Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
Organización Nacional de Trasplantes, Madrid, Spain.
Transplantation. 2018 Oct;102(10):1768-1778. doi: 10.1097/TP.0000000000002226.
The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs.
This is a retrospective analysis of 2001 to 2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the United States. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons.
According to the DCI and of the countries included in the study, Spain, France, and the United States had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally.
Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues.
百万人口的捐赠率（DR）对于比较国家间的器官捐献计划效率并不理想。DR 没有考虑到潜在的捐献能力的可变性，而潜在的捐献能力主要取决于导致脑死亡的原因造成的死亡人数。在本研究中，捐献活动与特定原因导致的死亡率相关联。基于这一指标，本研究评估了不同捐献计划的效率。
这是对 2001 年至 2015 年的器官捐献和死亡率登记数据进行的回顾性分析。研究包括 27 个欧洲委员会国家以及美国。计算了供者转化率指数（DCI），以评估不同时间点和国际比较中的捐献计划效率。
根据 DCI 和本研究中包括的国家，西班牙、法国和美国在 2015 年拥有最有效的捐献计划。尽管在研究期间大多数国家因所选原因导致的死亡率有所下降，但国际比较中的差异仍然存在。这表明，潜在的器官捐献及其转化为实际捐献在国际上还远远不够相似。
与 DR 相比，DCI 考虑了潜在的器官捐献，因此是一种更准确的表现指标。国家捐献计划可以通过确定失去潜在捐献能力的领域，并实施解决这些问题的措施来优化表现。
