Abstract
Evidence is not homogeneous on indicators able to monitor and assess quality performance for organ donation. This may be related to differences in healthcare organizations among countries but also to the scarcity of data on this topic so far. In the present review, we assessed available evidence on quality metrics in solid organ procurement in the United States and in Europe by means of a PubMed search. Evidence was summarized according to countries, considering that the donation and transplantation systems differ from country to country. In United States, the assessment of these indicators is periodically performed by the national network for organ sharing to evaluate the performance of each Organ Procurement Organization (OPO). Quality metrics consider several factors, in primis population characteristics (i.e. race/ethnicity, age, socio-economic status). That is why the assessment of each OPO performance relies on several quality metrics, not only one single indicator. In Europe, quality improvement programs represent a structural element of organ and transplant system in several countries, but few papers have to date addressed the results obtained by a quality improvement program based on indicators. In Poland, the use of quality indicators and improvement procedures were associated with better results in those hospitals which implemented these programs in respect to hospitals who did not. In Tuscany Region (Italy) the implementation of a monitoring and reporting approach based on indicators by the Regional Transplant Center was associated with an increased in transplant and donation activity (especially in cDCD donors). According to available evidence, the development of a method for quality assessment and quality improvement has been recognized as pivotal for donation and transplant authorities to identify key interventions either at national and/or hospital levels.