"Access of non-residents to transplantation of deceased donor organs: practices and strategies in the European setting."

BACKGROUND The access of non-resident patients to the deceased donor waiting list (DDWL) poses different challenges. The European Committee on Organ Transplantation of the Council of Europe (CD-P-TO) has studied this phenomenon in the European setting. METHODS A questionnaire was circulated among Council of Europe member states to inquire about the criteria applied for non-residents to access their DDWL. RESULTS Information was compiled from 28 countries. Less than 1% of non-residents received a deceased donor organ. Two countries never allow non-residents to access the DDWL, 4 allow access without restrictions and 22 only under specific conditions. Of those, most give access to non-resident patients already in their jurisdictions who are in a situation of vulnerability (urgent life-threatening conditions). In addition, patients may be given access: i) after assessment by a specific committee (4 countries); ii) within the framework of official cooperation agreements (15 countries); iii) after patients have officially lived in the country for a minimum length of time (8 countries). The ethical and legal implications of these policies are discussed. CONCLUSIONS Countries should collect accurate information about residency status of waitlisted patients. Transparent criteria for the access of non-residents to DDWL should be clearly defined at national level.