UMC Ljubljana • National center

10. Goals • Offer TX to all the patients in need • Donor • Recipient • Achieve comparable results of treatment

11. Future • Professional development • Organizational development • Give better opportunity for the patients

12. EU Directive on Organ Transplantation • Is it a positive change in the field of transplantation?

13. Answer • Makes people to redifine attitude • Explores existing situation • Raises positive effect

14. Role of ET • The best possible use of a donor organ • Localy • Regionaly • Nationaly • Internationaly

15. ET benefits • Best use of organs Best match • Waiting list mangement Strict rules • International excahange Balance of organs • HU patients management Time • Regular meetings Sharing knowledge • Exchange • Discussion • R & D

16. ET potential • Registries – national, international • Statistics • Adverse events • Data management • Logistical support • Profesional support • Export of good practices • expansion

17. Regionalization of ET?

18. Definition • Region? • ET – UNOS – UK – others • Voluntary / obligatory • Responsibilities (country, ET, personal) • Sanctions

19. Impact oforgan procurement organization on organ quality and exchange with Eurotransplant V. Sojar, UMC Ljubljana, Slovenia

20. Impact oforgan procurement organization on organ quality and exchange with Eurotransplant • Education • Formal ? • Equal ? • Certified ?

21. Quality • Education • Control • Trust

22. Trust • Same principles (language also) • Education • Personal • Formal

23. Slovenia • Small team (8 surgeons) • 6 – 12 y experience • Step wise involvement • Self education (experience) • Internal courses (the whole team) • International courses

24. Working principles • Donor/organ accepted by tx surgeon • Online contact during retrieval • Biopsy in doubt • Regular feedback • Regular update of protocols

25. Possible improvements • Certification (European diploma – EBS, Div. of Transplantation) • National • International • Respect of protocols • Regular feedback on potential risks and adverse events • Organ quality • Complication after tx • Logistics (coordination, comunication, transport) • Quality managment in ET • Board for quality assesment ? • Inspections ? • Funds • EU Directive

26. ET is not

27. ET is

28. Thank you

29. Danger