Organ donation, a new subject developed in China towards professionalism
Wenshi Jiang1,2,3, Xiangxiang He1.
1Intelligence Sharing for Life Science Research Institute, Shenzhen, People's Republic of China; 2Institute of Transplantation Medicine, No. 923 Hospital of Chinese People's Liberation Army, Nanning, People's Republic of China; 3Quality Management Committee for Organ Transplant, Organ Transplant Physicians sector, Chinese Medical doctors’ Association , Beijing, People's Republic of China
Introduction: It has been 10 years since the kick-off of national pilot program of deceased organ donation (OD) in China. The number of deceased OD has increased from 34 in 2010 to 6302 in 2018, accounting for more than 15% of the global annual total. As described by World Health Organization, China has established a scientific-ethical system to foster the OD and organ transplantation (OT) practices. This paper provides a 10-year review for the development of OD in China at the professional level, aiming to look for the best practice in achieving self-sufficiency for OT through enhancing professionalism.
Materials and Methods: By reviewing the progress of promoting OD toward professionalism in the recent decade, from a professional prospective.
Results: In the past decade, foundation has been laid out for OD to be developed as a an interdisciplinary subject. Those include: 1) The legal framework: following the implementation of National Regulation on Human Organ Transplantation, the legal framework for OD and OT has also been built at the regional level. 2) Interdisciplinary integration: the practice of OD involves not only the knowledge in medicine, but also in law, ethics, health economy and social humanities. This integration has been reflected in the content of our clinical guideline and the multidisciplinary background of professionals participating daily. 3) The set-up of clinical pathway and dedicating teams for OD: The educational pathway for professionals in the field has been established. More than 2600 donation coordinators have been certified by China organ donation administrative center. Through the joint effort from the international and local group, more than 2000 Chinese medical staffs form ICU, emergency department, neurology, hospital management also received training for the filed. A selecting group of doctors in each region has been trained and certified by national authority. 4) Management model for OD was launched: In 2019, National Health Commission called for the construction of organ procurement organizations (OPOs) in the hospital/regional level, meanwhile, being independent with any transplant teams. 5) The implementation of quality-control system for OD has been put into practice, both at national/hospital level. Discussion: Even in many of well-developed countries in this field, actions have been taking continuously to improve OD rate. It is also the responsibility for local experts to absorb such valuable experience worldwide and to implement program that best fits to the local situation.
Conclusion: Sets of action have been taking in the country to promote OD as a new scientific subject. However, The OD rate per million population (4.53 in 2018) is far from satisfaction. In additional to the strong governmental support, professionalism is another key element and the next step in achieving self-sufficiency for OT for the country. Meanwhile, it is necessary to create an academic atmosphere and a clear career path for staffs in the fields.
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