DONOR & TRANSPLANT STATISTICS 217 SECTION BELGIAN TRANSPLANTCOORDINATORS BTS 217
BELGIAN TRANSPLANT COORDINATORS 217 President: D. Van Deynse (UCL) Vice-President: N. Mauws (UZG) Be-KPAC: G. Van Beeumen (UZA), N. Mauws (UZG) Be-ThAC: W. Van Donink (UZA), D. Claes (UZL) Be-LIAC: M.H. Delbouille (ULG), C. Walraevens (UZG) Be-OPC: M.H. Delbouille (ULG), N. Mauws (UZG), G. Van Beeumen (UZA), B. Desschans (UZL), A. De Grauwe (UZB), D. Van Deynse (UCL), J. Gyssens (Erasme) LDEP: N. Mauws (UZG) Belgian Transplant Council: D. Van Deynse (UCL), N. Mauws (UZG) Belgian Transplant Society: D. Van Deynse (UCL), N. Mauws (UZG) OPC Eurotransplant: B. Desschans (UZL) CSWG Eurotransplant: W. Van Donink (UZA) Financial Committee Eurotransplant: L. Colenbie (UZG) ETCO National Keymember: D. Van Deynse (UCL)
ACTIVITIES 217 EDHEP training: 5 (NL) & 3 (FR) sessions PRESENTATIONS: [CATEGORIENA AM] [PERCENTAGE] [CATEGORIENA AM] [PERCENTAGE] [CATEGORIENA AM] [PERCENTAGE]
REGISTER NATIONAL DATABANK 3 25 2 Registrations 15 1 5 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 PRO 27449 28999 3295 32557 5832 74331 88228 9898 14992 115744 156213 181194 24234 21125 247435 27723 CONTRA 192542 192867 193585 1934 19257 191668 192959 18979 18854 1878 18674 186324 186612 18734 19964 19366 PRO CONTRA
DECEASED ORGAN DONOR STATISTICS 217
DONORS PMI / BELGIUM 23,9 21,2 22,7 26 27,5 24,8 25,7 24,3 29,2 28,8 27,4 25,3 28 28,4 3,6 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
POTENTIAL DECEASED ORGAN DONORS 199 217 9 8 7 67 64 621 677 71 88 6 5 4 3 2 1 199 1991 1992 1993 1994 1995 1996 1997 1998 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 n
POTENTIAL DECEASED ORGAN DONORS 199 217 DBD VS DCD DBD DCD 9 8 7 6 5 4 254 348 3 2 456 46 1 216 217
EFFECTIVE DECEASED ORGAN DONORS 1994-217 4 35 3 25 5 28 38 42 6 45 6 7 65 8 16 95 13 4 23 196 214 227 193 238 8 = N 2 15 1 263 222 223 243 216 226 245 253 223 216 218 262 25 241 22 29 226 245 5 1994 1995 1996 1997 1998 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 DBD DCD n = 348
DONOR ORIGIN University Non-University 69 63 71 64 67 69 7 = % 31 37 29 36 33 31 3 211 212 213 214 215 216 217
EFFECTIVE DCD 25-217 = N 25 26 27 28 29 21 211 212 213 214 215 216 217 Euthanasie 1 1 1 2 1 1 3 3 4 8 5 5 DCD IV 1 1 1 2 2 1 DCD III 8 27 38 37 57 41 57 67 62 74 96 89 98 DCD II 2 1 1 1 3 3 1 n= 13
% EFFECTIVE ORGAN DONORS 199-217 1% 9% 8% 7% 57 6% 5% 4% 3% 2% 43 1% % 199 1991 1992 1993 1994 1995 1996 1997 1998 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Effective Refusals
% REASON OF NO DONATION 1991-217 4 36,4 35 3 = % 25 2 15 1 14,2 Family refusal Medical CI Objection Registry Objection coronor Other/unknown 5 1991 1992 1993 1994 1995 1996 1997 1998 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 3,3 2,3,5 217
DONOR PROFILE (DECEASED ORGAN DONORS)
AGE OF EFFECTIVE DONORS 199-217 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % 9 91 92 93 94 95 96 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 < 2 2-39 4-59 6+ Note number of donors 1994: 23 vs 217: 348
CHILDREN ( 15Y) 216-217 8 7 6 1 5 4 3 6 1 2 1 3 1 1 1 216 217 216 217 216 217 Y - 5Y 6Y - 1Y 11Y - 15Y DBD DCD
