Kosieradzki M, Czerwinski J, Jakubowska-Winecka A, Kubik T, Zawilinska E, Kobryn A, Bohatyrewicz R, Zieniewicz K, Nyckowski P, Becler R, Snarska J, Danielewicz R, Rowinski W
Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland.
Transplant Proc. 2012 Sep;44(7):2176-7. doi: 10.1016/j.transproceed.2012.07.110.
Despite the long-standing history of transplantation, the shortage of organs has remained its most restrictive factor. In 2010, the number of actual deceased organ donors in Poland was 13.5/million population (pmp). However, a huge difference in organ recovery rates is evident between various regions, eg, 32 pmp, in western Pomerania compared with 1-3 pmp in southern districts. A substantial number of patients who die while awaiting organ transplantations could be saved were effective programs able to overcome barriers in deceased organ donation. Such programs, eg, the European Donor Hospital Education Program, Donor Action, European Training Program on Organ Donation, United States Collaborative in Donation were introduced several years ago, but after transient improvements there has not been real progress. A new comprehensive program-Regional Partnership for Transplantation-was initiated a year ago in 4 districts of southern Poland by the Polish Union for Transplantation Medicine. The letter of intent to activate the donation program was signed by the local administration, the president of the local medical school, president of the Physician's Chamber, transplant centers, the Polish Union for Transplantation, and the Polish Transplant Coordinating Center. The plan of action included training of in-hospital coordinators, visits to all regional hospitals in company of a representative of the hospital founding body, examination of the real donation pool and the need for participation in a donation program training and education of the hospital staff in legal and organizational aspects of donation, brain death recognition, and various aspects of donor care. In addition, the program included communication skills workshops for intensive care unit physicians (with participation of 2 actors, an experienced anesthesiologist, and a psychologist), lectures for high school and university students and for hospital chaplains as well as alumni of higher seminaries. The preliminary results (after the first year) showed 40%-70% increases in activity of the local hospitals in the organ donation process.
尽管移植手术有着悠久的历史，但器官短缺仍然是其最具限制性的因素。2010年，波兰实际的已故器官捐赠者数量为每百万人口13.5人（pmp）。然而，不同地区的器官回收率存在巨大差异，例如，西波美拉尼亚地区为32 pmp，而南部地区为1 - 3 pmp。如果有有效的项目能够克服已故器官捐赠中的障碍，那么大量在等待器官移植时死亡的患者本可以被挽救。这样的项目，如欧洲捐赠医院教育项目、捐赠行动、欧洲器官捐赠培训项目、美国捐赠协作项目等，在几年前就已推出，但经过短暂改善后并未取得实质性进展。一年前，波兰移植医学联盟在波兰南部的4个地区启动了一项新的综合项目——区域移植伙伴关系。地方行政部门、当地医学院院长、医师协会会长、移植中心、波兰移植联盟以及波兰移植协调中心签署了启动捐赠项目的意向书。行动计划包括培训医院内协调员，由医院创始机构的代表陪同走访所有地区医院，审查实际的捐赠库以及医院工作人员参与捐赠项目培训和教育在法律和组织方面、脑死亡识别以及捐赠者护理各个方面的需求。此外，该项目还包括为重症监护病房医生举办沟通技巧工作坊（有2名演员、一名经验丰富的麻醉师和一名心理学家参与），为高中生、大学生、医院牧师以及高等神学院校友举办讲座。初步结果（第一年之后）显示，当地医院在器官捐赠过程中的活跃度提高了40% - 70%。
