Newsletter September 2005

NEWSLETTER SEPTEMBER 2005

TRANSPLANT Vol. 10. Nº 1

INTERNATIONAL FIGURES ON ORGAN DONATION AND TRANSPLANTATION - 2004

COUNCIL CONSEIL OF EUROPE DE L’EUROPE

FUNDACION RENAL IÑIGO ALVAREZ DE TOLEDO 2005 INTERNATIONAL FIGURES ON ORGAN, TISSUE & HEMATOPOIETIC STEM CELL DONATION & TRANSPLANTATION ACTIVITIES. DOCUMENTS PRODUCED BY THE COMMITTEE OF EXPERTS ON THE ORGANISATIONAL ASPECTS OF CO-OPERATION IN ORGAN TRANSPLANTATION (2004) Editors: Rafael Matesanz & Blanca Miranda

NATIONAL DATA PROVIDED BY:

– AUSTRALIA – ITALY – ARGENTINA Lee Excell Paola di Ciaccio Carlos Alberto Soratti – AUSTRIA – LATVIA – BOLIVIA Guido Persijn (ET) Sergej Trushkov www.gpuntacana.org – BELGIUM – LITHUANIA – BRASIL Guido Persijn (ET) Julija Shirokova Roberto Soares – BULGARIA – LUXEMBURG – CHILE Yanko Nachkov Guido Persijn (ET) Nelly de Lourdes Alvarado – CANADA – MALTA Jose Luis Rojas Kim Badovinac Tony Bugeja – COLOMBIA – CROATIA – NEW ZEALAND Rafael Romero Mirela Busic Lee Excell – CUBA – CYPRUS – NORWAY Alexander Marmol George Kyriakides Frank Pedersen (SKT) – DOMINICANA – CZECH REPUBLIC – POLAND www.gpuntacana.org Eva Pokorna Jaroslaw Czerwinski – ECUADOR – DENMARK – PORTUGAL Ignacio Ramirez Frank Pedersen (SKT) Luisa Taveira – EL SALVADOR – ESTONIA – ROMANIA www.gpuntacana.org Peeter Dmitriev Victor Gheorgue Zota – GRUPO PUNTA CANA – EUROTRANSPLANT (ET) – SCANDIATRANSPLANT (SKT) Argentina, Brasil, Bolivia, Germany, The Netherlands, Denmark, Sweden, Chile, Colombia, Costa Rica, Austria, Belgium, Slovenia, Norway, Finland, Iceland Cuba, Ecuador, El Salvador, Luxemburg Frank Pedersen Guatemala, Honduras, Guido Persijn (ET) – SLOVAK REPUBLIC México, Panamá, Paraguay, Marjan Slot Ludovit Laca Perú, Puerto Rico, – FINLAND – SLOVENIA Dominicana R., Uruguay, Frank Pedersen (SKT) Lea Lamjnet Venezuela – FRANCE Guido Persijn (ET) www.gpuntacana.org Ylana Chalem – SPAIN – GUATEMALA Philippe Tuppin Carmen Martin Rudolf A. García-Gallont – GEORGIA Mª Jose Lopez – MEXICO Gia Tomadze Carmen Cobo José Salvador Aburto – GERMANY – SWEDEN – PANAMA Guido Persijn (ET) Frank Pedersen (SKT) www.gpuntacana.org – GREECE – SWITZERLAND – PARAGUAY Georgia Menoudakou Diane Moretti Eduardo Wilson Martínez Marianthi Katsani – THE NETHERLANDS – PERU – HUNGARY Arnoud Sloof Carmen Fajardo Peter Borka Guido Persijn (ET) – PUERTO RICO – ICELAND – TURKEY E. Santiago-Delpín Frank Pedersen (SKT) Altay Köken – URUGUAY – IRELAND – UNITED KINGDOM Raul José Mizraji Phil Pocock Phil Pocock – VENEZUELA – ISRAEL – UNOS: USA Carmen Luisa Lattuf Sharona Bem Ami www.unos.org de Milanés

Data recorded & prepared by Organización Nacional de Trasplantes (ONT) – Spain Dr. Rafael Matesanz Dra. Blanca Miranda Ana García Marina Alvarez

Foot Note: For the purposes of this Newsletter the following definitions were used: Organ donor: Every potential donor transferred to the operating theatre from whom, at least, one solid organ has been retrieved Multiorgan donor: Every donor from whom, at least, two different solid organs have been retrieved Absolute number: Include all figures corresponding to all donors/patients adults and children Paediatric: Includes only paediatric activity (patients under 15 years old)

AULA MÉDICA EDICIONES. Paseo Pintor Rosales, 26. 28008 Madrid (España) 2 Tel. 91 542 09 55. Fax 91 559 51 72. Depósito legal: M- NEWSLETTER TRANSPLANT 2005

INTRODUCTION

FROM EUROPE TO OTHER PARTS OF THE WORLD

The outstanding work of the Transplant Committee of the Council of Europe in the field of organ, tissue and cells donation and transplantation for many years is now serving as a mo- del for other International bodies in other parts of the world for setting standards, obtaining accurate data of activity, and implementing new forms of organization.

UE has widely used the documents elaborated by this Committee for the tissue and cell directive. WHO is now in the phase of development of the 57th World Health Assembly Re- solution about Human Organ and Tissue Transplantation and certainly our experience will serve as a basis for the future work in Latin America or Asia.

TRANSPLANT NEWSLETTER is now the only official publication which provides data of organ donation and transplantation of everyday more and more countries all over the world. A wonderful example has been Latino America. Thanks to the cooperation of professionals and authorities of these countries and the coordinators of the GRUPO PUNTACANA, we

CONTENTS

•INTRODUCTION: FROM EUROPE TO OTHER PARTS OF THE WORLD 3

•INTERNATIONAL FIGURES ON ORGAN DONATION AND TRANSPLANTATION. YEAR 2004

•INTERNATIONAL DATA ON ORGAN DONATION, TRANSPLANTATION, WAITING LIST AND FAMILY REFUSALS. YEAR 2004

•INTERNATIONAL DATA ON TISSUES AND HEMATOPOIETIC STEM CELL TRANSPLANT ACTIVITY. YEAR 2004

•DOCUMENTS AND RECOMMENDATION PRODUCED BY THE TRANSPLANT COMMITTEEOFTHECOUNCIL OF EUROPE. YEAR 2004

–LINK TO: GUIDE TO SAFETY AND QUALITY ASSURANCE FOR ORGANS, TISSUES AND CELLS

–RECOMMENDATION REC (2004) 19 OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON CRITERIA FOR THE AUTHORISATION OF ORGAN TRANSPLANTATION FACILITIES

–RECOMMENDATION REC (2005) 11OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON THE ROLE AND TRAINING OF PROFESSIONALS RESPONSIBLE FOR ORGAN DONATION (TRANSPLANT «DONOR CO-ORDINATORS»)

started to publish their data and now we are the more accurate source of data for this con- tinent. The recent approval of the project of IBEROAMERICAN COUNCIL OF ORGAN DO- NATION AND TRANSPLANTATION which will serve to harmonize these activities in Spanish and Portuguese speaking countries can be considered as a reflex of this Committee at the other side of Atlantic ocean.

