Stela Ivcic-cosic
During the 1990s, despite the enthusiasm of transplant professionals and legal regulation for cadaveric donation based on presumed consent, the organ donation and transplantation rates in Croatia were very low. In 1998, a resolution on fostering organ transplantation was adopted and actions were implemented by the Ministry of Health. The most important was the appointment of the national transplant coordinator, establishment of a well-organized and highly efficient transplant coordinators network and international collaboration. Hospital based coordinators have become intensive care specialists who went through the internationally recognized training courses. They introduced a proactive approach to early identify all potential donors and apply standardized protocols for optimal donor management. These joined efforts resulted in a tremendous increase of the organ donor rate in Croatia and a progressively shortening waiting time for organ transplantation. Although the prevalence of patients on renal replacement therapy increased by 49% (to 980 p.m.p.) between 2001 and 2011, a reduction in the percentage of patients on hemodialysis treatment by 18% was possible due to the increase in the percentage of patients with a functioning kidney transplant from 15 to 34%. Average waiting time for kidney transplantation decreased to less than two years, and average waiting time for pancreas and heart transplantation to one and two months, respectively. In 2012, Croatia became the leading country in the world by increased deceased donation and transplantation rates, with 34.2 utilized donors p.m.p. (157 actual donors, 36.5 p.m.p.) and the highest annual rate of transplanted organs (93.2 p.m.p.).
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