Wits boosts organ donor numbers with new procurement strategy

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The Wits Transplant Unit substantially increased organ donor numbers after revising the way they communicate with families and medical staff after a potential donor died, reports a study in the SA Medical Journal.

The Times reports that the study, published by members of the Wits Transplant Unit team from the Donald Gordon Medical Centre, shows an increase in donations to the organisation from 25% to 73% in the last 18 months.

The report says they created a handbook for other donation centres to use in the hope of increasing the organ pool so patients in need could receive life-saving transplants.

According to the Organ Donor Foundation, there are about 4,300 people waiting for a life-saving organ or tissue transplants in South Africa, but only 0.2% of South Africans are registered organ donors. And of the 0.2%, only a fraction will donate their organs.

The report says in 2016, the Wits Transplant Unit was in a state of crisis. The unit is the largest solid-organ transplant unit in sub-Saharan Africa, but donations were low. The unit only performs kidney and liver transplants but coordinates other organ donations. The team decided to go back to the drawing board to improve procurement.

They came up with a model with two phases, the first being speaking to hospital staff to increase their referral rate and the other being to then convert the referral rate into consent by families for donation.

Marlize de Jager, a transplant coordinator and co-author of the article, is tasked with building relationships and educating medical staff at hospitals on the donation process. She also works directly with donor families to get consent to retrieve organs. “We found a lot of potential donors had fallen through the cracks. But now we have had increased referrals which have led to increased consent and increased donations.

Abstract
In 2016, deceased-donor organ procurement at Wits Transplant, based at Wits Donald Gordon Medical Centre in Johannesburg, South Africa (SA), was in a state of crisis. As it is the largest-volume solid-organ transplant unit in SA, and as we aspire to provide transplant services of an international standard, the time to address our procurement practice had come. The number of deceased donors consented through our centre was very low, and we needed a radical change to improve our performance. This article describes the Wits Transplant Procurement Model – the result of our work to improve procurement at our centre. The model has two core phases, one to increase referrals and the other to improve our consent rates. Within these phases there are several initiatives. To improve referrals, the threefold approach of procurement management, acknowledgement and resource utilisation was developed. In order to ‘convert’ referrals into consents, we established the Wits Transplant ‘Family Approach to Consent for Transplant Strategy’ (FACTS). Since initiation of the Wits Transplant Procurement Model, both our referral numbers from targeted hospitals and our conversion rates have increased. Referrals from targeted hospitals increased by 54% (from 31 to 57). Our consent rate increased from 25% (n=6) to 73% (n=35) after the initiation of Wits Transplant FACTS. We hope that other transplant centres in SA and further afield in the region will find this article helpful, and to this end we have created a handbook on the Wits Transplant Procurement Model that is freely available for download (http://www.dgmc.co.za/docs/Wits-Transplant-Procurement-Handbook.pdf).

Authors
M de Jager, C Wilmans, J Fabian, J F Botha, H R Etheredge

The Times report SA Medical Journal abstract

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