the convention and the consequences of the 8th european donor day in istanbul, turkey

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The Convention and the Consequences of the 8th European Donor Day in Istanbul, Turkey A. Bozoklar, A. Cakiroglu, N. Altug, and S. Alyanak ABSTRACT The 8th European Donor Day took place in Istanbul, Turkey, on October 14, 2006. It was jointly sponsored by the Council of Europe and the Local Health Care Directorate of Istanbul. International problems of transplantation and organ donation were discussed in the public arena by professionals in five round tables. As a result, the importance of working together internationally to promote organ donation was strongly emphasized, and the immediate positive consequences of this kind of collaboration in Istanbul were discussed. T HE PROGRAM started with the welcoming and open- ing remarks of Mehmet Bakar on behalf of the organizing committee, and continued with the speeches of Alexandr Vladychenko and Muammer Guler, the Governor of Istanbul. The speeches were followed by the opening ceremony, which focused on raising public awareness. Ber- nard Loty emphasized the crucial importance of govern- mental support in organ donation, and Knud Erben, Munci Kalayoglu, and Natassha Vosnides contributed their com- ments on the significance of the meeting. Five round tables concentrated on various issues relating to transplantation and donation. The summaries of these round tables as stated by the reporters are presented herein. The first round table was on the “Current Situation in Organ Donation in Europe and Turkey.” The partici- pants were Jose Maria Dominguez-Roldan, Engin Cevik, and Murat Kiliç. Werner Lauchart was the reporter. He pointed out that 1. The direct correlation between donation rates and the number of transplant coordinators working in hospitals highlighted the importance of these profes- sionals in the system. 2. The close collaboration among European countries, like the Council of Europe, will help to improve the reliability of defining minimal requirements to create effective organizations or structures for organ dona- tion and transplantation. Such efforts would be an example for countries like Turkey which need to increase their cadaveric donor pool. 3. The serious shortage of cadaveric donors pushes Turkey to use living donors in nearly 75% of all transplantations. If this shortage continues, the num- ber of living donations is likely to increase. However, in some regions, cadaveric donors obtained per mil- lion people are as high as 18 to 20 due to the local efforts of regional organizations. This raises hopes for the future of other parts of Turkey. The second round table was on the “Ethical Aspects of Transplantation.” The participants were Knud Erben, Mark Murphy, Murat Tuncer, and Timur Erk. Jose Maria Dominguez-Roldan was the reporter. He pointed out that 1. Living donation is a possible but only a partial solution to organ shortage. 2. Unifying criteria of brain death in European coun- tries is of utmost importance. 3. Professionalization of transplant coordinators is of great importance and there should be governmental economic support in this endeavor. This support can easily be compensated for by the expenses of dialysis and the quality of life of the patients. 4. Cadaveric donation is the best way to fight against death that is caused by organ failure. The third round table was on “Organ Trafficking.” The participants were Knud Erben, Suzanne Szalamanov, I ˙ lgin Özden, Sunay Akyildiz, and Nilgün Kocamanog ˘lu. Knud Erben was the reporter. He pointed out that the main reason for organ trafficking between countries is the lack of cadaveric organs. From a realistic point of view, there is a market and sometimes laws are not enough to prevent this From the Ege University Transplantation Center (A.B., N.A., S.A.), Ege, and the Regional Transplant Coordination Center of Istanbul (A.C.), Istanbul; Turkey. Address reprint requests to Ata Bozoklar, Ege University Transplantation Center, Izmir, Turkey. 0041-1345/08/$–see front matter © 2008 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2007.12.009 360 Park Avenue South, New York, NY 10010-1710 42 Transplantation Proceedings, 40, 42– 43 (2008)

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Page 1: The Convention and the Consequences of the 8th European Donor Day in Istanbul, Turkey

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he Convention and the Consequences of the 8th European Donoray in Istanbul, Turkey

. Bozoklar, A. Cakiroglu, N. Altug, and S. Alyanak

ABSTRACT

The 8th European Donor Day took place in Istanbul, Turkey, on October 14, 2006. It wasjointly sponsored by the Council of Europe and the Local Health Care Directorate ofIstanbul. International problems of transplantation and organ donation were discussed inthe public arena by professionals in five round tables. As a result, the importance ofworking together internationally to promote organ donation was strongly emphasized, andthe immediate positive consequences of this kind of collaboration in Istanbul were

discussed.

