BACKGROUND Organ donation-rates using deceased donors and organizational approaches to organ donation differ drastically between countries at a similar level of health care as measured by the Euro Health Consumer Index (EHCI). MATERIAL AND METHODS Expert opinions from intensive care nurses, physicians, transplant coordinators and transplant surgeons from Austria, Germany, Spain, and the U.K. were obtained in semi-structured interviews followed by qualitative content analysis. Results were reported back to all interview partners to identify potential controversies and consensus recommendations. RESULTS No controversies could be detected. On a variety of beneficial factors an interprofessional consensus between interview partners could be reached: A) The relevance of standardization of the screening for potential donors, the family approach and training; B) standards and best-practice procedures should be regulated and supervised by state authorities; C) full transparency and the prevention of scandals is essential; D) overburdened intensive care unit (ICU) doctors need to be supported by full-time in-house special nurses who organize donor evaluation, transport logistics and pastoral care, if required; E) public awareness campaigns are helpful; F) a broad public consensus on the concept of donation after brain and cardiac death is essential; G) incentives for the reporting of potential organ donors are inappropriate; H) an opt-out system alone is not sufficient. CONCLUSIONS Expert opinions from different professional backgrounds from different European health care systems reach a broad consensus on the most relevant issues for the improvement of organ donation.

译文

背景器官捐赠-根据欧元健康消费者指数 (EHCI) 衡量,在医疗保健水平相似的国家之间,使用已故捐赠者的比率和器官捐赠的组织方法差异很大。材料和方法在半结构化访谈中获得了来自奥地利,德国,西班牙和英国的重症监护护士,医生,移植协调员和移植外科医生的专家意见,然后进行定性内容分析。结果已报告给所有访谈合作伙伴,以确定潜在的争议和共识建议。结果未发现任何争议。在各种有利因素上,可以在面试伙伴之间达成专业间共识: a) 筛选潜在捐助者的标准化,家庭方法和培训的相关性; B) 标准和最佳实践程序应由国家当局管理和监督; C) 充分透明和预防丑闻至关重要; D) 负担过重的重症监护病房 (ICU) 医生需要得到全职内部特殊护士的支持,这些护士在需要时组织捐助者评估,运输后勤和牧区护理; E) 公众意识运动是有帮助的; F) 对脑死亡和心源性死亡后的捐赠概念达成广泛的公众共识至关重要; G) 报告潜在器官捐献者的激励措施是不合适的; H) 仅选择退出系统是不够的。结论来自欧洲不同医疗体系的不同专业背景的专家意见在器官捐献改善最相关的问题上达成了广泛共识。

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