AGE OF ORGAN DONORS 217 Age DBD DCD Total Donor max 89 79 89 Donor min 2 Mediaan (IQR) 53 (39-65) 56 (47-66) 54 (42-66) Average 51 54 52 Age Heart Lung Liver Kidney Pancreas Oldest 217 68 81 89 81 5 Oldest 216 63 82 87 8 44 Oldest 215 66 79 91 79 22 Oldest 214 58 79 86 79 49
CAUSE OF DEATH DONORS 217 DBD & DCD DBD DCD TUMOR TRAUMA (ROAD ACCIDENT) TRAUMA (OTHER) SUICIDE (GUNSHOT) OTHER MENINGITIS INTOXICATION (SUICIDE) ICB EUTHANASIE CEREBRAL ISCHEMIA CARDIOVASCULAR ANOXIA / STRANGULATION 1 28 37 4 7 2 4 2 4 5 12 3 19 23 7 6 35 21 18 = N 2
ORGANS USED FOR TX 217 DBD VS DCD 5, 4,5 = n 4, 3,5 3, 2,5 2, 3,6 3,7 2,5 2, 3,8 2,4 3,7 3,5 3,4 2,7 2,7 2,7 3,4 3,3 3,3 2,6 2,3 2,3 3,1 2,7 3,6 2,5 1,5 1,,5, 27 28 29 21 211 212 213 214 215 216 217 DBD DCD
% USED ORGANS OF EFFECTIVE DONORS 1 9 8 7 82,7 74,4 6 % 5 4 3 2 1 36,8 23,6 4,9 28 29 21 211 212 213 214 215 216 217 Kidney Liver Lung Heart Pancreas 217 = 54% of the donors are a tissuedonor
STATISTICS 217 WAITINGLIST (WL) TRANSPLANTS (DECEASED DONORS) MORTALITY
HEART 217 Active WL 14 = n 12 1 8 6 58 67 59 76 95 89 11 117 13 4 2 33 34 32 29 34 43 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
HEART 217 TX Active WL 14 12 = n 1 8 89 73 7 73 72 75 68 68 76 77 75 82 82 7 79 6 4 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
HEART 217 14 12 1 8 = n 6 4 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Mortality 14 12 17 1 12 21 22 19 23 16 23 19 13 2 18 TX 89 73 7 73 72 75 68 68 76 77 75 82 82 7 79 Active WL 33 34 32 29 34 43 58 67 59 76 95 89 11 117 13
LUNG 217 Active WL 16 14 143 12 119 122 = n 1 8 76 95 9 81 85 82 12 6 4 59 46 6 56 52 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
LUNG 217 16 Single Lung Double Lung Active WL = n 14 12 1 8 6 4 2 126 12 118 18 99 99 97 93 93 79 67 53 41 44 36 34 28 28 19 21 21 15 11 12 9 2 5 6 3 3 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
LUNG 217 16 14 12 1 = n 8 6 4 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Mortality 1 1 8 7 5 6 9 7 9 1 16 11 1 7 8 Single Lung 28 28 19 34 21 15 11 21 12 9 2 5 6 3 3 Double Lung 41 36 44 53 93 67 79 93 99 12 99 97 18 126 118 Active WL 59 46 6 56 52 76 95 9 119 81 85 82 12 122 143
LIVER 217 Active WL 3 25 243 249 = n 2 184 185 176 189 191 193 172 181 184 187 172 174 21 15 1 5 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
LIVER 217 Split Liver Tx Full Liver Tx Active WL 3 25 2 212 183 189 25 229 199 28 27 255 25 254 23 247 255 26 = n 15 1 5 23 2 25 12 11 18 12 3 7 1 2 4 9 1 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
LIVER 217 3 25 2 = n 15 1 5 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Mortality 42 27 49 47 43 45 53 48 54 52 3 44 62 45 39 Split Liver Tx 23 2 25 12 11 18 12 3 7 2 1 4 1 9 Full Liver Tx 212 183 189 25 229 199 28 27 255 25 254 23 247 255 26 Active WL 184 243 249 185 176 189 191 193 172 181 184 187 172 174 21
KIDNEY 217 12 Active WL 1 8 852 936 955 911 84 813 866 914 883 791 77 878 813 797 849 = n 6 4 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
KIDNEY 217 12 Kidney en bloc Kidney Tx Active WL 1 8 = n 6 4 434 353 359 445 449 442 428 44 474 48 435 387 48 453 485 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