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HE PROGRAM started with the welcoming and open-ing remarks of Mehmet Bakar on behalf of the

rganizing committee, and continued with the speeches oflexandr Vladychenko and Muammer Guler, the Governorf Istanbul. The speeches were followed by the openingeremony, which focused on raising public awareness. Ber-ard Loty emphasized the crucial importance of govern-ental support in organ donation, and Knud Erben, Muncialayoglu, and Natassha Vosnides contributed their com-ents on the significance of the meeting.Five round tables concentrated on various issues relating

o transplantation and donation. The summaries of theseound tables as stated by the reporters are presentederein. The first round table was on the “Current Situation

n Organ Donation in Europe and Turkey.” The partici-ants were Jose Maria Dominguez-Roldan, Engin Cevik,nd Murat Kiliç. Werner Lauchart was the reporter. Heointed out that

1. The direct correlation between donation rates andthe number of transplant coordinators working inhospitals highlighted the importance of these profes-sionals in the system.

2. The close collaboration among European countries,like the Council of Europe, will help to improve thereliability of defining minimal requirements to createeffective organizations or structures for organ dona-tion and transplantation. Such efforts would be anexample for countries like Turkey which need toincrease their cadaveric donor pool.

3. The serious shortage of cadaveric donors pushesTurkey to use living donors in nearly 75% of alltransplantations. If this shortage continues, the num-

ber of living donations is likely to increase. However, T

041-1345/08/$–see front matteroi:10.1016/j.transproceed.2007.12.009

2

in some regions, cadaveric donors obtained per mil-lion people are as high as 18 to 20 due to the localefforts of regional organizations. This raises hopes forthe future of other parts of Turkey.

The second round table was on the “Ethical Aspects ofransplantation.” The participants were Knud Erben, Markurphy, Murat Tuncer, and Timur Erk. Jose Mariaominguez-Roldan was the reporter. He pointed out that

1. Living donation is a possible but only a partialsolution to organ shortage.

2. Unifying criteria of brain death in European coun-tries is of utmost importance.

3. Professionalization of transplant coordinators is ofgreat importance and there should be governmentaleconomic support in this endeavor. This support caneasily be compensated for by the expenses of dialysisand the quality of life of the patients.

4. Cadaveric donation is the best way to fight againstdeath that is caused by organ failure.

The third round table was on “Organ Trafficking.” Thearticipants were Knud Erben, Suzanne Szalamanov, Ilginzden, Sunay Akyildiz, and Nilgün Kocamanoglu. Knudrben was the reporter. He pointed out that the main

eason for organ trafficking between countries is the lack ofadaveric organs. From a realistic point of view, there is aarket and sometimes laws are not enough to prevent this

From the Ege University Transplantation Center (A.B., N.A.,.A.), Ege, and the Regional Transplant Coordination Center of

stanbul (A.C.), Istanbul; Turkey.Address reprint requests to Ata Bozoklar, Ege University

ransplantation Center, Izmir, Turkey.

© 2008 by Elsevier Inc. All rights reserved.360 Park Avenue South, New York, NY 10010-1710

Transplantation Proceedings, 40, 42–43 (2008)

Page 2: The Convention and the Consequences of the 8th European Donor Day in Istanbul, Turkey

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8TH EUROPEAN DONOR DAY IN ISTANBUL 43

ituation. Possible solutions to prevent organ trafficking areetter cooperation between countries and governments;

ncreasing the number of cadaveric organs; and promotingegal use of living related donors.

