Factors that influence the development of an organ donation program.

The shortage of cadaveric donors is a universal problem that imposes a severe limit on the number of patients who can benefit from transplantation. At the same time, there is an ever-increasing demand for cadaveric solid organs all over the world. The organ shortage is not due to a lack of potential donors, but rather to a failure to turn many potential into actual donors. Spain is the only example in the world of continuous improvement in cadaveric organ donation registered in a large country during more than 10 years. This success is due to a proactive donor detection program performed by well-trained transplant coordinators, introduction of systematic death audits in hospitals, and the combination of a positive social atmosphere, an adequate management of mass media relations, and on adequate economic reimbursement for the hospitals. This model can be partial or totally adapted to other countries or regions, if basic conditions are guaranteed. A careful study of local characteristics, which influence organ donation in a direct or indirect way, should be performed before planning specific actions to improve organ donor rates. The principle factors that influence the development of this type of program are described in this article.