The number of actual organ donors in Brazil increased from 13.1 per million people to 14 per million in the second quarter of this year, according to the Brazilian Association of Organ Transplantation (ABTO). “This actual donor rate had been going down throughout 2015, became stable in the first quarter of 2016, and picked up again more recently in the second quarter of this year,” José Lima Oliveira Júnior, Coordinator of the ABTO's Organ Removal Commission, said on Monday (Aug. 22).
Despite the increase, the number of actual donors was lower than expected for the period—16 per one million people. Furthermore, the number of transplantations dropped in the second quarter, as well as the total potential donors, especially in the states with the largest populations (São Paulo, Rio de Janeiro, and Minas Gerais). This data is collected by ABTO and the Ministry of Health's National Transplantation System.
The number of Brazilians waiting for an organ donor has increased this year compared to the first half of 2015, going from 32,000 to 33,199 people. In absolute numbers, the highest demands are for corneas and kidneys, followed by livers, hearts, lungs, pancreases, and intestines.
According to Oliveira Júnior, there was an upward trend in number of potential donors, actual donors, and completed transplantations in the five years before 2015, which helped reduce queues. Last year, however, the trend shifted and all figures went down.
The coordinator says this has been due to bottlenecks in the process, caused by delays in payments to hospitals, terminated or unrenewed contracts, and failure to increase procedure fees, which resulted in transplantation understaffing and a decrease in the number of transplantations.
“We can still improve this system considerably, but we need our national infrastructure to operate well, and, above all, we must reduce the family refusal rate, which is high in the country. Forty nine percent is unacceptable.”
Brazil's potential donors are young, and usually the victims of violence, traumas, or car crashes, who were usually healthy prior to these incidents, which makes the organ more likely to be suitable for transplant. “We must raise our utilization rate,” Oliveira Júnior said.
According to the ABTO, the US have a ratio of 25 actual donors for every 25 to 30 million citizens. However, despite the large number of potential donors, most are elderly and suffer from such conditions as high blood pressure and diabetes, which may render the transplant impossible.
In the past half of the year, 71% of organs donated in Brazil could not be used, as the process requires infrastructure as well as a number of precautions in the removal of the organs. The donor's location, for instance, often lack the required infrastructure, so when medics come to perform the removal, the organ is no longer suitable for a transplant. “This system needs improvement,” he explained.
“Donors must be kept in an appropriate environment, with mechanical ventilation, medication for adjusting blood pressure, and infrastructure that allows body temperature to be preserved. Hormonal replacement is also necessary, and, more often than not, also blood transfusions, enteral feeding,” he listed.
Translated by Mayra Borges / Fabrício Ferreira
Fonte: Brazil organ donation statistics improve