[HEW score-a tool for the homogenisation of donor registrations to the DSO : Multicentre retrospective analysis of three university hospitals].

Abstract

Background: The persistently low number of postmortem organ donations in Germany has repeatedly led to political discussions and most recently to the amendment of the Transplantation Act with the strengthening of the role of the transplantation officer and the introduction of a register to document the will to donate. The background to these decisions was the assumption that a relevant proportion of potential organ donors in hospitals were being overlooked and not reported. However, due to the lack of guidelines as to when a potential organ donor must be reported to the DSO ("Deutsche Stiftung Organspende"), the existing data is only of limited validity.

Objectives: The transplantation officers of the university hospitals in North Rhine-Westphalia (NRW) therefore agreed on the HEW score (brain function loss-suitability-will) presented here as a shared standard for reporting potential organ donors.

Materials and methods: Assigning the scores from 1 to 3 to each of the three included attributes results in a score of 111 to 333, and reporting to the DSO is recommended if the threshold value of 213 is exceeded. For implementation, the HEW scores of the cases determined by TransplantCheck from the university hospitals in Bonn, Essen and Düsseldorf from 2022 were collected retrospectively and presented in this paper.

Results: Overall, the number of cases to be reported according to the HEW score was 13.5% below the number of cases actually reported at all three sites (126 vs. 109). In all three centres, the refusal rate was high at 54.5-64.9%.

Conclusion: The HEW score represents a tool for the detailed recording and standardised reporting of potential organ donors and can enable homogenised reporting behaviour as a data basis for future improvement approaches.