Information is an absolute need for taking decisions. It is a simple question of justice thank to all the people who provides these data every year from more and more countries. We all are contributing to provide these therapies everyday to more and more people all over the world.

Rafael Matesanz

COUNCIL CONSEIL OF EUROPE DE L’EUROPE

International Figures on organ donation and transplantation activity year 2004

5 8,8 11,4 2 0,9 13,6 0,5 10,2 20,9 6 17,8 16 14,7 10,2 13,7 20,5 13,4 22,6 18 19,6 21,1 13 11,9 12,6 2 15,5 21,8 21 13,8 16,7 22,1 34,6 CADAVERIC DONORS CADAVERIC Annual Rate p.m.p. 2004 22,2

6 11,9 21,4 3,6 1,8 25 0,9 16,5 36,8 10,5 30,9 27,3 18,4 28,4 25,5 24 39,3 42,4 27,5 37 30,6 25 24,1 22,6 20 25,9 33,9 36,7 24,4 36,7 TRANSPLANT 47,8 CADAVERIC KIDNEY CADAVERIC Annual Rate p.m.p. 2004 39,2

7 10 1,6 41,4 7,8 1,3 3,6 1 8 1,2 6,9 0,4 0,6 0,4 1,1 15,8 3,7 1,6 4,6 27,5 20,7 2,4 9,6 5,9 11,3 20 15,3 1,8 2,7 7,8 10,2 0,8 TRANSPLANT 1,4 LIVING KIDNEY Annual Rate p.m.p. 2004 2,9

8 100 85,1 65,9 68,2 41,6 12,5 2,5 6,55 88,8 1,3 39,5 2 0 3,7 38,1 8,6 6,1 9,8 0 35,8 7,1 27,8 19,7 31,6 0 37,1 5,1 6,7 24,3 2 % 100 2,8 LIVING KIDNEY TRANSPLANT / TOTAL TRANSPLANT / KIDNEY TRANSPLANT 6,6

9 6,6 6,7 0,1 9,6 0,8 2,6 5,2 4,3 14,8 8,1 9,7 16,1 7,5 9,8 18,2 7,8 10,7 14,8 11,7 22 15,1 3,6 11,5 24,1 LIVER TRANSPLANT Annual Rate p.m.p. 2004 20,5

10 2,5 0,4 0,1 4 0,4 0,2 0,5 2 1 2,7 3,4 4,7 1,8 7,8 1,5 7,4 6,2 5 4,5 4 2 7,4 5,2 3,1 6,8 HEART TRANSPLANT HEART Annual Rate p.m.p. 2004 Heart - Lung Transp. Included Transp. Heart - Lung 4,5

11 4,3 0,02 1,9 0,4 0,03 2,9 0,7 9,5 2,4 1,5 5,2 2,9 5 3,3 6,1 2,8 2,3 3,3 Single + Double Lung LUNG TRANSPLANT Annual Rate p.m.p. 2004 Heart - Lung Transp. Included Transp. Heart - Lung 0,1

12 1,3 0,5 2,5 0,1 0,4 1,2 0,9 5 2,4 2,2 1,6 2,3 1,5 1,3 4 1,7 1,3 1 1,7 Annual Rate p.m.p. 2004 PANCREAS TRANSPLANT PANCREAS –included all the combinations– 1,2

13 1,3 0,3 2,5 0,1 0,4 1,2 0,6 1,6 3,6 1,7 1 1,9 1,4 1,1 1,7 1,4 1,2 1 TRANSPLANT 1,4 KIDNEY-PANCREAS Annual Rate p.m.p. 2004 1,2

POPULATION: 31,9 millions (pmp) Cadaveric donors 414 (13),0 Cadaveric Kidney Transplant 603 (18,9) Living Kidney Transplant 413 (12,9) Liver Transplant 420 (13,2) Heart Transplant 146 0(4,6) Heart - Lung Transplant 3 0(0,1) S. Lung + D. Lung Transp. 135 0(4,2) CANADÁ Pancreas Transplant 61 0(1,9)

POPULATION: 20,1/4,1 millions Australia N. Zealand Cadaveric donors (pmp) 218 (10,8) 40 0(9,8) Cadaveric Kidney Transplant 405 (20,1) 58 (14,2) Living Kidney Transplant 246 (12,2) 48 (11,8) Liver Transplant 177 0(8,8) 36 0(8,8) Heart Transplant 78 0(3,8) 6 0(1,4) USA Heart - Lung Transplant 6 0(0,2) –0000–0 S. Lung + D. Lung Transp. 98 0(4,8) 12 0(2,9) Pancreas Transplant 31 0(1,5) 2 0(0,4)

POPULATION: 297 millions (pmp) Cadaveric donors 7.150 (24,1) Cadaveric Kidney Transplant 9.354 (31,5) AUSTRALIA Living Kidney Transplant 6.647 (22,4) Liver Transplant 6.168 (20,8) Heart Transplant 2.055 0(6,9) Heart - Lung Transplant 39 0(0,1) S. Lung + D. Lung Transp. 1.173 0(3,9) Pancreas Transplant 1.484 0(5),0

NEW ZEALAND

Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by 2004, 31st Dec. 2.975 667 129 181 154 Patients dead while on the WL during 2004 0.058 096 026 043 003 CANADÁ

Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by 2004, 31st Dec. 1.399 104 45 87 30 USA Patients dead while on the WL during 2004 –––––

Kidney Liver Heart Lung Pancreas Patients admitted to the waiting list AUSTRALIA during 2004 27.298 10.180 2.908 1.964 2.788 Patients awaiting for a transplant by 2004, 31st Dec. 61.924 17.336 3.309 3.659 4.159 Patients dead while on the WL during 2004 21.548 09.537 3.150 1.882 2.604 Kidney Liver Heart Lung Pancreas Patients awaiting for a transplant by NEW ZEALAND 2004, 31st Dec. 301 12 10 7 4

