1. Kidney transplantations in the Slovak republic, Hungary, and Austria
Stacey Geisel
The University of Central Florida

2. KIDNEY TRANSPLANTATION OVERVIEW
Surgical procedure to place a healthy kidney from a live or deceased donor into a person whose kidneys no longer function properly
Most common type of transplant
The First Cadaveric Kidney Transplantation in the Slovak Republic was performed in June 1972 at the Department of Urology at the Dérer’s Hospital in Bratislava
The National Transplant Organization
Transplant centers located in Bratislava, Banská Bystrica, Martin and Košice

3. TRANSPLANT VS. DIALYSIS
People with end-stage renal disease need to have waste removed from their bloodstream via dialysis or a kidney transplant to stay alive
Better quality of life and more freedom
93% survival rate 1 year following transplantation
Annual savings in dialysis post kidney transplantation ~€17,000/year/patient

4. LIVING DONOR CRITERIA Adult blood relative, partner or friend
Two healthy kidneys
Similar blood type
Negative cross-match
Absence of disease

5. DECEASED DONOR CRITERIA
Implied consent for donation after death
Every citizen has the right to refuse to donate
If refusing to donate, one must fill out a form and send it to the National Transplant Organization
The NTO keeps a register of people who have refused to donate organs, tissues, and cells after death

6. CHALLENGES
2% of the health care budget in Europe goes towards kidney failure
Waitlist
Average wait of 3 years
Low rate of living donors
Related to substantial morbidity risk
Continuous follow-up after surgery & access to healthcare and social care
No rules concerning medical treatment after transplantation
Example: if country of residence changes

7. AUSTRIA First Kidney Transplant Vienna, Austria 1965
4 Transplant Centers
Austria Kidney Transplant: €17,200 first months & €12, months+
Austria Dialysis: €43,600 first months & €40, months+
Only 15% living donors in Austria

8. HUNGARY First Kidney Transplant Szeged, Hungary 1962
5 Transplant Centers
Presumed Consent
Eurotransplant: Support for deceased donation

9. AUSTRIA & HUNGARY
(Eurotransplant, 2016)

10. 2013 KIDNEY TRANSPLANTS PER MILLION POPULATION, COUNCIL OF EUROPE
(European Commission, 2014)

11. 2013 KIDNEY TRANSPLANTS PER MILLION POPULATION, COUNCIL OF EUROPE
954
119
291
421 60
(European Commission, 2014)

12. LIVING DONOR BEST PRACTICE
Highest living donation: Netherlands
Nephrologists actively search for potential donors within patient family and approach directly
Living donation priority over deceased
Only put on waitlist for donation if no suitable living donor could be identified
Increase number of transplant donor coordinators

13. OPPORTUNITIES FOR IMPROVEMENT
Address difficulties
Exchange best practice
Create action plan
Prevention
Donor education
Increase living donor participation
Decrease waitlist time
Formal pre-transplant counseling & follow-up care

14. REFERENCES
Asztalos L., Csajbók E., Kalmár N., Langer R., Perner, F., Szederkényi E., & Szenohradszky P. (2013). 50 year history of kidney transplantation in Hungary. Retrieved from
Conklin, A., Hatziandreu, E., Janta, B., Ling T., Patruni, B., Rabinovich, L., Tiessen, J., & Vries, H. (2008). Improving Organ Donation and Transplantation in the European Union. Retrieved from
European Comission. (2013). 4th Journalist Workshop on Organ Donation and Transplantation. Retrieved from
European Commission. (2014). Organ Donation and Transplantation Recent Facts and Figures. Retrieved from
Eurotransplant (2015). Eurotransplant International Foundation: Annual Report Retrieved from
Eurotransplant. (2016). Kidney transplants per million population, per year, by country, by donor type. Retrieved from _characteristic=&search_text=
Gutjahr, G., Haller, M., Harnoncourt, F., Kramar, R., & Oberbauer, R. (2010). Cost-effectiveness analysis of renal replacement therapy in Austria. Retrieved from
Kofler, B. (2012). Danger of kidney disease underestimated. Retrieved from
Margreiter, R., & Mühlbacher, F. (2014). The history of organ transplantation in Austria. Retrieved from
National Transplant Organization. (2016). Retrieved from
Prihodova, L., Nagyova, I., Rosenberger, J., Majernikova, M., Roland, R., Groothoff, J. W., & Dijk, J. P. (2014). Adherence in patients in the first year after kidney transplantation and its impact on graft loss and mortality: a cross-sectional and prospective study. Journal Of Advanced Nursing, 70(12), doi: /jan.12447