The fourth round table was on “Governmental Measuresn Transplantation.” The participants were Terry Mangan,ernard Loty, Vahap Acar, and Altay Kocer. Aydin Dalgicas the reporter. He pointed out that

1. The detection and the consequent referral of braindeath cases should be obligatory by law.

2. The professionals must be appointed in hospitals andsupported by laws.

3. Serious efforts must be made for the training of theseprofessionals.

4. Living donors may be encouraged in some situations,and there is a need to have more discussions aboutdefining the ethical aspects of using living donors.

The fifth round table was supposed to be on “Theeligious Point of View of Donation.” Since this wasiscussed by the clerical leaders of the three religions in thepening ceremony, there was no need to conduct anotheround table on this issue. However, a general consensus waseached on the merits of donation. There was unanimousgreement that organ donation should be promoted andncourged. At the end of the day the final message waselivered by Alexandr Vladychenko. He emphasized pro-otion of organ donation and the importance of govern-ents, parliaments, politicians, medical doctors, media, andhoever is involved in the issue to work together.

FFECTS OF THE 8TH EDD IN ISTANBUL

he efforts at collaboration between the official institutionsere impacted in a positive manner. The Local Health Careirectorate was one of the sponsors of the Convention with

he Council of Europe. After the meeting, the Local Healthare Directorate encourged all of the public hospitals toetect and refer brain death cases in intensive care units.his intervention was not only encouraged but also mildly

einforced.Within 2 months, the number of transplant coordinators

n the city was increased more than 6 times, from 4 to 26.fter the EDD, the Istanbul Bar Association held a meet-

ng to establish general principles in the practice of cadav-ric organ donation within the confines of National Law.he 8th EDD awakened public awareness to such an extent

hat many national TV channels interested in the issueegan to prepare serial donation programs. This effort

nformed the public and helped to establish trust betweenrofessionals and the people.

ISCUSSION

he improvement in cadaveric donations can be seen in Fig. 1.he comparison of detected brain death cases during the

rst 6 months of 2006 and 2007 showed that the 8th EDD

ad a strong affirmative effect on the cadaveric donorrganizations in the city. The issues of transplantation andonation were positively impacted by this internationaliscussion in the public arena, because these were not onlyedical events but also social, ethical, legal, and diplomatic

nes as well.

CKNOWLEDGMENT

he program of the 8th European Donor Day (EDD) was actual-zed by the invaluable participation of the following scholars:

lexandr Vladychenko, Director General, Social Cohesion, Coun-cil of Europe

ernard Loty, Director, Direction Médicale et Scientifique,Agence de la Biomédecine, Chair of the Committee of Expertson SP-CTO

ose Maria Dominguez-Roldan, Vice President of ETCOerner Lauchart, Vice President of SP-SQA

erry Mangan, President of European Heart and Lung TransplantFederation

uzanne Szalamanov, President of The Transplant Foundation forRenewed Lives

nud Erben, Secretary General of CEAPIRatassha Vosnides, Representative of the Hellenic TransplantOrganizationark Murphy, Member of CEAPIRuammer Guler, Governor of Istanbulehmet Bakar, Head of the Health Directorate of Istanbulunci Kalayoglu, Director of the Department of Liver Transplan-tation Center, University of Wisconsin, United Statesydin Dalgic, Director of the Liver and Kidney Transplant Pro-gram of Gazi University, Turkeyurat Kılıç, Director of the Liver Transplant Program of EgeUniversity, Turkey

ngin Cevik, Transplant Coordinatorurat Tuncer, Nephrology Department of Akdeniz University,Turkey

imur Erk, Head of the Turkish Kidney Foundationilgün Kocamanoglu, Member of the Transplantation Depart-ment, Ministry of Health

Ilgin Özden, Transplant Surgeon, Department of Surgery, IstanbulUniversity

unay Akyildiz, Member of the Body of Lawyers of Istanbulltay Kocer, Member of the Transplantation Department, Ministryof Healthta Bozoklar, Director of the National Board of Transplant

ig 1. The number of brain death cases and donors during therst 6 months of 2006 and 2007 in Istanbul.

Coordinators