CADAVERIC DONORS Annual Rate p.m.p. 2004

3,1 14,1 21,8

0,3

1,9 6,8 6

3,2

7,7 1

0,3

0,2

8,9 10,8 19,2

CADAVERIC KIDNEY TRANSPLANT & / LIVING KIDNEY TRANSPLANT Annual Rate p.m.p. 2004 16,5 1,5 1,4 16 0 6,1 2,8 0,5 5,5

3,6 10 4,21 2,1 8,9 1,9

3,2 2,6

10,2 1,6 7,3 0,9 0 1,2

15,6 2,2 15,3 5 26,3

LIVING KIDNEY TRANSPLANTS / TOTAL KIDNEY TRANSPLANTS % 0 8,6 27,9 100 92

53,4 17,9 17,5

44,4

41,7 36,1

100

12,3 2,7 0

LIVER TRANSPLANT Annual Rate p.m.p. 2004

1 2,3 17,9

1,5

5,3 0,2

0,4

4,7 6,6

HEART TRANSPLANT Heart - Lung Transp. Included Annual Rate p.m.p. 2004 0,2 0,3 4,6

1,1

0,2

1,4 1,9 3,1

LUNG TRANSPLANT Single + Double Lung Heart - Lung Transp. Included Annual Rate p.m.p. 2004 0,3

1,8

0,1

0,2

0,4 0,8 0,3

PANCREAS TRANSPLANT –included all the combinations– Annual Rate p.m.p. 2004

2,8

0,4

0,1 0,2 1,6

COUNCIL CONSEIL OF EUROPE DE L’EUROPE

International data on organ and donation transplantation activity, waiting list and family refusals Year 2004

23 (10’5) (2’6) 1 56 (0’9)12 (0’2) 117 (1’42) 7 (0’08) 2423 (39’4) 8 (1’6) 2478 (30’07) 192 (17’4) 23 7 (0’1) 7 1 (0’02) 6 (0’1) 49 (0’8) 38 31 DONATION 7 (10) 33 (0’5) 2 (0’18) TRANSPLANTATION 95 (21.59) 1 (1.4) 404 (39’3) 35 (25) 2226 (36’2) 114 (10’4) 2181086878 8’2 10’4 7.8 4.4 0.7 10’3 5’4 1’4 5’2 61’5 5 8’4 11 (pmp) (Rate - pmp -) 185 (22’56) 227 (21’83) 7 (0.9) 59 (13.4) 8 (11.4) 211 (20’5) 64 (11’9) 19 (13’6) 109 (20’9) 1291 (21) 1075 (13’05) 66 (6) -Domino Liver TX(pmp)Living Liver TX (pmp)NHB Liver TX (pmp) 6 (0’73) 25 (2’40) 1 (0’10) 1 (0.13) 5 (0’48) 1 (0’1) 1 (0’2) 48 (0’8) 64 (0’78) -Single TX (pmp) -Double TX (pmp) Living TX (pmp)NHB kidney TX (pmp)Paediatric <15 years-Split Liver TX (pmp) 13 (1’59) 38 (4’6) 7 (0’67) 19 (1’8) 8 8 (0’98) 10 (1.3) 20 (1’92) 7 (1.59) 31 29 (41.4) 38 (3’7) 1 (0.13) 52 (9’6) 5 (3’6) 2 (0’2) (1) 5 164 (2’7) 8 (1’6) 3 489 (5’9) 76 (6’9) 11 4 51 91 COUNTRIESPopulation (million inhabitants) Cadaveric D. - included NHBD NHB Donors (pmp) donors% Multiorgan KIDNEY AUSTRIATX – included all the combinations - (pmp) BELGIUM 386 (47’07) 372 (35’77) BULGARIA CROATIA 24 (3) CYPRUS 3 (0,37) 76’8 113 (25.7) CZECH R. 5 (0’48) DENMARK 44 (62.8) ESTONIA 83’7 442 (43)LIVER FINLANDTX – included all the combinations - (pmp) FRANCIA 187 (34’6) 57 132 (16’10) GEORGIA 40 (28’6) 229 (22’02) 1 (0.13) GERMANY 197 (37’4) GREECE 83 43 (9.7)HEART TX-included Heart-lung transplant- (pmp)Paediatric <15 years 64 (7’8)HEART-LUNG (pmp)Transplants 77 (7’4) 83 (8’1)Paediatric <15 years 2 (0’19) 54 1 (0.13) 42 (7’8)LUNG TX – included all the combinations - (pmp) 8 (1.8)Paediatric <15 years 78 (9’51) 65’6 63 (6’06) 10 50 (9’6) 1 (0’12)PANCRE1AS 2 TX – included all the combinations - (pmp) 931 (15’1) 48 (4’7) 3 (0’29)Paediatric <15 years 41 (5) 56 TX (pmp)-Kidney - Pancreas 1 TX Alone (pmp)-Pancreas 24(4’5) 42 (4’04)SMALL BOWEL 96 11 (2.5)TX – included all the combinations - (pmp) 881 (10’69) 29 30 (3’66) 18 (1’73) 5 (0’61) 21 (4)MULTIVISCERAL 11 (2.5) 7 (0’7) 5 (0’48) 339 (5’6) 76’7 28 (5’2) 25 (2’4) (5) 412 10 (1’9) 6 (0’54) 1 (0’2) 17 (1’6) 167 (2’8) 8 (0’8) 2 (0’4) 240 (2’91) 22 (0’4) 103 (1’7) 14 (0’17) 86 (1’4) 192 (2’33) 17 (0’3) 163b (1’98) 20 (0’24) % (Living TX/ Total TX)% (Living TX/ Total Paediatric <15 yearsCadaveric TX (pmp) 9.8 14 348 (42’44) 5.1 353 (33’94) 14 (1.8) 16 106 (24) 41.6 15 (21.4) 6.1 404 (39’3) 135 (25) 65.9 35 (25) 192 (36’8) 8.6 2259 (36’7)-Single (pmp)-Double - included Heart/ Lung TX (pmp)NHB – double + single - Lung TX (pmp) 27.8 58 (7’1) 35 (3’4) 1989 (24’14) 116 12.5 2.5 20 (2’4)Paediatric <15 years 6.7-Liver + Small Bowel (pmp) 28 (2’7)-S. B. TX Alone (pmp) 100 19.7 4 (0’4) 39.5 6 (1’1) 3 (0’3) 7 (1’3) 22 (4’1) 120 (2) 3 (0’6) 196 (2’4) 47 (0’7) 44 (0’5)

