Exchange of best practices within the European Union: surgery standardization of abdominal organ retrieval.

Considering the growing organ demand worldwide, it is crucial to optimize organ retrieval and training of surgeons to reduce the risk of injury during the procedure and increase the quality of organs to be transplanted. In the Netherlands, a national complete trajectory from training of surgeons in procurement surgery to the quality assessment of the procured organs was implemented in 2010. This mandatory trajectory comprises training and certification modules: E-learning, training on the job, and a practical session. Thanks to the ACCORD (Achieving Comprehensive Coordination in Organ Donation) Joint Action coordinated by Spain and co-funded under the European Commission Health Programme, 3 twinning activities (led by France) were set to exchange best practices between countries. The Dutch trajectory is being adapted and implemented in Hungary as one of these twinning activities. The E-learning platform was modified, tested by a panel of Hungarian and UK surgeons, and was awarded in July 2013 by the European Accreditation Council for Continuing Medical Education of the European Union of Medical Specialists. As a pilot phase for future national training, 6 Hungarian surgeons from Semmelweis University are being trained; E-learning platform was fulfilled, and practical sessions, training-on-the-job activities, and evaluations of technical skills are ongoing. The first national practical session was recently organized in Budapest, and the new series of nationwide selected candidates completed the E-learning platform before the practical. There is great potential for sharing best practices and for direct transfer of expertise at the European level, and especially to export this standardized training in organ retrieval to other European countries and even broader. The final goal was to not only provide a national training to all countries lacking such a program but also to improve the quality and safety criteria of organs to be transplanted.

Results of a multilateral approach to donation-transplantation process in Hungary in the past 2 years.

Hungarotransplant Public Service Corporation, the national organ exchange organization, was established in 2001. The assessment of donation- and transplantation-related data allows the evaluation of the current situation and future trends. The donor reports show involvement of new hospitals and an increase in reported donors. These results are due to a new centralized organ referral system implemented by Hungarotransplant, employment of donation links in donor hospitals, training for key persons in intensive care units, and implementation of a Donor Action program, generating frequent and positive media attention. In 2002 the number of realized cadaveric donors increased by 21% and remained stable in 2003 despite the further increase in referrals. In 2002 the number of heart transplants remained the same, and liver transplant activity declined. In contrast, in 2003 the heart transplant activity rose by 33% and liver transplant activity by 82%. The multiorgan donation rate and the total number of transplanted organs have increased continuously. Our data demonstrate that organized multilateral efforts resulted in an immediate improvement in donation-transplantation activity in Hungary. However, the role of factors other than the shortage of organs, such as capacity problems and limited financial resources, are also highlighted.