The Catalan Transplant Organization, the OCATT
The OCATT is the organization responsible for planning ordering and coordinating activities related to the extraction, preservation, distribution, transplant and interchange of organs and tissues for their use to therapeutic ends in Catalonia.
Functionally, in the external area the organization has the collaboration of professionals who intervene in the donation and transplant processes (through the advisory commissions), while in the internal area it counts on its own staff, made up of the management, the technical team, the administrative unit and the Organ Interchange and Coordination Unit (UCIO).
The main functions of the OCATT are:
To transmit the importance of donation and transplant in our society and also to publicise the organization, the OCATT carries out a variety of activities aimed at both the general population and health professionals:
- Public information and awareness campaigns (press, radio, television, schools, social organizations, among others).
- Displaying on the web publications on the subject of donation and transplant ( Donation and transplant channel).
- Collaboration with patient associations for patients who have received or are awaiting a transplant (workshops, publications in magazines, among others).
- Information and continuous training for professionals and university students.
- Specific awareness campaigns in primary and secondary schools, with the collaboration of hospital transplant coordinators.
To be a donor is to be a generous person. Donation is one of the most altruistic acts that you can do for other people.
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En aquest tríptic, a més del carnet de donant, trobareu informació bàsica i rellevant sobre la donació i el trasplantament d'òrgans, teixits i cèl·lules (nomès en català).
Organ interchange coordination is carried out by the OCATT from their Organ Interchange Coordination Unit (UCIO), which is in charge of, among other work, of:
- Administrating patient transplant waiting lists.
- Allocating available organs according to specific and consensual criteria.
- Giving logistic support to organ interchange (organizing and managing land or aerial transfer of organ extraction and transplant health teams).
Among the tasks of data processing related to the activities coordinated by the OCATT, the objective of which is to detect which are the points for improvement related to donation and transplant, the following stand out:
- Monitoring and analysing organ and tissue donation and transplant activity, using information provided by the centres.
- Periodical reports (monthly, trimestral, annual), addressed to clinical professionals who provide data to the Health Administration.
Activity data is collected continuously and introduced in a register of donors and patients on waiting list for a transplant. This register, apart from donation and transplant data, also contains data on patients awaiting hepatic, cardiac, lung, or pancreatic transplant. From the OCATT comes quality control of non-related donor searches for hematopoyetic stem cell donors, for patients awaiting transplant (stem cells from blood cells). The data obtained from this activity comes from the two hundred centres authorised to perform this type of treatment and from the Spanish Register of Bone Marrow Donation (REDMO), managed by the Josep Carreras Foundation.
The OCATT is in charge of managing the registries and following-up patients who have received an organ, tissue or hematopoyetic stem cell transplant. These registries permit us, among other things:
- To know the epidemiological characteristics and evolution of patients who have received a transplant.
- To know the transplant results, in terms of survival and mortality.
- To provide information to evaluate and control utilization criteria of this treatment.
- To prepare statistical reports and clinical and epidemiological studies.
The registers currently managed by the OCATT are:
- Register of renal patients of Catalonia
- Register of hematopoyetic stem cell transplants of Catalonia
- Register of hepatic transplant of Catalonia
- Register of cardiac transplant of Catalonia
- Register of lung transplant of Catalonia
The OCATT has the responsibility to create and develop new patient registers to evaluate and control new technical, experimental or consolidated therapies.
Following European directives, the OCATT manages living donor registers with these objectives:
- To protect the safety of the donor and the process of living organ donation.
- To Provide information for the evaluation and control of this treatment’s utilization criteria.
- To prepare statistical reports and clinical and epidemiological studies.
In this area, the registers managed by the OCATT are:
- Register of living kidney donors
- Register of living liver donors
The OCATT produces large quantities of information about donation, transplant and their reults, useful for decision making, both in the clinical environment and the Health Administration.
To make this information known:
- Different channels of communication are used, such as the organization of various courses and the participation of workshops and congresses.
- Periodical reports and statistical records are prepared, with the aim of returning the information to those professionals who provide data to the Health Administration. Monographic Publications, as well as articles and scientific journals, are also issued to the care network.
- In collaboration with the Catalan Transplant Society and Foundation, The Transplant Bulletin has been published every six months for many years.