24 48) 1 (0’1) 46 (4’6) 18 (0’5) 5 (0’5) 9 (0’43) 1 (0’03) 1 (0’03) 10 (0’1) (57’6) 1067 (27’9) 436 (43’6) 189 (9) MALTA NORWAY POLAND PORTUGAL ROMANIA LUXEMBURGO DONATION 3 (0’1) 1 1 39 (0’6)6 (0’1) 1 (0’02) (0’4) 2 1 (0’03) TRANSPLANTATION 23 (3’38) 40 (0’7) 10 0’3 3’9 6’8 56.9 2’3 3.4 0’5 0.4 4’6 38’2 10 21 (pmp) (Rate - pmp -) 160 (16) 5 8 (16’7) 86 (22’1) 60 (8’82) 1203 (21’1) 41 (17’83) 35 (10.2) 1 (2) (10) 4 90 (19’6) 562 (14’7) 222 (22’2) 10 (0’ Population (million inhabitants) NHB Donors (pmp) donors% Multiorgan 45Living TX (pmp)NHB kidney TX (pmp) 80Living Liver TX (pmp)NHB Liver TX (pmp) 11 (1’1) 75 1 (0’14) 3 (10’2) 3 (0’8) 83’7Paediatric <15 years 69 (10) 2’44 15 (6’53) 135 (2’4) 17.1 1 (0’44)-Double - included Heart/ Lung TX (pmp) 2 (0’29)NHB – double + single - Lung TX (pmp) 4 (1.2) 4 (0’4) 100 100 TX (pmp)-Kidney - Pancreas TX Alone (pmp) -Pancreas 24 (10’44) 6 (0’88) (10) 4 90 19 (0’3) 95 (20’7) 12 (1’2) 39 22 (0’6) 6 (0’88) 29 (2’9) 45 (0’8) 79’7 (8) 168 4 (1) 80 9 (1’32) 55 (1) 11 (2’4) 8 (1’7) 15 (0’4) 12 (1’2) 2 (0’1) COUNTRIESCadaveric D. - included NHBD KIDNEY HUNGARYTX – included all the combinations - (pmp) ICELAND 295 (29’5) IRELAND 3 (10’2) ISRAEL 146 (37’4) ITALY 81 (11’9) 1881 (33) LATVIALIVER 72 (31’31) LITHUANIA TX – included all the combinations - (pmp) 61 (17.7)Paediatric <15 years 43 (4’3)-Split Liver TX (pmp) 10 (20)-Domino Liver TX(pmp) 11 (27.5) 265 HEART TX-included Heart-lung transplant- (pmp) 45 (11’5)Paediatric <15 years 10 (1’0) 6 45 (6’61)HEART-LUNG 1035 (18’2) (pmp) Transplants LUNG TX – included all the combinations - (pmp)Paediatric <15 years 4 (0’4)-Single (pmp) 17 (2’5)PANCREAS TX – included all the combinations - (pmp) 6 353 (6’2)Paediatric <15 years 12 (1’2) 2 (0’29) 1 (0’44) 94 (1’6)SMALL BOWEL 61TX – included all the combinations - (pmp) 29 (4’26)Paediatric <15 years -Liver + Small Bowel (pmp) 85 (1’5) (1) 4 45 (9’8)-S. B. TX Alone (pmp) 2MULTIVISCERAL 199 (5’2) 9 (1’32) 205 (20’5) 14 94 (1’6) 16 (0’76) 1 34 (7’4) 105 (2’7) 4 45 (4’5) 4 (0’19) (0’2) 1 7 (0’1) 5 11 (2’4) 1 (0’03) 33 3 (0’3) 10 (0’1) 10 (2’2) 11 1 16 (0’4) 12 (1’2) 2 2 2 (0’1) 1 % (Living TX/ Total TX)% (Living TX/ Total Paediatric <15 yearsCadaveric TX (pmp)-Single TX (pmp)-Double TX (pmp) 3.7 13 284 (28’4) 100 284 (28’4) 2 143 (36’7) 10 81 (11’9) 138 (35’4) 85.1 1746 (30’6) 70 (10’29) 71 (30’87) 1564 (27’4) 14 57 (16.5) 7.1 71 (30’87) 5 (1’3) 57 (16.5) 10 (20) 40 1.3 (20) 8 170 (37) 6.55 1 101 (1’8) 8 (20) 1045 (27’3) 392 (39’2) 0 19 (0’9) 1045 (27’3) 391 (39’1) 35.8 1 2 9 6.6 31 88.8 10 7

