Assessing Barriers to the Involvement of Emergency Departments in Organ Donation

Abstract

Organ transplantation has become increasingly successful in terms of patient survival and is currently the best treatment option for patients with organ failure. With living donor opportunities only being available for certain organs, most efforts are aimed to increase donation rates from deceased donors. In various countries, including the Netherlands and Australia the government has implemented reforms with an aim to increase the number of organ donations for life saving transplants. In this thesis the Australian approach is being analysed and compared to the management of organ donation in the Netherlands, and the involvement of ED clinicians in Australia is analysed in detail in order to find methods that can be used to optimize the donation rate. Australia has historically had sub-optimal deceased donation rates and family consent rates compared to other countries in the developed world. Following the introduction of a national reform agenda in 2008 and the establishment of the DonateLife network in 2009 the number of organ donors has increased from 11.4 donors per million people in 2009 to 16.9 in 2013, a 48% increase. However, the number of people on the waiting list for an organ transplant has only decreased slightly from 1768 in 2009 to 1556 in 2013 and therefore the search for strategies to increase deceased donation continues.