Comparing organ donation practices and rates between Australia and the Netherlands to detect best practices and areas for improvement.

Abstract

Improving deceased organ donation rates is a priority worldwide. Australia and the Netherlands are developed countries that have historically had similar donation outcomes, but varying attitudes and practices make comparison of interest, as opportunities may exist to learn from each other. For example, Australia has successfully implemented a reform to increase donation and transplantation rates in 2009, whereas Dutch rates have only slightly increased following the implementation of a similar government plan in 2008. While 30-40% have registered their wish regarding donation in both countries, more than 10% of the Dutch population registered unwilling to donate, compared to only 0.1% in Australia. Differences exist in donation after circulatory death (DCD) practices and rates, with Australia implementing DCD pathways in hospitals in recent years. Emergency department (ED) clinicians in Australia are increasingly involved in donor recognition and referral, whereas the number of potential donors in Dutch EDs is unknown and Dutch ED clinicians have minimal involvement in donor identification and referral. In both countries potential donors are still missed, but comparisons are made difficult as data collection and reporting methods differ. There are significant areas of lack of data, such as potential DCD numbers in Australia and potential donors transiting the ED in the Netherlands. Assessing these potential donor pools may help increase organ donation rates. Comparing practices and outcomes between countries can be a useful method to detect effective practices in each country and identify areas for improvement, and this may be further facilitated by applying international data collection and reporting standards.