FAQS1. Why were the three working areas in ACCORD selected? 1. Why were the three working areas in ACCORD selected?The three areas covered by ACCORD are: 1- Live donor registries; 2- Cooperation between intensive care and donor transplant coordinators; 3.-Twinnings in the field of organ donation and transplantation. The three areas were selected based on a detailed review of the current situation of donation and transplantation activities in the European Union (EU) and on the identified challenges, and in alignment with the European Commission´s Action Plan on Organ Donation and Transplantation (2009-2015): Strengthened Cooperation between Member States , and Directive 2010/53/EU of the European Parliament and of the Council on standards of quality and safety of human organs intended for transplantation. Live kidney donation activity is increasing in the EU to better meet the transplantation needs of patients. But the live donor faces risks which make mandatory an appropriate framework of donor care in compliance with universal standards. These include the development of a live donor registry, essential for transparency and for building evidence on the consequences of donating an organ during lifetime. Directive 2010/53/EU has settled down the obligation for Member States to develop live donor registries, but they are not available yet in many countries. ACCORD intends to provide recommendations for building up live donor registries and will set the basis for international data sharing in this field. Organ shortage is a global challenge. Deceased donation has to be developed to its maximum potential in order to satisfy the transplantation needs of patients, as specified in the WHO Madrid Resolution. The main reason justifying differences in deceased donation rates across countries is failure to identify potential organ donors. A close cooperation between intensive care professionals, dealing with end-of-life care, and donor transplant coordinators, is fundamental to possible donors becoming actual donors. ACCORD will explore differences in intensive care practices and develop a rapid improvement methodology that facilitates the aforementioned interaction, based on the identified models of neurocritical care. Countries across the EU have developed specific knowledge and/or tools that are useful for other countries with a need to be supported in addressing the challenges identified by the European Commission in organ donation and transplantation: increasing organ availability, enhancing the efficiency and accessibility of transplant systems and improving safety and quality. ACCORD will develop collaborative projects (twinnings) between countries in Europe on these three fields. 2. Do all European Union Countries have a registry for the follow-up of live organ donors?Not all countries have developed national registries on live organ donors. These are essential in monitoring practices and the outcome of live donors in the short, mid and long term follow-up. With a view of protecting the live organ donor, Directive 2010/53/EU has established the obligation for Member States to develop this type of tools. ACCORD will support countries in implementing this requirement. Of note, a link with previously developed EU-funded projects in this field will be ensured, mainly the EULID project (http://www.eulivingdonor.eu/). 3. Does a European registry of the live organ donor exist?Not yet. ACCORD will work on that by specifying recommendations for internationally sharing data collected by and obtained from existing national registries on live organ donors. This will help to increase our level of understanding of consequences of live donation. A pilot will be carried out during the project life-time with the most prominent existing registries. 4. Why were intensive care professionals selected as a target group to facilitate the interaction with donor transplant coordinators?Most of the persons who may potentially be organ donors are persons who die in an intensive care unit. If these opportunities for deceased donation are not identified, deceased donation will never occur. The key issue is that the corresponding physician – the intensive care professional- identifies these situations and alerts the donor transplant coordinator for him to proceed with the necessary activities for donation to finally occur, as obtaining consent. 5. What is a twinning?Twinnings are collaborative projects in which a country supports another country (or a group of countries) in improving performance in a specific area. Twinnings to be carried out during ACCORD lifetime should address the three challenges that the European Commission identified as a basis for action in the field of donation and transplantation in the EU: increasing organ availability, enhancing the efficiency and accessibility of transplant systems and improving safety and quality. 6. What aspects are covered by the twinnings to be performed in ACCORD?Aspects are captured on the principles of Directive 2010/53/EU and the Action Plan on Organ Donation and Transplantation (2009-2015).1,2 In particular, France will support Bulgaria in developing donation and transplantation activities. Italy will support Cyprus, Czech Republic, Lithuania and Malta in developing a system for the accreditation and audit of transplant centers. Last but not least, the Netherlands will support Hungary in improving organ recovery techniques. What were the criteria for selecting the twinnings to be carried out during the ACCORD lifetime? Twinnings to be selected were to be based on the national priority actions on organ donation and transplantation (aligned with the Action Plan 2009-2015) and on Directive 2010/53/EU.1,2 All Member States were called for applying, either as supporting or supported countries. The twinning work package leader (ABM, France) guided potential twinners in developing an ad-hoc project, with achievable and quantifiable objectives, a dedicated methodology and a description of expected outcomes. Projects were the evaluated and selected by the ACCORD WP Steering Committee, in advance to the application for receiving the European Commission´s Grant. 7. What were the criteria for selecting the twinnings to be carried out during the ACCORD lifetime?Twinnings to be selected were to be based on the national priority actions on organ donation and transplantation (aligned with the Action Plan 2009-2015) and on Directive 2010/53/EU.1,2 All Member States were called for applying, either as supporting or supported countries. The twinning work package leader (ABM, France) guided potential twinners in developing an ad-hoc project, with achievable and quantifiable objectives, a dedicated methodology and a description of expected outcomes. Projects were the evaluated and selected by the ACCORD WP Steering Committee, in advance to the application for receiving the European Commission´s Grant.
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