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Organ donation: Brazil saves record number of lives

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In 2017, country reached historical record of 16.6 effective donors per million inhabitants. For the first time, number of donors has grown for seven consecutive quarters
published: Jun 15, 2018 04:00 AM last modified: Jun 15, 2018 04:15 PM
Andre Gomes de Melo/ GERJ via Agência Brasil

Survey by the Brazil Government portal shows that the number of organ donors has reached record-breaking figures. The data was collected from the Brazilian Organ Transplant Association (ABTO) and shows that the country is experiencing the best donation scenario in 20 years.

In 2016, 25 thousand transplants were conducted, while in 2017 this figure reached 27 thousand. The figures shows that after a few years of downturn and small advances, the number of transplants is growing again.

In relation to the rate of effective donors - those who had organs transplanted to other people - up to 2017, this indicator grew for seven consecutive quarters - something not seen since 2009, when ABTO started publishing quarterly reports. As a result of this increase, in the last year's final quarter, the country reached a rate of 16.6 effective donors per million people (pmp).

For the president of the Brazilian Alliance for Organ and Tissue Donation (Adote), Rafael Paim, a number of factors have contributed to this improvement after years of living in a state of alert, with few donations.

According to Paim, one of the most important factors is the training of transplant teams. Among other activities, the training helped improve the way the possibility of donation was communicated to family members of the deceased.

Despite recent advances, work is far from over. At the end of last year, over 32.4 thousand adult patients were in the waiting list for an organ, in addition to another thousand children, who were also waiting for a transplant. Most of them (30 thousand adults and 785 children) were waiting for kidneys or corneas.

Pro-life task force

"Brazil has greatly increased training activities of donation teams", reports Paim. “Concrete evidence and data from around the world point out that donation rate increases range from 40% to 500% when comparing between trained and untrained staff", he states.

Two decrees signed by President of the Republic Michel Temer, one in 2016 and the other in 2017, were also essential for the increase in the effective donor rates. One of them establishes that a Brazilian Air Force (FAB) aircraft remain grounded to exclusively transport organs for transplants. Since the signing of the decree in June 2016, FAB has transported 512 organs: 235 livers; 143 hearts; 76 kidneys; 21 pancreas; 27 lungs; 6 bone tissues; and 4 spleens.

“These reasons add up when donor professionals see the federal government supporting the cause with say, an FAB plane to transport the organs", explains

the Adote president. “It is good for health professionals to know that they have more resources available to enable the efforts they make", he says.

Legislation that helps save lives

Decree 9,175 / 2017 regulates and details the criteria for brain death notification. With the decree, it is no longer mandatory for the notification to be delivered by neurologists, becoming the charge of other properly trained doctors. According to Rafael Paim, in the medium and long term, the figures show how this decree has contributed to making more donations effective.

Paim also reports that in 2016 and 2017, the number of brain death notifications were less than half they could have been in Brazil. He says that this was considered the main organ donation related problem in the last ten years. “A lot of the difficulty in donating occurs because there are not enough neurologists. Now, other suitably trained physicians are able to make the brain death call", he explains.

ABTO reports express an optimism that the numbers had not allowed for a long time. Since 2011, effective donor rates had been wavering, with constant moments of alert. Advances themselves were slow and targets were not met. “This year we saw donation grow again, with more effective donations and organ transplants. We have to enhance this effort so that in 2018, we reach 18 donors pmp", informed the association in the Brazilian Transplant Registry of the last quarter in 2017.