25 ) 9354 (31’5) ’4) 2055 (6’9) 2) 36 (8’8) 6168 (20’8) 1 (0’03) (32’3) 1061 (33’2) 106 (26’1) 16001 (54) 1 46 792 TURKEY U. K. AUSTRALIA CANADA N. ZEALAND USA T. NETHERLANDS T. SWIZERLAND DONATION TRANSPLANTATION 5’4 2 43’2 9 7’2 16’3 67’8 59 20’1 31’9 4’1 297 (pmp) 2 (0’2) (Rate - pmp -) 55 (10’22) 36 (18) 1495 (34’6) 123 (13’7) 91 (12’6) 247 (15’5) 136 (2) 813 (13’8) 218 (10’8) 414 (13) 40 (9’8) 7150 (24’1) -Single TX (pmp)-Double TX (pmp)Living TX (pmp)NHB kidney TX (pmp)Paediatric <15 years-Split Liver TX (pmp)-Domino Liver TX(pmp)Living Liver TX (pmp)NHB Liver TX (pmp)Paediatric <15 years 55 (27’50) 2025 (46’9) 2 (0’4) 39 (0’9) 92 (2’1) 61 (1’4) 160 (22’2) 142 (15’8) 58 18 (0’4) 81 (11’3) 14 (0’3) 7 (0’2) 3 (0’4) 250 (15’3) (1) 9 12 (1’6) 243 (3’5) 6 (0’7) 5 (0’1) 13 529 (7’8) 171 (10’49) 1358 (23) 4 (0’6) 463 (7’8) 2 (0’3) 1 (0’01) 20 402 (19’9) 5 2 (0’3) 246 (12’2) 147 (2’5) 589 (18’4) 3 (0’18)-Liver + Small Bowel (pmp) 3 (0’04) 413 (12’9)-S. B. TX Alone (pmp) 54 (13’2) 6 (0’37) 8 (0’4) 2 133 (1’9) 48 (11’8) 11 8 (0’1) 2 (0’02) 10 (0’2) 6647 (22’4) 3 (0’1) 60 (1) 1 (0’04) 8 (0’49) 14 (0’4) 53 (1’7) 28 (1’3) 2 (0’03) 4 (0’9) 10 (0’3) 83 2 (0’4) 28 (0’5) 6 1 323 (1’1) 4 (0’1) 3 (0’1) 10 24 1 1 580 32 1 (0’01) 297 6 (0’1) 1 (0’02) 152 (0’5) COUNTRIESCadaveric D. - included NHBD NHB Donors (pmp) donors% Multiorgan KIDNEY TX – included all the combinations - (pmp) R. SLOVAK SLOVENIA 99 (18’4) SPAIN 55 (27’50) SWEDEN 32’73 2125 (49’2) 372 (41’3) 64 256 (35’5)LIVER TX – included all the combinations - (pmp) 673 (41’29) 775 (11’4) 83.5 1905 (32’3) 651 71 88’6HEART 15 (7’50)TX-included Heart-lung transplant- (pmp) 1040 (24’1) 80 133 (14’8) 11 (2’04)HEART-LUNG (pmp)Transplants 84 (11’7) 3 (1’50)Paediatric <15 years 53 109 (6’69) 6 (0’8)LUNG 294 (6’8)TX – included all the combinations - (pmp) 245 (3’6)Paediatric <15 years 31 (3’4) 111 (6’81)-Single (pmp) 731 (12’4) 17-Double - included Heart/ Lung TX (pmp) 1 (0’01) 177 (8’8) 29 (4)NHB – double + single - Lung TX (pmp) 87 (1’5)PANCREAS 420 (13’ 84TX – included all the combinations - (pmp) 32 (1’96)Paediatric <15 years 4 (0’2) 33 (0’4) 84 180 (3’1)SMALL BOWEL 143 (3’3)TX – included all the combinations - (pmp) 78 (3’8)Paediatric <15 years 26 (2’9) 102 (2’4) 85 146 (4’6) 7 (0’2) 36 (5) 7 (0’2) 7 (0’8)MULTIVISCERAL 6 (1 74 (1’7) 80 54 (3’31) 34 (4’7) 7 8 (0’9) 2 (0’02) 47 (2’9) 41 (0’9) 134 (2’3) 11 (1’5) 7 (0’2) 98 (4’8) 19 (2’1) 22 (1’35) 135 (4’2) 37 (0’5) 2 (0’3) 97 (1’6) 1 12 (2’9) 79 (1’3) 7 (0’4) 87 (4’3) 5 1173 (3’9) 31 (1’5) 1 2 (0’02) 106 (3’3) 61 (1’9) 10 (2’4) 37 (0’6) 2 (0’4) 15 (0’3) 11 (0’5) 2 (0’03) 1484 (5) 6 (0’2) 29 (0’9) 1 (0’01) 5 2 (0’4) 3 (0’09) 7 80’1) 4 39 (0’1) 1 (0’03) 6 152 (0’5) 54 % (Living TX/ Total TX)% (Living TX/ Total Paediatric <15 yearsCadaveric TX (pmp) 0 1 99 (18’4) 0 55 (27’50) 2064 (47’8) 230 (25’5) 2.8 163 (22’6) 68 423 (25’95) 246 (3’6) 38.1 1442 (24’4) 14 405 (20’1) 31.6 603 (18’9) 58 (14’2 6 37.1 68.2 38 TX (pmp)-Kidney - Pancreas TX Alone (pmp)-Pancreas 24.3 37.8 86 38.9 8 45.2 61 (1’4) 41.5 12 80’3) 5 (0’6) 3 (0’3) 10 (1’4) 1 (0’1) 18 (1’10) 21 (0’3) 4 (0’25) 764 69 (1’2) 16 (0’2) 23 (1’1) 10 (80’2) 5 (0’2) 45 (1’4) 2 (0’4) 16 (0’5) 880 (3) 604 (2) Population (million inhabitants)

26 408 4600 82 39 18 8141 4 9 29 1 3 WAITING LIST WAITING 114244 71411452 2112411 2212611 111121 1 8.2 10.4 10.29 0.7 5.4 1.4 5.2 61.53 5 82.4 11 4 Dec 805 936Dec 608 108 100 243Dec 75 403 46 34 23Dec 74 244 16 5626Dec 57 18 46 2 9270Dec 22 36 847 474 4 53 1021 Dec 277 6 41 1525 613 4 47 18 144 22 13 457 181 2 4 158 14 st st st st st st st Patients admitted to the WL during 2004Patients awaiting for a TX by 2004, 31 38 37 5 5 111 213 13 Patients dead while on the WL during 2004 during 2004ESRD on dialysis treatment 44 31Patients dead while on the WL during 2004 44 52 4504 5 26Patients dead while on the WL during 2004 19 240 7 3 12 3 16 5 2Patients dead while on the WL during 2004 13 115 2 11Patients dead while on the WL during 2004 1 3 482 103 5 4 87 8 43 288 172 1 15 2 44 13 108 Patients dead while on the WL during 2004 Patients dead while on the WL during 2004 Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 402 452Patients admitted to the WL during 2004Patients awaiting for a TX by 2004, 31 440 183 20 308Patients admitted to the WL during 2004Patients awaiting for a TX by 2004, 31 257 95 93 40 93Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 224 75 52 3032Patients admitted to the WL during 2004Patients awaiting for a TX by 2004, 31 100 33 66 50 2833 16 1160Patients admitted to the WL during 2004 23Patients awaiting for a TX by 2004, 31 371 429 1427 45 81 756 9 9 176 21 405 9 COUNTRIESPopulation (million inhabitants) KIDNEY NºTX CENTRES: AUSTRIA BELGIUMLIVER CZECH R.NºTX CENTRES: CYPRUS DENMARK ESTONIA FINLANDHEART NºTX CENTRES: FRANCIA GEORGIA GERMANY GREECEHEART-LUNG HUNGARY NºTX CENTRES: LUNG NºTX CENTRES: PANCREAS NºTX CENTRES: SMALL BOWEL NºTX CENTRES:

27 14 7 2 18 2 52536 11 32 7 16 1 1414 1 30 459 8 14 25 MALTA NORWAY POLAND PORTUGAL ROMANIA 190 15340 LUXEMBURGO WAITING LIST WAITING 1 3186 14214 2 1320 1317 0.3 3.9 6.8 56.99 2.3 3.4 0.5 0.4 4.6 38.23 10 21 131 11185 1163912 Dec 171Dec 21 497 130 6561Dec 121 1457 375 640 434Dec 6 14 85Dec 44 169 238 1201Dec 4 4 7 105Dec 22 1626 178 290 205 72 st st st st st st st Population (million inhabitants) Patients dead while on the WL during 2004 Patients dead while on the WL during 2004 during 2004 ESRD on dialysis treatment Patients dead while on the WL during 2004 29 188Patients dead while on the WL during 2004 12 27 4 137 24 93 1 13 38Patients dead while on the WL during 2004 73 1 42 8 Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 41 186 Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 220Patients admitted to the WL during 2004 2604Patients awaiting for a TX by 2004, 31 52Patients admitted to the WL during 2004 61Patients awaiting for a TX by 2004, 31 3 68 498 25 6 192 1190Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 432 35 213 8 35 COUNTRIESKIDNEY NºTX CENTRES: ICELAND IRELANDLIVER ISRAELNºTX CENTRES: ITALY LATVIAHEART NºTX CENTRES: LITHUANIA HEART-LUNG NºTX CENTRES: LUNG NºTX CENTRES: PANCREAS NºTX CENTRES: SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 118 1359Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 53 290 126 234 Patients dead while on the WL during 2004 Patients dead while on the WL during 2004 10 66 7

