Introduction: ODISSeA-Organ Donation Innovative Strategies for Southeast Asia is an Erasmus+ proj... more Introduction: ODISSeA-Organ Donation Innovative Strategies for Southeast Asia is an Erasmus+ project funded by the European Commission. The objective is to design and implement an academic postgraduate program on organ donation (OD) in 8 Southeast Asian (SeA) universities from Malaysia, Myanmar, Philippines & Thailand and 3 universities from European Union (EU). SeA has the lowest organ transplantation rate and highest growth rate of people entering end-stage organ failure. The number of deceased donors per million population (pmp) in 2017 was 1.10 in Malaysia, 0.45 in Philippines and 4.27 in Thailand while Myanmar has no deceased donation program. ODISSeA feeds from previous EU projects in establishing postgraduate programs in OD which includes EMPODaT (European-Mediterranean Postgraduate Program on Organ Donation and Transplantation) and KeTLOD (Knowledge transfer and leadership in Organ Donation). Method: In the first phase, a diagnosis analysis is conducted through questionnaires to university personnel, faculty and potential students to assess existing OD training programs, digital literacy, access, awareness and attitude towards OD. The second phase consists of a "Train the Trainers" blended program to future SeA trainers (5 faculty per institution). SeA & EU experts will then develop and implement the postgraduate program (35 students per institution) of 30 ECTS credits (750 study hours). The program employs online training, projects, informative events and seminars. Self-assessment activities, Pre and Post Training assessment will be used to evaluate students. Result: The postgraduate academic program will provide a common framework for 8 SeA Universities to develop learning strategies corresponding to specialized knowledge in OD, in accordance with European Space for Higher Education guidelines. Upon completion, a diploma accredited by SeA universities will be issued. Conclusion: ODISSeA is an innovative initiative to establish recognized academic training in OD in 8 SeA universities, following best practices from previous Eras-mus+ educational projects in OD & successful European models.
Background. Large international differences exist in kidney transplantation (KT) rates. We aimed ... more Background. Large international differences exist in kidney transplantation (KT) rates. We aimed to investigate which factors may explain the total, deceased donor, and living donor KT rates over the last decade. Methods. KT experts from 39 European countries completed the Kidney Transplantation Rate Survey on measures and barriers and their potential effect on the KT rate in their country. In the analyses, countries were divided into low, middle, and high KT rate countries based on the KT rate at the start of study period in 2010. Results. Experts from low KT rate countries reported more frequently to have taken measures regarding staff, equipment and facilities to increase total KT rate compared with middle and high KT rate countries. For donor type specific KT, the largest international differences in measures taken were reported for deceased donor KT, with middle and high KT rate countries taking more measures, such as the use of expanded criteria donor kidneys, the presence of transplantation coordinators, and (inter)national exchange of donor kidneys. Once a measure was taken, experts' opinion on its success was similar across the low, middle and high KT rate countries. Experts from low KT rate countries more often reported potential barriers, such as patients' lack of knowledge and distrust in the health care system.
The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation
Transplantation, Oct 21, 2022
Supply Possibility of Necessary Stone Material for Pavement Construction of the Adriatic Motorway. In: Proceedings - 1ST Symposium on Traffic and Engineering Aspects of Adriatic Motorway, Dubrovnik, 13-15 November 1989
The paper studies the supply of aggregate necessary for pavement construction of the Adriatic mot... more The paper studies the supply of aggregate necessary for pavement construction of the Adriatic motorway from Rijeka to the border of Montenegro. It has been established that there are very good supply possibilities from not too distant quarries and for all pavement layers except for the wearing courses of either flexible or rigid pavements. Granular stone material for the construction of wearing courses would have to be transported from more distant locations in the interior of Yugoslavia. Due to high costs of these materials, further researches should be performed in order to obtain more economic solutions. For the covering abstract of the conference see IRRD 833144. (TRRL)
Social and Religious Influences on Organ Donation
The Croatian Model of Organ Donation and Transplantation
The Republic of Croatia is a global leader in organ donation and transplantation despite having f... more The Republic of Croatia is a global leader in organ donation and transplantation despite having fewer resources and more modest healthcare expenditures than other countries in the European Union. The results of an extensive literature review were combined with expert input in an iterative multi-step data collection and evaluation process designed to assess trends in Croatian organ donation and transplantation and identify key elements, policy changes, and drivers of the system that have contributed to its success. Multiple sources of evidence were used in this study, including primary documents, national and international transplantation reports, and insights from critical informants and content experts. The results highlight several key organizational reforms that have substantially improved the performance of the Croatian transplant program. Our findings emphasize the importance of strong central governance led by an empowered national clinical leader acting under the direct auspices of the Ministry of Health and a comprehensive and progressive national plan. The Croatian transplant system is notable for its integrated approach and efficient manner of managing scarce health resources. Collectively, the results suggest that Croatia has become nearly self-sufficient due to its systematic implementation of the guiding principles for organ donation and transplantation.
