The National Transplant Center – One Center for AllThe National Transplant Center was established by the Ministry of Health in 1994, with the purpose of creating an official and independent body for the management and coordination of the organ donation and transplant system in Israel. The Center is a unit within the Ministry of Health, and its workers are civil servants. The National Transplant Center is the sole organization in Israel, in which registration for transplant is done and by means of which the allocation (distribution) of the organs for transplant takes place. Moreover, each organ transplant carried out in Israel - from a live or a deceased donor - requires an individual authorization of the National Transplant Center - Ministry of Health. The activity of the National Transplant Center is regulated by the Organ Transplant Law, 5768 – 2008.
Aims of the National Transplant Center:
- Increase of the number of organ and tissue donations in Israel.
- Optimal use of the organs destined for transplant.
- Implementation of an egalitarian and transparent organ allocation policy.
- Management of a Quality Assurance System in the field of organ donations.
- Raising of public awareness and readiness with regard to organ donation.
- Increase of the number of bearers of a donor card (Adi).
- Support and guidance of families that have donated organs of their loved ones, by means of memorials and support groups.
- Implementation of programs of transplant from live donors, including a National Transplant Approval Committee.
Structure of the Center:Chairman:
At the head of the National Transplant Center is a very senior medical personality, appointed by the Minister of Health. The present Chairman of the Center is Prof. Rafael Biar, Director of the Rambam Medical Center in Haifa.
The policy of the Center is outlined by the Steering Committee, headed by the chairman of the Center, which includes the leading transplant surgeons and representatives from the fields of psychology, law, ethics, and associations of patients waiting for and having undergone transplant.
The functions of the Committee are: establishment of an organ transplant policy, implementation and development of a transplant promotion program, and maintaining of a QC mechanism.
Apart from the Steering Committee, designated organ committees (Heart and Lung Committee, Liver Committee and Kidney Committee) act within the Center. These are professional committees, the members of which are transplant specialists whose role is to advise the Steering Committee as to organ allocation, procedures, transplant promotion programs and QC.
Quality Control Committee:
The Chairman of the Committee is the Chairman of the Steering Committee, and two of its members are members of the Steering Committee, in accordance with the dispositions of the Organ Transplant Law, 5768 – 2008. The objective of the Committee is to examine the quality of the medical activity of medical centers authorized for organ harvesting and transplant.
A specialist with the role of procedure supervision, from the stage of locating donation candidates, through the donation process, to the transplant surgery.
National Transplant Coordinator:
The National Transplant Coordinator of the Center is a nurse in charge of the actual implementation of the policy of the Center: organ donation recruitment, coordination of harvesting procedures, coordination of transplant procedures and any matter related to the actual performing of donations and transplants in hospitals. The national transplant coordinator is in direct cooperation with the transplant coordinators in the hospitals, at all hours, day and night.
National Medical Advisor:
A National Medical Advisor works at the Center. His job consists in advising and approving transplant candidates; initiating the elaboration and update of therapy protocols; providing guidance to teams in charge of donor care; and being available, 24 hours a day, to the medical teams from all hospitals.
The activity of the Center takes place by means of three systems:
a.System for organ donations from deceased donors; b.System for patient registration and organ allocation; c.System for guidance and information.
System for organ donations from deceased donorsIn each medical center and hospital in Israel, there is a Transplant Coordinator - a nurse representing the National Transplant Center. Her job is to locate potential donors, to approach the families, and to provide maximum guidance and support during the entire decision-making process with regard to the donation.
The transplant coordinator is also responsible for the guidance of medical teams in matters of location and treatment of organ donors and compilation of the medical protocols necessary for the donation process and for the harvesting of the organ. In this capacity, the coordinators are employees of the National Transplant Center, they are professionally subordinated to the Center, and they receive full guidance and support from the Center in the execution of their duties.
Apart from the transplant coordinator, the hospital also has a Transplant Trustee Physician, whose job consists in centralizing the medical treatment for organ preservation and the promotion of organ donation in the hospital.
The transplant coordinators and the transplant trustees have no connection whatsoever with the patients waiting for transplant. There is complete separation between the donation process and the decision making as to the transplant.
System for patient registration and organ allocationThe National Transplant Center is the only body in Israel centralizing the registration of candidates from the entire country. The patient is free to choose the hospital in which the transplant shall take place, and the transplant unit team shall register the patient. The transplant waiting list is managed by the Center by means of a computerized system. The position on the list is determined according to criteria decided upon by the Steering Committee and including the age of the patient, the medical urgency, the tissue match, the waiting time on the list, and other medical criteria. The position on the list constantly changes, in a computerized manner, in accordance with changes in the data, such as: aggravation of the medical state of the patient, decrease or increase of the number of patients on the waiting list, etc.
Only after the transplant coordinator obtains the consent for the organ donation, are the data of the donor transferred to the National Transplant Center and fed into the computerized system. The system cross-checks the data of the donor with those of the candidates and locates the most suitable candidates by a computerized priority calculation.
The decision as to the allocation of the organ is the exclusive prerogative of the National Transplant Center.