28 USA NEW ZEALAND 2 1 219 TURKEY U. K. AUSTRALIA CANADA 2 1 3 2604 T. NETHERLANDS T. SWIZERLAND WAITING LIST WAITING 211 3 3 18 1822 12645167 4 1 4246 252520243250 177891117 112433 1274121131 211734 1 259271141 1032 5.38 2 43.2 9 7.2 16.3 67.8 59 20.11 31.94 4.06 297 Dec 759 108Dec 7 4231 350 6Dec 3 488 701 116 16 17Dec 7904 113 86 5299 16 155Dec 1399 18 737 2975 45 301Dec 253 182 61924 104 145Dec 6 111 667 31 45 12 79 17 129 17336 86 1 10 1 6 3309 272 34 87 35 6 181 36 7 30 1 3659 154 4 4159 195 st st st st st st st Patients dead while on the WL during 2004 during 2004ESRD on dialysis treatment 70 1Patients dead while on the WL during 2004 1225 1 21031 1 6Patients dead while on the WL during 2004 1 163 18 5 6Patients dead while on the WL during 2004 111 36 15Patients dead while on the WL during 2004 34262 2 21 273 6 1Patients dead while on the WL during 2004 16 62 26 58Patients dead while on the WL during 2004 6 3 17 3 96 21548 14 26 1 9573 46 3150 43 1882 Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 224 38Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 3 357 12Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 9 282 1460 9 832 130 1403 115 394 2808 154 36 631 45Patients admitted to the WL during 2004 875Patients awaiting for a TX by 2004, 31 59 24Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 206 27298 98 10180 8 12 39 2 2908 5 26 14 2788 244 COUNTRIESKIDNEY NºTX CENTRES: R. SLOVAK SLOVENIA SPAINLIVER NºTX CENTRES: SWEDEN HEART NºTX CENTRES: HEART-LUNG NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 LUNG NºTX CENTRES: PANCREAS NºTX CENTRES: SMALL BOWEL NºTX CENTRES: Patients admitted to the WL during 2004 Patients awaiting for a TX by 2004, 31 1 209 38 41 88 1 205 1964 Population (million inhabitants)

COUNCIL CONSEIL OF EUROPE DE L’EUROPE

International data on tissue and hematopoeitic stem cell transplant activity Year 2004

31 TURKEY U. K. T. NETHERLANDS T. SWIZERLAND 8192(200.2)(61.3/ 38.7) 5665 (354.1) (22/19/53) 14 69 90.2 94 Corneas 15 31 9.8 6 Musculo Skeletal Tissue TISSUE ACTIVITY INDICATORS (61.3)(13.6)(82.6) (2.1) (3.4) (38.7) (59.3) (312.4) (0.19)(11.7) (4.2)(16.9) (0.85) (1.23) (37) (12.8) (11.7) (113.5) (65.5) (4.4) (138.2) (86.9) (6.3) (8.2) (124.7) (35.6) (18.7) (66.7) (0.33) (55.6) (3.47) (38) (52.5) (68.5) (6.25) (107.9) (30) (53) (32.3) (30) (41.6) 7.8 11 6.8 56.99 3.4 38.23 10 21 2 43.2 7.2 16 67.8 59 COUNTRIES BULGARIA GREECE ISRAELNº Cadaveric donors (pmp) ITALY 478 LITHUANIANº Living D. (pmp) POLAND PORTUGAL ROMANIANº Grafted Patients (pmp) SLOVENIA 106 SPAIN 14 644 Pieces Nº Bank Processed 7015 191 2207 3380 7513 Nº Cadaveric donors (pmp) 11944 91 4Nº Grafted Patients (pmp) 46 132 Pieces Nº Bank Processed (pmp) 26 250 174 141 18 of DesestimationPercentage 506 6471 76 15 4953 5970 (22.3) 2829 101 28 11953 356 716 12 1068 1996 7 556 178 (209.7) 73 (3.5) 76 2268 (4.7) 2961 45 1726 2043 4316 848 1903 2043 2454 1533 (99.9) 1666 (95.8) (24.5) (pmp) of Desestimation Percentage of Tissues Distributed: Types Bone % (frozen/freeze-dry/ demineralizated) (899.3) of Tissues Distributed: Types % Tendon (131.8) Population (million inhabitants)

32 TURKEY U. K. 12 (0.75) T. NETHERLANDS T. SWIZERLAND 147 (3.4) 20.9 4.8 29.7 40/ 60 Valves Vascular Tissue Vascular TISSUE ACTIVITY INDICATORS (2.9) (2.9)(2.9) (2.1) (0.3) (4.07) (2.3) (2.1) (0.86) (4.6) (3.5) (0.1) (7) (4.6) (2.9) (4.05) (2.36) (21.4) (0.1) 7.8 11 6.8 56.9 3.4 38.23 21 2 43.2 7.2 16 67.8 59 (pmp) of Desestimation Percentage of Tissues Distributed: Types Artery of Tissues Distributed: Types Vein (17.1) 58.95 7 of Tissues Distributed: Types Aortic/ Pulmonary % 41.05 of Tissues Distributed: Types Mitral % Tricuspid/ 41.1/ 58.9 95.2 Nº Grafted Patients (pmp) Pieces Nº Bank Processed 166 972 7 11Nº Grafted Patients (pmp) Pieces Nº Bank Processed (pmp) of Desestimation Percentage 99 119 512 3 176 287 (9) (7.5) 154 299 7 (6.9) COUNTRIES BULGARIA GREECE ISRAELNº Cadaveric donors (pmp) ITALY LITHUANIA POLAND PORTUGAL ROMANIA SLOVENIA SPAIN 168 10 Nº Cadaveric Donors (pmp) 47 265 176 10 175 17 342 7 Nº Living Donors (pmp) Population (million inhabitants)

