Landmark report sets out plan for a new national organ donation and transplantation plan for Greece

For the first time in its history, Greece now has a National Plan for Organ Donation and Transplantation
- Prime Minister Mitsotakis
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The President of the Onassis Foundation handing over the report to the Greek Prime Minister. Credit: Andreas Simopoulos

A comprehensive plan to improve rates of organ donation and transplantation in Greece, led by academics from LSE and Imperial College London, has been accepted by the Greek Government.

The Report for a New National Solid Organ Donation and Transplantation Plan in Greece was commissioned by the Onassis Foundation, which has undertaken a national initiative for the renaissance of the transplant sector in Greece.

The report provides practical recommendations for a comprehensive long-term plan that ensures progress and sustainability. It also sets out a roadmap for the creation of a national network of excellence in donation and transplantation, including the new Onassis National Transplant Center.

While Greece excels in other areas of medicine, it has some of the lowest rates of organ donation and transplantation in Europe. Despite the efforts of health-care providers and professionals across the country, it has lacked a system-wide approach and long-term plan to address high levels of need.

The report is the product of two years of in-depth research by a joint team from LSE and Imperial College London, reflecting their complementary expertise in health systems and policy.

The report is unique internationally as a template for a national transplantation programme, and its rigorous methodology can be used for the appraisal or development of other countries’ transplant programmes.

Among the report’s recommendations is that an independent nation-wide National Transplant Organisation (NTO) should have responsibility for every part of the donation and transplantation process. It should report directly to the Greek Parliament and working in close cooperation with the Ministry of Health.  

The report has been presented to the Greek government and its recommendations have been endorsed by President of the Hellenic Republic and the Prime Minister, who each provided a foreword to the summary of the report.

In his foreword, Prime Minister Mitsotakis says: “For the first time in its history, Greece now has a National Plan for Organ Donation and Transplantation. This will serve as our Charter for this pioneering medical achievement, as it is high time for our country to put it in the service of our fellow citizens’ life and health.

“The National Plan for Organ Donation and Transplantation will soon make its way to the Parliament to be voted for implementation.”

A committee will be formed to prepare the necessary legislation and oversee the implementation of the report's recommendations. Professors Elias Mossialos and Vassilios Papalois, - the Co-Chairs of the Commission that produced the report - will be members of this committee.

Professor Elias Mossialos, Brian Abel-Smith Professor of Health Policy at LSE, and Professor of Health Policy and Management at the Institute of Global Health Innovation at Imperial College London, said: “Organ transplantation is a miracle of modern medicine that should be equitably available to as many people who would benefit from it.  While other European countries have made great strides in this area, Greece stands in stark comparison. Its transplantation rates are among the lowest in the developed world, despite having relatively high levels of need. The statistics, in terms of lives lost, and those who face an uncertain future while waiting for a transplant, paint a tragic picture, the human cost of which cannot be quantified.”

The report recommends that the NTO should establish national protocols for the management and treatment of patients before, during and after transplantation, which are in line with international best practice.

Infrastructure, training and quality standards must be improved. This includes expanding operating theatre capacity and access to diagnostic services.

Professor Vassilios Papalois, Professor of Transplantation Surgery at Imperial College London and consultant transplant and general surgeon at Hammersmith Hospital, who is also the President of the European Society of Organ Transplantation, said: “Our vision is for Greece to establish an organ donation and transplantation system capable of attaining and sustaining world-class levels of performance within ten years. This will be a major undertaking requiring wide-ranging reform, sustained commitment, investment and collaboration across the system, but dramatic improvements can be achieved in a much shorter timeframe.  The proposals cover the whole spectrum of modern transplant practice with emphasis on education and research as main drives for progress.”

The report emphasises the importance of reducing the need for transplants through the introduction of programmes to address the underlying causes of organ failure. This would include public health programmes designed to help people to stop smoking, eat more healthily and to exercise more.

Dr. Anthony S Papadimitriou, President of the Onassis Foundation, said: “In 2019, the Onassis Foundation assigned the elaboration of the report on the National Plan for Solid Organ Donation and Transplantation to a research team from the London School of Economics, in cooperation with the Imperial College London, led by Professors Elias Mossialos and Vassilios Papalois. Two years later, on July 6, 2021, this National Plan report is ready and delivered to the Greek State, marking a new beginning in transplantations to save even more lives. This report is a pioneering scientific piece of work globally, an outstanding and comprehensive study that can become the road map for transplantations in Greece in the following years. It is an important step forward and, at the same time, an answer to the long-standing demand raised by healthcare professionals, patients, and all transplantation stakeholders. In this framework, we would like to thank the two Professors and their team for the great work that they have done.”

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