移植技術と研究

System Level Challenges and Resolutions in Organ Donation and Transplantation Program in Qatar

Abstract

Hassan Al-Thani, Tulika Mehta Agarwal, Rajvir Singh, Betsy Varughese, Yousuf Al-Maslamani and Ayman El-Menyar

Introduction: Organ donation and transplantation programs are affected by factors impacting donation decisions of individuals. These factors have been widely researched world over. However, few researches have studied the organ donation system level challenges that jeopardize the system even when prospective donors are available. It is important to understand these challenges and find appropriate resolutions for them. This qualitative study was conducted to understand the challenges and resolutions in the organ donation and transplant system of Qatar.
Methodology: Eight focus group discussions were carried out with homogenous groups of health care workers working in the field of organ donation or organ transplantation in Qatar. After consenting, they were asked open ended questions by an unbiased moderator. Each session lasted for 60-90 min and ended with session summary and participant feedback. The question workbooks were prepared after extensive review of literature and discussion with non-participating stake holders of the organ donation and transplant program in Qatar. Discussions were audio recorded, transcribed and later coded and analyzed on Nvivo software. COREQ checklist was used while reporting the results of this study.
Results: Underutilization of potential donors, organ donation campaign, brain dead donors, family consenting, living donation, infrastructure, staff training, allocation and recruitment were main system level challenges to resolve to ensure maximum utilization of potential donors and donated organs.
Conclusion: Inclusion of multidisciplinary teams during organ transplant, increased representation from departments doing transplants in transplant committee, minimizing wastage of available organs, streamlining the process of brain dead identification, declaration and maintenance of deceased organ, centralized facility for living donor work up and improved infrastructural facility were advocated to improve utilization of donated organs to resolve system level challenges. Improvement in after care and compliance in transplanted patients, registering higher number of donors and increasing family consent by ensuring communication of donation decision to family are the need of the hour.