33 TURKEY U. K. T. NETHERLANDS T. 29 (4.03) 58.6 SWIZERLAND 159210 (3365.3) 2 36 64 Skin Cell Cultures 14(0.4)99(2.6) 83 12 (1.92)14 (1.66) 147 (3.4) TISSUE ACTIVITY INDICATORS (0.5) (0.38) (45.1)(38) (22.5) (3.8) (19.7) (0.28) (1.4) (1.5) (0.66) (21.6) (1.2) 7.8 11 6.8 56.9 38.23 21 2 43.2 7.2 16 67.8 59 Nº grafted patients (pmp) 296 1122 52 14 55 COUNTRIES BULGARIA GREECE ISRAELNº Cadaveric donors (pmp) ITALY 352 LITHUANIANº living donors (pmp) POLAND PORTUGAL ROMANIA SLOVENIA SPAIN 151 Pieces Nº Bank Processed 308 217 Nº Cadaveric donors (pmp) 28 413939 6 8 68 346 (pmp) of DesestimationPercentage 81 (39.5)Nº Living Donors (pmp) Nº Grafted Patients (pmp) Pieces Nº bank Processed (pmp) of Desestimation Percentage (6916.8) of Tissues Distributed: Types Chondrocytes of Tissues Distributed: Types % Keretinocytes of Tissues Distributed: Types Other % Population (million inhabitants)

COUNCIL CONSEIL OF EUROPE DE L’EUROPE

Documents produced by the Transplant Committee of the Council of Europe 2004

35 GUIDE TO SAFETY AND QUALITY ASSURANCE FOR ORGANS, TISSUES AND CELLS - 2nd Edition (2004)

This Guide includes standards for procurements, preservation, processing and distribution of organs, tissues and cells. It is the first international text on this topic adopted by Health Authorities.

ISBN: 92-871-5518-6 Format: 16 x 24 cm No. of pages: 95

SYNOPSIS

The purpose of this guide is to provide guidance for all those involved in the transplantation to maximise the quality, and thereby the success rate, of transplants, and to minimise the risks to all involved in this complex procedure. It includes safety and quality standards for procurement, preservation, processing, and distribution of organs, tissues and cells of human origin (allogeneic and autologous) used for transplantation purposes.

As the European Union Directive on Tissues and Cells (2004/23/EC) was recently adopted, the European Commission will build on the Council of Europe’s guide when establishing technical standards under the directive. This co-operation will ensure that the same standards are applied throughout Europe.

CONTENTS

1. Introduction. 2. Quality management: principles for ensuring the quality of organs, tissues and cells. 3. Selection of donors. 4. Organ procurement and preservation. 5. Tissue and cell procurement. 6. Tissue establishments. 7. Transplantation practices. Appendices.

http://www.coe.int/T/E/Social_Cohesion/Health/Activities/Organ_transplantation/

36 RECOMMENDATION REC(2004)19 OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON CRITERIA FOR THE AUTHORISATION OF ORGAN TRANSPLANTATION FACILITIES

Adopted by the Committee of Ministers on 15 December 2004 at the 909th meeting of the Ministers’ Deputies

The Committee of Ministers, under the terms of Ar- – member states should therefore provide high- ticle 15.b of the Statute of the Council of Europe, quality transplant services for the benefit of their citizens. Considering the limited organ supply, all Considering that the aim of the Council of Euro- necessary steps should be taken to make sure pe is to achieve greater unity between its mem- all available organs are properly safeguarded and bers and that this aim may be pursued inter alia used so as to maximise the benefit to patients; by the adoption of common action in the health field; – the highest professional standards are to be maintained in the area of organ transplantation, Taking into account Resolution No. R (78) 29 on harmonisation of legislation of member states relating Recommends that the governments of member to removal, grafting and transplantation of human states take all necessary measures to ensure the fo- substances, the final text of the 3rd Conference of Eu- llowing: ropean Health Ministers (Paris, 16-17 November 1987); Articles 19 and 20 of the Convention of Human 1. An appropriate mechanism for the authorisa- Rights and Biomedicine, and Articles 3 and 4 of the tion1 of health care facilities carrying out organ Additional Protocol to the Convention on Human transplantations 2 should be set up. In order to Rights and Biomedicine, on Transplantation of Organs obtain authorisation these facilities should meet and Tissues of Human Origin; the following criteria:

Considering that: – feasibility of programme, based on clinical need assessment and a documented estimate – organ transplantation is a well-established, life- of organ supply, to ensure that projected ac- saving, and effective treatment: a successful or- tivity levels are sufficient to maintain clinical gan transplantation may be the only treatment expertise and programme quality; available for some forms of end stage organ failure and is the most clinically and cost effective treatment for chronic renal failure; 1 For the purpose of this Recommendation, the term «authori- – organ exchange and circulation of recipients sation» refers to any appropriate mechanism for designating, aut- among member states is becoming a more fre- horising, accrediting or licensing health care facilities carrying out organ transplantations. quent phenomenon, and that a minimum common standard should be guaranteed to the citi- 2 This Recommendation refers to the facilities where organs are zens; being «implanted».

– standards of vocational training of team nal registers, at an equivalent degree of com- members, and infrastructural conditions rela- plexity of patients. In order to guarantee clini- ting to availability of beds, intensive care cal results and cost-effective performance, mi- facilities, and diagnostic and therapeutic nimal yearly activity standards shall be back-up services (radiology, microbiology, im- established in order to maintain an active pro- munology services, etc.), and to care provi- gramme. ded by nursing, physiotherapy, social services and related medical professionals. 6. These minimal activity standards, required to ke- ep active each kind of transplant programme, 2. Medical professionals forming part of an organ should be related to the mean number of cada- transplant team should be properly qualified and veric organs available to the transplant team in their previous training in the field of transplanta- recent years. tion should be documented and personalised. 7. Any transplant centre which, after several war- 3. A quality-management system should be put in nings, continues to fail to meet activity or out- place to evaluate performance against establis- come criteria may have its authorisation with- hed national and/or international standards as drawn. applicable, and to ensure the quality of the process of organ procurement and transplantation, 8. No new transplant centre may be authorised if following the principles described in the Coun- there are not enough organs available to ena- cil of Europe’s Guide to safety and quality assu- ble a new centre to reach the required stan- rance for organs, tissues and cells. dards.

4. Authorisations should be regularly reviewed 9. Any new transplant centre should be authorised, against agreed quality criteria and standards, as accredited or licensed on the basis of agreed well as against audit results. criteria and initially should be limited in time. If, within an agreed timescale, the new centre do- 5. Outcome results for each type of transplant es not achieve the required standards, authori- should be within the margins of internatio- sation shall be withdrawn.

