Status of Organ Donation and Solution of Organ Shortage in Korea

Won-Hyun Cho

doi:10.4285/jkstn.2018.32.3.38

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Cho: Status of Organ Donation and Solution of Organ Shortage in Korea

Review Article

The Journal of the Korean Society for Transplantation 2018; 32(3): 38-48.

Published online: 27 September 2018

DOI: https://doi.org/10.4285/jkstn.2018.32.3.38

Status of Organ Donation and Solution of Organ Shortage in Korea

Won-Hyun Cho, M.D.

Korea Organ Donation Agency, Seoul, Korea.

Corresponding author: Won-Hyun Cho. Korea Organ Donation Agency, #29, Eonju-ro 133-gil, Gangnam-gu, Seoul 06053, Korea. Tel: 82-10-2520-1065, Fax: 82-2-3447-5631, Wh51cho@gmail.com

Received 28 August 2018 Accepted 31 August 2018

The Korean Society for Transplantation

Abstract

Deceased organ donation in Korea has increased steadily after legislation of transplantation law. Since last year, however, several obstacles resulting in a decrease in organ donation have been experienced. Among them, the reduced reporting of potential brain death from large size hospitals and reduced consent rate of medically available deceased donors are two main hurdles. The consent rate of organ donation was 41.9% in 2017 but has dropped to approximately 10% than 2016. Other strong family members overrode approximately 10% of donations initially consented by their next of kin. In addition to the medical points, difficulties in labor shortage are being experienced during donor management, testing and organ recovery in the hospital. Some end stage patients who are candidates as organ donor give up further management and decide to withdrawing life sustaining treatment, which deprive the chance of donation. Moreover, the national mortality rate of cerebrovascular and traffic accidents, which occupy a major part of brain death, have decreased over the recent 10 years. All of these events can cause a decrease in brain death development so it is important to find solutions to overcome all of them. Revising transplant law and donation system should be led by government. Efforts to increase the consent rate, procurement rate, and transplant rate and decrease the organ discard rate are all the responsibility of the medical team. Public awareness and a positive attitude towards organ donation are the most important basic requirements for increasing organ donation. A comprehensive task force team to overcome all of these problems is requested.

Keywords: Organ and tissue procurement, Waiting lists, Organ transplantation, Informed consent, Organ donor

Figures and Tables

Fig. 1

Organ donation & waiting list of Korea. Data from 2017 annual report of KONOS and KODA.

Fig. 2

Consent rate in medically available donor. Data from 2017 annual report of KODA.

Fig. 3

Deceased donor in USA.

Abbreviations: DBD, donation after brain death; DCD, donation after cardiac death; DD, deceased donor

Adapted from Table 3 of reference [31].

Fig. 4

Rate of recoverd organs not transplanted.

Reprinted from Table 27 of reference [31].

Fig. 5

Influence of mass media on actual organ donation.

Table 1

Rejection rate of organ donation in Spain and Korea

^aRejection rate of organ donation among the family approached medically available potential brain death donor (58.0% in 2017).

Data from 2017 annual report of KODA.

Table 2

Changing pattern of donor a age

^aIn 2017, youngest donor was 125 days old, oldest was 82 years old and mean age was 48.2 years old.

Table 3

Actual working time for managing deceased donor and organ recovery

^aMeans procedure starting time of each donor; ^b( ) means percentage of holiday work.

Table 4

Initial family consent changed by other family member

Abbreviation: PBD, potential brain death.

^aOrgan donation is agreed by next of kin initially but changed later by other family member.

Table 5

Donor card in Korean and actual deceased donor with donor card

Abbreviation: DD, deceased donor.

Table 6

Number of actual donor per hospital and total donor type of OPO

Abbreviations: DIP, Donor Improvement Program; OPO, Organ Procurement Organization; HOPO, Hospital-based Organ Procurement Organization; KODA, Korea Organ Donation Agency.

^aProcure rate of actual donor per hospital.

^bDIP activity: Donor improvement activity such as MRR, HAS, staff education etc. were done by KODA staffs.

^cNumber of actual donor by whole HOPO or KODA contracted hospitals.

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