The important development the different transplant programs throughout the whole of Spain have gone through is due, to a large part, to the effort dedicated to donor detection and organ and tissue extraction. This is the result of the work of a large number of professionals involved in these procedures, in particular the hospital transplant coordinators.
However, the lack of available organs forces us to evaluate the quality of the organ and tissue detection, donation and extraction process, so as to know the donation potential and determine which areas are susceptible to improvement, where organ donation could be optimized.
The complexity of the process demands continuous, exhaustive evaluation at each phase to detect and correct possible deficiencies, something which would not be possible without the collaboration of all the intervening professionals.
On the other hand, and given that the main limitation for greater development of transplant programs is lack of organ availability, all factors which can be analysed and improved will have favourable repercussions on the number of transplants.
To this end, Catalonia designed a system of control in the 80s. Later on, from the year 1998, following a pilot study in 25 state hospitals, the National Transplant Organization (ONT) introduced a quality program in the organ generating hospitals of the different autonomous communities, which Catalonia joined in 2001.
The three main objectives of the program are:
- To know the theoretic capacity of organ donation according to generating hospital type (the type of hospital is defined according to the medical/surgical specialties available, particularly the existence of a neurosurgical service).
- To detect losses of possible donors and analyse the causes.
- To describe the hospital factors which can influence the donation process.
The transplant of tissues and cells of human origin, whether to a proven therapeutic end, or for clinical trials, has become a common clinical activity performed in the majority of hospitals in Catalonia. One of the factors which make this important use of tissue and cells possible, is their availability through donation and the important work carried out by tissue banks to make them viable for transplant.
The new legislation established to regulate all the processes necessary to obtain tissue and cells viable for transplant, donation, tissue banks and inplant in recipients, foresees the application of exhaustive quality norms, aimed at guaranteeing the safety of tissues and cells. Biovigilance is one of these.
Biovigilance consists of detection, notification and registration of incidents, effects and adverse reactions which could have been produced in any of the processes indispensable to make donated tissue and /or cells viable.
With the notification of the facts an autonomic-level register is established, which in Catalonia is situated at and depends on the Catalan Transplant Organizationon (OCATT), which permits the application of appropriate corrective measures, in function of their transcendence.The information generated and the corrective measures applied are addressed to the Ministry of Health, at the ONT, which holds all the information in Spain, and the management of the European biovigilance register.
The most important objective of biovigilance is detection to foresee the possible undesired effects which could be produced with the utilization of derivatives of human origin, to know and improve processing and procedural techniques which must be applied so as to offer recipients and transplant professionals safe tissue and cells for transplant.
The OCATT is in charge of resgistering activity carried out in Catalonia regarding advanced therapies, as well as coordinating research in this field, so as to transfer the results of this research to its clinical application, fulfilling legal requirements, quality, safety and ethical principles. The OCATT must also have a technical and legislative advisory role for basic and clinical researchers, who need assistance to carry out clinical trials in advanced therapies.
Organization or participation in various training courses on donation and transplantation of organs, tissues and cells intended for health and non-health professionals, directly or indirectly involved in this field.
- Organization and participation in various courses on specific aspects for transplant coordinators.
- Organization of training courses for judges and forensic scientists at the Judicial College of Barcelona.
- Organization of the first theoretical course about biovigilance for persons responsible for biovigilance in authorized centers.
- Organization online course on nursery and donation in cardiac death as part of the final process of life.
- Organization course on new forms of communication in the process of organ and tissue donation.
- Organization of the course on communication in critical situations.
- Participation in the TPM course (Transplant Procurement Management) for the training of transplant coordinators.
- Participation in courses of donation and transplantation for Neurology specialists, Emergency doctors, ICU doctors, etc.
OCATT also promotes and participates in several research projects in donation and transplantation of organs, tissues and cells. Some of the projects that are currently underway are:
- A multi-centric study on the evolution of serious brain pathology.
- Multi-centric study about family interviews in organ and tissue donation.
The advisory commissions are groups of professionals who, among other functions, provide the Catalan health Service and the Department of Health with information and opinions on specific health matters, useful for planning and rationalising available resources, so as to offer the population access to the most appropriate health care for their needs.
Regarding transplants, different advisory commissions have been created with the aim of debating scientific, technical, ethical, legal and organizational aspects related to this activity and to collaborate with the OCATT in the development of assigned functions.
Each of the commissions is made up of professionals expert in the subject and of OCATT representatives.