38 RECOMMENDATION REC(2005)11 OF THE COMMITTEE OF MINISTERS TO MEMBER STATES ON THE ROLE AND TRAINING OF PROFESSIONALS RESPONSIBLE FOR ORGAN DONATION (TRANSPLANT «DONOR CO-ORDINATORS»)

Adopted by the Committee of Ministers on 15 June 2005 at the 930th meeting of the Ministers’ Deputies

The Committee of Ministers, under the terms of Ar- Considering that the transplant process is complex, ticle 15.b of the Statute of the Council of Europe, involves various services and therefore requires effective organisation and co-ordination of health care pro- Considering that the aim of the Council of Euro- fessionals; pe is to achieve greater unity between its members and that this aim may be pursued, inter alia, Bearing in mind that in many member states the by the adoption of common action in the health training and employment of health care professionals field; responsible for detecting potential deceased organ donors and organising the donation process has in- Taking into account Resolution (78) 29 on the har- creased the efficiency of the procurement of organs monisation of legislation of member states relating and improved the functioning of local and national to removal, grafting and transplantation of human transplant systems; and that such professionals can substances, the final text of the 3rd Conference of also increase the rate of donation of tissues for trans- European Health Ministers (Paris, 16 and 17 No- plantation, vember 1987); Articles 19 and 20 of the Convention on Human Rights and Biomedicine, and Articles 3 Recommends that the governments of member and 4 of the Additional Protocol to the Convention states take the measures contained in the appendix on Human Rights and Biomedicine concerning to this recommendation as regards the role and trai- Transplantation of Organs and Tissues of Human ning of professionals responsible for organ donation Origin, and principles established in the 1998 Coun- (transplant «donor co-ordinators»). cil of Europe consensus document entitled «Meeting the organ shortage»;

Considering that organ transplantation is a well-es- APPENDIX TO RECOMMENDATION tablished, life-saving, and effective treatment: a suc- REC(2005)11 cessful organ transplant may be the only treatment available for some forms of end stage organ failure 1. A professional responsible for the identification and is the most clinically effective and cost-effective of potential deceased organ and/or tissue do- treatment for chronic renal failure; nors should be appointed in every hospital with an intensive care unit. This professional should Considering the universal shortage of organs for have appropriate training and experience, be in- transplantation; dependent of any transplant teams, and have

clearly defined responsibilities for the establish- transplant organisations. Donor co-ordinators ment, management and audit of a hospital-ba- may be complemented by, or responsible to, ot- sed system for potential deceased donor iden- her transplant co-ordinators at regional or natio- tification and organ/tissue procurement. The nal level. person should also be responsible for monito- ring the donation and procurement process and 3. Donor co-ordinators, and any other transplant for identifying and implementing improvements. co-ordinators should have a high standard of For the purposes of this recommendation, the professional training consistent with internatio- professional will be termed a transplant «donor nally recognised standards, to ensure the hig- coordinator». hest possible professional and ethical standards in organ donation and procurement. Member 2. Donor co-ordinators should be properly ac- states should establish formal national or inter- countable to senior management of the relevant national accreditation for donor co-ordination health institution and to any regional or national activities/donor co-ordinators.

40 MEMBERS OF THE TRANSPLANT COMMITTEE OF THE COUNCIL OF EUROPE

AUSTRIA LITHUANIA Ferdinand Mühlbacher Julija Shirokova BELGIUM MALTA Ludo Muylle Peter Cauchi Jean-Paul Squifflet NORWAY BOSNIA AND HERZEGOVINA Per Pfeffer Marina Bera POLAND BULGARIA Janusz Walaszewski Yanko Nachkov POTUGAL CROATIA Manuel M. Abecasis Mirela Busic Luisa Taveira CYPRUS RUSSIAN FEDERATION George Kyriakides Nikolay V. TarabarKo CZECH REPUBLIC ROMANIA Premysl Fryda Irinel Popescu Sylva Dusilova-Sulkova SCANDIATRANSPLANTSLOVENIA DENMARK Denmark, Sweden, Norway, Finland, Iceland Jorn Carlsen Per Pfeffer ESTONIA Arnt Jakobsen Peeter Dmitriev SERBIA AND MONTENEGRO EUROTRANSPLANT Sinisa Gradinac Germany, The Netherlands, Austria, SLOVAK REPUBLIC Belgium, Slovenia, Luxemburg Ludovit Laca Guido Persijn SLOVENIA Bernard Cohen Danica Avsec- Letonja FINLAND SPAIN Kaija Salmela Rafael Matesanz FRANCE SWEDEN Bernard Loty Hakan Gabel GEORGIA SWITZERLAND Gia Tomadze Philippe Morel GERMANY TURKEY Günter Kirste Bekir Keskinkilic GREECE THE NETHERLANDS Ioannis Boletis Bernadette Haase-Kromwijk HUNGARY UNITED KINGDOM Jozsef Borsi Chris Rudge Ferenc Perner Stephen Powis IRELAND David P HicKey COUNCIL OF EUROPE ISRAEL (Secretariat) Tamar Ashkenazi Alina Tatarenko Alain Berrebi Sophie-Marie Le Guilloux ITALY Jacqueline Lostao Alessandro Nanni Costa EUROPEAN COMMISSION Giuseppe Piccolo Eduardo Fernandez-Zincke LATVIA WHO Rafail Rozental Luc Nöel

A GIFT FOR LIFE

14 October 2005 Palexpo, Geneva, Switzerland

Council of Europe 7th European Day for Organ Donation and Transplantation

1st World Day for Organ Donation and Transplantation With the participation of the World Health Organization

Preliminary Program

Morning: Council of Europe’s 7th European day for organ donation and transplantation with participation of the Council of Europe Committee of Experts on Transplantation (SP-CTO)

10:00-10:55 Welcome from local, national and international representatives Council of Europe Role in Transplantation and Organ Donation

11:00 – 11:45 Round table I: Quality of life after organ transplantation

11:55-12:40 Round Table II: Organ Donation: Ethical and religious aspects Handing the vase over to Turkey, which will host the 8th European Day in Istanbul

12:40-14:00 Lunch

Afternoon: 1st World day for organ donation and transplantation With the participation of the World Health Organisation (WHO)

14:00-14:45 Resolution WHA 57.18 of the 57th World Health Assembly (organ and tissue transplantation) will be brought by a transplanted sport-person from the WHO headquarters to Palexpo. The content of the resolution will be presented

14:50-15:35 Round Table III: Economical aspects of organ donation and transplantation

15:45-16:30 Round table IV: Access to organ transplantation worldwide

16:40-18:00 Closing ceremony: Launch of an international donor card Passage of the baton to the organizers of the 2nd World day for organ donation and transplantation (Argentina) Human chain of solidarity

18:00 Onwards: Festive evening (concert, films)

A GIFT FOR LIFE

14 October 2005 Palexpo, Geneva, Switzerland

Council of Europe 7th European Day for Organ Donation and Transplantation

1st World Day for Organ Donation and Transplantation With the participation of the World Health Organization

COUNCIL CONSEIL OF EUROPE DE L’EUROPE