Spain has remained the undisputed leader in organ donation and transplant for the last 25 years or more.
Last year, it performed 5,000 deceased donor organ donations. If the Spain Transplant Model is considered to be the gold standard, it is because the government and society have invested a lot in developing the system and the procedures, says Maria Paula Gomez, executive director, TPM-DTI Foundation, a non-profit NGO in Barcelona, which has been training health-care professionals in Spain and other developing nations to become efficient Transplant Procurement Managers (TPMs).
Dr. Gomez, who is in the city on the invitation of the Kerala Network for Organ Sharing, talked to The Hindu.
If the reluctance of doctors to certify brain death in ICUs has almost brought Kerala’s once-robust deceased organ donation programme to its knees, in Spain, it is the health-care professionals who own and run the organ donation programme.
“The success of the Spanish model rests on three pillars — the structure and systems we have created over the past 40 years; the strong communication links between the system and Spanish society and the manner in which we train and engage our health-care professionals. The Organizacion Nacional de Trasplantes (ONT) was set up in 1989, which now has regional offices and a huge network of hospitals, each of which functions as a organ donation and transplant unit. Our ICU doctors, intensivists, emergency medicine specialists, all have to undergo a training programme in organ donation and transplant programme before they get their specialisation. Today, these doctors or TPMs are the ones who are fully responsible for running our organ donation programme,” said Dr. Gomez.
Issue in India
“The problem in India and in Kerala is not that the private sector is not doing more transplants but that the public sector is not doing enough. You have to invest in equipping and strengthening government hospitals and in training doctors so that they can do more deceased donor transplants and save lives,” Dr. Gomez said.
If the issue of brain death certification is what haunts Kerala’s organ donation programme, in Spain, this is a routine and mandatory procedure in the ICUs, whether organ donation takes place or not.
Doctor’s certification
“The treating doctor should certify that there is no point in continuing treatment and inform the family. This is important because there are enough salvageable patients waiting for ICU space and every life is precious,” Dr. Gomez said.