Francesc Marti

Saving lives over the last 10 years in Trinidad & Tobago

The SEUSA program, supported by Fundación Repsol and coordinated by DTI Foundation, has led the actions to strengthening the organ donation and transplant system in the island. From June 19th to 21st, a team of DTI experts has visited the country to continue the establishment of the program.

The donation and transplantation program in Trinidad & Tobago started in 2006 under the umbrella of the National Organ Donor Program, competence of the Trinidadian Ministry of Health implemented by the National Transplant Unit (NOTU). But was only in 2010 thanks to the help of WHO and the Donation and Transplantation institute (DTI), that the Donation and Transplantation activity reached its best results. A total of 122 patients have received a renal transplant since 2010 in Trinidad and Tobago.

These achievements were made possible also thanks to the collaboration of Fundación Repsol; a Spanish foundation that promotes entrepreneurship, supports and collaborates with social, educational, and cultural organisations in the development of their projects.

The project designed and implemented by DTI Foundation was based in the best organ donation practices from Spain, Europe and the United States; called SEUSA methodology.

Most of the SEUSA Trinidad and Tobago activities have been focussed on the:

• Design the structure and strengthening of the deceased donation program

As results, 238 potential donors have been detected. From these, 23 have become real donors. Out of 122 kidneys transplanted, 39 kidneys were from deceased donors.

• Education and Training: a total of 261 healthcare professionals have been trained in organ donation and transplantation as part of the project. Also, in 2017, an intensive care doctor graduated from the official Master in Donation and Transplantation of Organs, Cells, and Tissues, from the University of Barcelona, Spain.

SEUSA program

Thanks to the implementation of the SEUSA program, the engagement of the health professionals and the involvement of the health authorities the organ donation commitment in the country has increased significantly resulting in a rising donation rate.

The program was implemented in several phases. The initial step is a diagnosis study, aiming on identifying the organizational, structural and educational needs. After analysing the results and once identified, an action plan is formulated in order to foreseeing solutions. The next step is to improve the efficiency and effectiveness of the system by focusing on professionals’ involvement and management aspects. The third step is maximization of donor detection, by implementing the Deceased Alert System (DAS), an IT system that allows reporting potential brain-dead donors. All these actions need to be involved in a key cultural change within the healthcare professionals to nurture a positive attitude towards organ donation. The following step is auditing the hospitals to assure the accuracy and efficiency of the program’s implementation and its actions. The final step is analysing the program development to provide recommendations for improvement and professional training according to the local educational needs.

Despite the improvements and the progress that has been made, there are still some challenges left to overcome. The lack of a tissue donation program, the lack of physician’s engagement, the shortage of trained professional and a high family refusal rate are possibly the main ones.

June 2019 DTI expert visit

From June 19th to 21st, a team of DTI experts has visited Trinidad and Tobago to ensure the establishment of the program and to verify the progress made. Additionally, other CARICOM countries have been the focus of the DTI experts visit, extending the visit till June 26th. Guyana, Barbados and Jamaica hosted the team facilitating influential meetings with the key health care professionals and relevant authorities. The aim was to evaluate the possibility of regional involvement and as well as creating synergies for better practices in managing the end stage kidney disease.

During the two-day visit to Trinidad and Tobago the DTI team had the opportunity to meet the Minister of Health Mr. Terrence Deyalsingh to discuss the new action plan for the deceased organ donation program. A visit to the NOTU and the Repsol Foundation office was also facilitated.

In Guyana a meeting with surgeons attending the 17th Annual Caribbean College of Surgeons Scientific Conference was facilitated. This was an excellent opportunity to establish synergies of cooperation in Donation and Transplantation field within CARICOM regions. The DTI team also met Mr Slater, CARICOM assistant secretary general to establish better communication pathways with the Caribbean region.

During the visit to Barbados, the team visited the Queen Elisabeth Hospital. The visit included a very dynamic meeting with the Hospital CMO, Dr Anthony Harris and the nephrology and surgical team where they all had the chance to define the challenges for the implementation of the deceased donation program.

During the Jamaica stay the team visited the West Indies University Hospital where they had the opportunity to attend a meeting organized by Dr Carl Bruce, CMO. The meeting was joined by many key stakeholders of the deceased donor program, representatives of the Minister of Health, the Hospital legal department, nursing department, surgery department and professors from the West Indies University. The Ambassador of Spain, His Excellency Mr Josep Maria Bosch Messa offered his support attending the meeting.

Overall the visit has made possible a more detailed assessment of the current situation in the CARICOM and also has facilitated the establishment of working networks and synergies among CARICOM region.

It is now clear that there are many challenges ahead, but the right action plans are in place to made deceased organ donation possible in a near future in the Caribbean region.

by Francesc Marti