Skrb za bolesnike s bubrežnim transplantatom zahtijeva specijalizirano znanje u podrucju nefrolog... more Skrb za bolesnike s bubrežnim transplantatom zahtijeva specijalizirano znanje u podrucju nefrologije, imunologije, farmakologije, endokrinologije, infektologije i kardiologije. U kontekstu sve vece kompleksnosti zajedno s eksponencijalnim rastom medicinske literature, smjernice pomažu klinicarima i svim ostalima koji skrbe o bolesnicima da im pruže medicinu temeljenu na dokazima i na taj nacin poboljsaju ishod bolesnika. Nadalje, smjernice pomažu i u otkrivanju nedostataka u nasem znanju i sugeriraju podrucja gdje su potrebna daljnja istraživanja. Ove smjernice su nastale nakon temeljitog metodoloskog pristupa: 1) identifikacija i selekcija reprezentativne radne skupine, koja se sastojala od transplantacijskih strucnjaka (nefrologa, kirurga, imunologa) i strucnjaka za metodologiju smjernica ; 2) pronalaženje klinickih pitanja ; 3) isticanje važnih pitanja ; 4) sistematski pregled literature i kriticna procjena dostupnih dokaza ; 5) sastavljanje smjernica i njihovo stupnjevanje prema...
Nacionalne smjernice za obradbu i procjenu primatelja i darivatelja bubrega Izdavač: Ministarstvo... more Nacionalne smjernice za obradbu i procjenu primatelja i darivatelja bubrega Izdavač: Ministarstvo zdravlja Republike Hrvatske Izradila Nacionalna radna grupa za transplantaciju bubrega:
Nacionalne smjernice za obradu i odabir primatelja i darivatelja bubrega usklađene sa smjernicama 2013. ERBP GUIDELINE ON THE MANAGEMENT AND EVALUATION OF THE KIDNEY DONOR AND RECIPIENT
Sonja Kalauz i suradnici. Zdravstvena njega kirurških bolesnika
Sonja Kalauz i suradnici. Zdravstvena njega kirurških bolesnika, 2020
237.1: ODISSeA: Organ Donation Innovative Strategies For Southeast Asia
Remarkably, only 10 years ago Croatia was at the tail end of Europe with a (effective) donor rate... more Remarkably, only 10 years ago Croatia was at the tail end of Europe with a (effective) donor rate of only 2.7 per million population (pmp). Over the last ten years the number of donors has multiplied ten times over and the (effective) donor rate has increased from 2.7 to 28 pmp (Fig.1.
CK J R EV I EW Improvement in kidney transplantation in the Balkans after the Istanbul Declaration: where dowe stand today?
Due to the limited access to kidney transplantation (KTx) in developing countries, desperate pati... more Due to the limited access to kidney transplantation (KTx) in developing countries, desperate patients have engaged in the purchase and sale of kidneys. In 2004, theWorld Health Assembly urgedmember states to protect the poor and vulnerable from being exploited through practices of illegal organ trafficking that had become widespread throughout the world. In 2008, the international transplant community convened a summit of transplant professionals, legal experts and ethicists to combat organ trafficking, transplant tourism and transplant commercialism that resulted in the Declaration of Istanbul (DOI). The South-Eastern Europe Health Network (SEEHN) represents a nine country multigovernmental collaboration on health systems. The Regional Health Development Centre on Organ Donation and Transplant Medicine (RHDC) was established in 2011 in Croatia to facilitate cooperation among south-eastern European countries to improve organ transplantation within the Balkan region. Since 2011, a co...
Kidney Transplantation in Developing Countries
Chronic kidney disease (CKD) is a major global health burden and a public health priority. Becaus... more Chronic kidney disease (CKD) is a major global health burden and a public health priority. Because of its high prevalence (approximately 1 in 10 adults worldwide), CKD is associated with the risk of end stage renal disease (ESRD), cardiovascular disease, and premature mortality. A substantial proportion of patients with ESRD in developing countries may die without accessing renal replacement therapy. The World Health Organization (WHO) estimates that only 10% of those in need undergo kidney transplantation annually. Developing countries have a responsibility to address the organ donation and transplantation needs of its people, with a self-sufficiency based on resources obtained within a country or by regulated regional cooperation. If self-sufficiency in donation and transplantation is to be achieved, a comprehensive program must include a framework of national legislation with regulatory oversight; a program of deceased donation integrated into the national health system; an ethic...
Liver Transplantation in Croatia: "David Among Goliaths
Transplantation, 2021
330.2: Organ donation innovative strategies for Southeast Asia: ODISSeA
Brain death is defined as the irreversible loss of all brain functions, including the brainstem. ... more Brain death is defined as the irreversible loss of all brain functions, including the brainstem. The diagnosis of brain death allows organ donation or withdrawal of support. Therefore the exact criteria for the diagnosis of brain death must be determined. In the Croatian Act on Transplantation, repeated neurologic examination must show loss of brainstem reflexes, and one confirmation test must be done. Several tests are available, showing the cessation of brain or brainstem activity, or confirming the cerebral circulatory arrest. Bedside evaluation is possible through electroencephysiologic and neurosonologic tests. Conventional or digital subtraction angiography is done in radiology suite, and isotope angiography and technetium-99m hexamethylpropyleneamine oxime (99Tc-HMPAO) at the Department of Nuclear Medicine. Such tests require special settings, therefore bedside test like electroencephalography, evoked potentials and neurosonology tests are preferred. All tests require trained personel and strict protocols, which differ from routine investigations. The confirmatory tests used in brain death confirmation, the techniques, criteria, results and validity of the tests are presented.
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