KIDNEY 217 12 1 8 = n 6 4 2 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Mortality 25 36 3 5 21 23 3 34 37 3 28 27 43 33 31 Kidney en bloc 1 2 11 7 8 6 7 4 7 4 2 4 Kidney Tx 434 353 359 445 449 442 428 44 474 48 435 387 48 453 485 Active WL 852 936 955 911 84 813 866 914 883 791 77 878 813 797 849
PANCREAS 217 5 Active WL 45 44 44 = n 4 35 3 25 25 24 36 27 36 28 26 32 37 4 37 2 19 15 1 5 24 25 26 27 28 29 21 211 212 213 214 215 216 217
PANCREAS 217 5 45 4 35 3 = n 25 2 15 1 5 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Islet Tx 18 14 5 13 12 12 7 15 19 9 7 11 12 8 Vascular Tx 24 24 26 19 19 13 22 18 13 8 11 9 11 14 Active WL 25 19 24 36 27 36 28 26 32 37 44 44 4 37 Mortaliteit 1 1 1 2 4 4 2 3
INTESTINE-TX 1999-217 Intestine Tx ( = n) 4 4 3 3 3 3 2 2 2 1 1 1 1 1999 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217
TRANSPLANTED VS PROCURED ORGANS 217 Transplanted Procured 3 5 14 17 79 82 = N 239 255 269 3 485 485 HEART LUNG LIVER KIDNEY PANCREAS INTESTINE Remark transplanted: 3 single lungtx, 9 split livers Remark procured: 1 single lungdonors, 12 split livers & 1x kidneys en bloc
LIVING DONOR
LIVING DONOR TRANSPLANTS 217 Kidney Liver 8 7 6 57 63 68 57 67 63 5 4 3 2 1 2 13 13 27 15 3 1 4 32 25 25 24 41 42 18 26 45 13 49 49 23 33 4 37 32 42 4 33 46 36 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 216 217 Living liver: 3 domino transplants
LIVING DONOR EXCHANGE PROGRAM RESULTS 213: no transplants 214: 2 couples transplanted 215: 5 couples transplanted 216: no transplants 217: no transplants
LIVING DONOR EXCHANGE PROGRAM (LDEP) 213-217 Old New 4 = N COUPLES 6 7 8 8 5 11 6 1 5 8 3 13 15 3 13 2 RUN 1 RUN 2 RUN 3 RUN 4 RUN 5 RUN 6 RUN 7 RUN 8 RUN 9 213 217: 9 runs / 46 participating couples Runs: 2x / year
LIVING DONOR EXCHANGE PROGRAM 217 Reason of participating Relationship donor - recipient Family 9% Grandpare nt 4% XM 53% ABO- inc 47% Friends 9% Sister/ brother 11% Partner 56% Parent 11% ABO- inc XM Partner Sister/brother Family Parent Friends Grandparent
CONCLUSIONS
CONCLUSION 217 VS 216 ORGAN DONATION DONOR Increase of 9% positive registrations in the national registry in 217 Highest number of potential donors (= potential + effective donors), increase of 12% Effective donors (+8%) : Stable amount of DBD donors: 7% DBD 83% is a liverdonor, 5% is a pancreasdonor Potential donors: 36% donor refusals for medical reasons (highest number) Slight increase of family refusals (14,2% vs 13,1% in 216)
CONCLUSION 217 VS 216 TRANSPLANTATION HEART Slight decrease of the waitinglist (-13%) Increase of transplantations (+11%) Lower mortality on WL (-1%) LUNG Waitinglist increases (+7%), number of transplantations decreases (-6%) LIVER Waitinglist and transplantations increase (+16% & +5%) Lower mortality on WL = -13% Decrease of living donation (-22%) lowest number since 215
CONCLUSION 217 VS 216 TRANSPLANTATION Kidney Slight increase of WL and transplantations (+6,5% & +7%) Slight decrease in living donation (-6%) Pancreas Decrease of WL (-7,5%) Increase in vascular transplantations (+27%), decrease in islets transplantation (-33%)