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Transplantation the Official Journal of the Transplantation Society Supplement to June 15, 2011 ா Volume 91 Number 11S Transplantation The Official Journal of the Transplantation Society www.transplantjournal.com Contents - Note from the Secretariat ................................................... S27 - The Madrid Resolution on Organ Donation and Transplantation .................... S29 - Executive Summary ....................................................... S32 - Report of the Madrid Consultation Part 1: European and Universal Challenges in Organ Donation and Transplantation, Searching for Global Solutions ................... S39 - Report of the Madrid Consultation Part 2: Reports from the Working Groups ......... S67 - Working Group 1: Assessing Needs for Transplantation........................... S67 - Working Group 2: System Requirements for the Pursuit of Self-Sufficiency ........... S71 - Working Group 3: Meeting Needs through Donation ............................. S73 - Working Group 4: Monitoring Outcomes in the Pursuit of Self-Sufficiency ........... S75 - Working Group 5: Fostering Professional Ownership of Self-Sufficiency in the Emergency Department and Intensive Care Unit ........................................ S80 - Working Group 6: The Role of Public Health and Society in the Pursuit of Self-Sufficiency ........................................................ S82 - Working Group 7: Ethics of the Pursuit of Self-Sufficiency ......................... S87 - Working Group 8: Effectiveness in the Pursuit of Self-Sufficiency - Achievements and Opportunities .......................................................... S89 - Appendix 1: Expanded report on System Requirements for the Pursuit of Self-Sufficiency (Working Group 2) ......................................... S94 - Appendix 2: The Critical Pathway for Organ Donation after Death .................. S102 - Glossary of Terms ........................................................ S111 Participants Organizers: Steffen Groth and Luc Noe¨l, WHO; Rafael Matesanz and Beatriz Dominguez-Gil, ONT; Jeremy Chapman and Francis Delmonico, TTS. Working Group Leaders: Group 1: Assessing Needs for Transplantation; Christian Jacquelinet (France), Adeera Levin (Canada), Jha Vivekanand (India); Group 2: System Requirements for The Pursuit Of Self-Sufficiency, Curie Ahn (Korea), Martin Alejandro Torres (Argen- tina), Jose´ Ramo´nNu´n˜ez (Spain); Group 3: Meeting Needs through Donation: Francis Delmonico (United States), Beatriz Dominguez-Gil (Spain), Faissal Shaheen (Saudi Arabia); Group 4: Monitoring Outcomes in the Pursuit of Self-Sufficiency: John Gill (Canada), Axel Rahmel (The Netherlands), Naoshi Shinozaki (Japan); Group 5: Fostering Emergency Department and IC Professional Ownership of Self-Sufficiency: Alexander Capron (United States), Alex Manara (United Kingdom), Gerry O’Callaghan (Australia); Group 6: The Role of Public Health and Society in the Pursuit Of Self-Sufficiency: Jeremy Chapman (Australia), Gregorio Obrador (Mexico), Harjit Singh (Malaysia); Group 7: Ethics of the Pursuit of Self-Sufficiency: Nikola Biller Andorno (Switzerland), Rudolf Garcia-Gallont (Guatemala), Farhat Moazam (Pakistan); Group 8: Effectiveness in the Pursuit of Self-Sufficiency, Achievements, and Opportunities: Luc Noe¨l (WHO), Chris Rudge (United Kingdom), Anantharaman Vathsala (Singapore). Rapporteurs of the Consultation: Beatriz Dominguez-Gil (Spain); Martı´ Manyalich (Spain); Dominique Martin (Australia); Sarah White (Australia), Lead Rapporteur and Editor. Other participants: Carmel Joseph Abela (Malta), Maria Joao Aguiar (Portugal), Adewale Akinsola (Nigeria), Mustafa Al-Mousawi (Kuwait), Ine´s A´ lvarez Saldı´as (Uruguay), Manuel Arias Rodriguez (Spain), Tamar Ashkenazi (Israel), Gloria Ashuntantang (Cameroon), Danica Avsec-Letonja (Slovenia), Mohamed Salah Ben Ammar (Tunisia), Pavel Brezovsky´ (Czech Republic), Mirela Busˇic (Croatia), Mar Carmona (WHO), Leen Coene (Belgium), Elisabeth Coll (Spain), Fiona Constable (WHO), Filip Danninger (Slovak Republic), Gabriel Danovitch (United States), Miguel A´ ngel De Frutos Sanz (Spain), Francisco Jose´ Del Rı´o (Spain), Roser Deulofeu (Spain), Visist Dhitavat (Thailand), Jose´ Luis Di Fabio (WHO), Boucar Diouf (Senegal), Peter Doyle (United Kigdom), Valter Duro Garcia (Brazil), Teodora Dzhaleva (Bulgaria), Ehtuish Ehtuish (Libyan Arab Jamahiriya), Linda Ezekiel (Tanzania), Serguei Gautier (Russian Federation), Gayatri Ghadiok (WHO), Athina Gompou (Greece), Carl Groth (Sweden), Niels Grunnet (Denmark), Sudhir Gupta (India), Valentina Hafner (WHO), Mohamed Hilal Abdou (Egypt), Arnt Jakobsen (Norway), Gu¨nter Kirste (Germany), Anni Ku¨u¨svek (Estonia), Tong Kiat Kwek (Singapore), George Kyriakides (Cyprus), Ko Kyung Soon (Republic Of Korea), Mirjana Lausevic (Serbia), Alan Leichtman (United States), Sveinn Magnu´ sson (Iceland), Beatriz Mahillo (Spain), P.G. Mahipala (Sri Lanka), Rui Maio (Portugal), Terence P. Mangan (Ireland), Rosario Marazuela (Spain), Trevor B. McCartney (Jamaica), Geeta Mehta (WHO), Nabila Metwalli (WHO), Marina Minina (Russian Federation), Fernando Morales Billini (Dominican Republic), Enrique Moreno (Spain), Ferdinand Mu¨ehlbacher (Austria), Elmi Muller (South Africa), Alessandro Nanni Costa (Italy), Howard M. Nathan (USA), Jean-Bosco Ndihokumbayo (WHO), Alejandro Nin˜o Murcia (Colombia), Gerry O’Callaghan (Australia), Kevin O’Connor (United States), Izaaq Odongo (Kenya), Freda O’Neill (Ireland), Arie Oosterlee (The Netherlands), Marie- Odile Ott (Council Of Europe), Ole Øyen (Norway), Anna Pavlou (European Commission), Ferenc Perner (Hungary), Lola Perojo (Spain), Francesco Procaccio (Italy), Rosana Reis Nothen (Brazil), Oleg Reznik (Russian Federation), S. Adibul Hasan Rizvi (Pakistan), Jose´ Luis Rojas (Chile), John Rosendale (United States), Wojciech Rowinski (Poland), Rafail Rozental (Latvia), Bassam Saeed (Syrian Arab Republic), Kaija Salmela (Finland), Jacinto Sa´nchez Iba´n˜ez (Spain), Manav Saxena (Singapore), Hans J. Schlitt (The Netherlands), Vijay Sharma (Nepal), Rakesh Kumar Srivastava (India), Endang Susalit (Indonesia), Zoltán Szabo´ (Hungary), Shiro Takahara (Japan), Annika Tibell (Sweden), George Tsoulfas (Greece), Andre´s Valdivieso Lo´pez (Spain), Koenraad Vandewoude (Belgium), Ernie Vera (Philippines), Andi Wahyuningsih (Indonesia), Haibo Wang (People’s Republic of China), Lori J. West (United States), Daniel Wikler (United States), Liu Yongfeng (People’s Republic of China), Kimberly Young (Canada), Victor-Gheorghe Zota (Romania), Gerson Zafalon (Brazil), Zhongyang Shen (People’s Republic Of China). © WORLD HEALTH ORGANIZATION 2011. All rights reserved. The World Health Organization has granted the publisher permission for the reproduction of this supplement. Copyright in the typographical arrangement, design, and layout resides with the publisher Lippincott Williams & Wilkins. The authors alone, whether they are staff members of the World Health Organization or not, are responsible for the views expressed in this publication, and they do not necessarily represent the decisions, policy or views of the World Health Organization. Third WHO Global Consultation on Organ Donation and Transplantation: Striving to Achieve Self-Sufficiency, March 23–25, 2010, Madrid, Spain NOTE FROM THE SECRETARIAT organ transplantation as the optimal approach to prevent The Third World Health Organization (WHO) unethical practices in organ transplantation such as com- Global Consultation on Organ Donation and Transplan- mercialism, organ trafficking, and transplant tourism. The tation was organized by the WHO, The Transplantation aim of the Madrid meeting was to identify the factors nec- Society (TTS), and the Organizacio´n Nacional de Tras- essary to best meet population needs for transplantation plantes (ONT). The partnership among the three organi- and to propose practical and immediate recommendations zations made the best of their complementarities, and the for society, health authorities, and international organiza- utmost recognition and gratitude go to Rafael Matesanz tions. Striving for self-sufficiency has the potential to (Director, ONT), Beatriz Domínguez-Gil (Medical Offi- impact health systems from the delivery of preventive in- cer, ONT), Jeremy Chapman (President, TTS), and Francis terventions to tertiary medical services; at a societal scale, Delmonico (Director of Medical Affairs, TTS) for their self-sufficiency promotes community values such as soli- respective roles in advancing this significant and industri- darity and reciprocity. The outcomes of the Consultation ous collaboration. The main goal of the Consultation was establish the practical, ethical, and philosophical ground to discuss the concept of national self-sufficiency in organ on which self-sufficiency may be understood and illumi- donation and transplantation and to outline strategies by nate the path to greater global equity in access to trans- which this goal might be achieved. plantation, most critically with respect to the central role The Consultation took place at a critical moment for of donation from deceased donors. transplantation both at the European Union (EU) and at a Prior to the Consultation, eight working groups were global level. The draft Directive on Quality and Safety formed. Group members were chosen to represent a variety of Standards of Human Organs Intended for Transplantation background and expertise, including representatives of health was discussed at the European Council and the European authorities and clinicians with different specialties and geo- Parliament. “Trilogues”
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