Zusammenfassung
Das Transplantationsgesetz von 2019 fordert von allen Beteiligten mehr Engagement
bei der Organspende. Kliniken und Transplantationsbeauftragte (TxB) erhalten damit
vehemente Unterstützung, aber auch klar definierte Vorgaben für Supervision und Management.
Elementar wichtig für den Erfolg des Organspendeprozesses ist die Steuerung durch
die TxB. Diese wird im Folgenden von der Evaluation infauster Hirnschädigungen bis
zur Organentnahme beleuchtet.
Abstract
According to the Transplantation Act (TPG), clinics and transplant commissaries (TxB)
are obliged to ensure quality in donor evaluation. They are supervised. TxBs exist
in every hospital that carries out organ harvesting and are always available. They
are responsible for the conception of the organ donation process and should manage
each individual case from the evaluation to the implementation of the patientʼs wishes.
The evaluation for potential organ donors should be routine and supported by IT technology.
The intensive care team must inform the TxB about living patients who “come into consideration”
as organ donors. Reasons for exclusion can be known rejection, absolute medical contraindications
and loss of function of all transplant organs. ICBF (irreversible cessation of brain
function) deceased without reasons for exclusion must be reported to the DSO immediately.
Talks with relatives about the neurological outcome, the ICBF diagnostics and organ
donation are of fundamental importance for the implementation of the (presumed) wish
of the potential organ donor and the relatives. The aim of the talks should be a sound
decision with which the relatives can conclude. The TxBs support the ICU team to achieve
this.
Organ donation should be handled like an emergency. Typical bottlenecks are the instrument-based
examinations and the availability of the operating room. The TxBs should draw up a
schedule, communicate this to the interfaces and be available at all times during
the entire organ donation process. Documentation of all details is important, as the
TxBs must prepare detailed individual case analyses for quality assurance purposes
and forward them to the clinic management and the DSO. Quality circles and especially
peer review procedures are used and recommended as further QM tools.
Schlüsselwörter
Spenderevaluation - Organentnahme - Transplantationsbeauftragter - Angehörigenbetreuung
- Qualitätsmanagement
Key words
donor identification - organ procurement - transplantation commissary - support for
relatives - quality management
