Scandiatransplant Organ Exchange Activities
Scandiatransplant is the organ exchange organization covering Denmark, Finland, Iceland, Norway, Sweden, and Estonia, serving as a platform for organ transplantation activities including kidney, liver, and thoracic transplantation. It operates ethically, transparently, and collaboratively to promote research and best practices in organ donation and transplantation.
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Slideshow 2024 Scandiatransplant activities Slide presentation of Scandiatransplant activities Presentation, purpose, awards and office Slide 3 Organ procurement and transplantation activities in Scandiatransplant Slide 8 Kidney Transplantation Slide 14 Liver Transplantation Slide 26 Thoracic Transplantation Slide 30 Pancreas and Islet Transplantation Slide 41
Scandiatransplant Scandiatransplant is the organ exchange organization for the member hospitals in Denmark, Finland, Iceland, Norway, Sweden and Estonia. It covers a population of about 29,7 million inhabitants. It is owned by the eleven hospitals performing organ transplantation in these countries. The office is located at Aarhus University Hospital, Denmark.
Purpose of Scandiatransplant to serve as a common organ exchange organisation and allocation resource for its member hospitals including kidney, liver, heart, lung, pancreas, pancreatic islet, liver cells, composite graft, intestinal and multivisceral transplantation. This is done transparently, using ethical principles and in full compliance with the national legislation of the members countries, to maintain and operate a common waiting list for transplantation, to ensure complete traceability from organ donors to patients, to maintain and operate follow-up registries of transplanted patients, to maintain and operate follow-up registries of living donors, to serve as a collaborative platform through specialized working groups and advisory groups in order to facilitate best practice recommendations and policies optimizing retrieval, allocation and transplantation of organs, and to form a collaborative network for the member hospitals to promote research and development related to organ donation, allocation and transplantation.
Reykjavik Oslo Gothen- burg Uppsala Stock- holm Sk ne Copen- hagen Odense Aarhus Helsinki Tartu Council of Representatives NKG NLTG Chair Board SHLG N TG NTCG Medical Director Scandiatransplant office STTG SIDG NTC Scandiatransplant IT system YASWA
Awarded Grants in 2024 Travel Grants Research Grants Principal investigator: Vera Nils n: "Outcome of split-liver transplantation with extended right grafts in the Nordic countries a donor-matched analysis". Supported with 100.630 DKK No sponsorship granted. Principal investigator: Susanne Dam Poulsen: "Prediction of progression from urinary tract infection to bloodstream infection in kidney transplant recipients". Supported with 260.000 DKK
Scandiatransplant Office Activities 2024 Customize the IT system to the user s wishes and optimizing security and functionality of the system. Introducing the possibility to upload, share and view DICOM files within the IT system. Providing real-time statistics on donors, transplantations and waiting lists. Registration of all OEO organ offers within the IT system. Educate users and comply with demands from users, owners, researchers and the public. Arrange and participate in meetings for groups, committees, board and council of representatives. Take care of finance and personnel. Launched a new website.
2024 Organ procurement and transplantation activities in Scandiatransplant
Scandiatransplant 2024 631 Utilized deceased donors (21,27 PMP) Organ transplants performed 1419 kidneys (319 were kidneys from living donors) 404 livers (5 were liver from living donors ) 130 hearts 147 lungs (2 heart-lung) 46 pancreas (39 as combined kidney-pancreas) 4 pancreatic islet 3 intestine (3 multiviceral) 2360 patients on waiting list at the end of 2024
Patients entered on waiting list during 2024 (2023 figures) Kidney Liver Heart Lung Pancreas Kidney + Pancreas Liver + Kidney Pancreatic Islets TOTAL 1367 (1338) 386 (452) 148 (150) 147 (178) 7 (4) 48 (60) 11 (18) 14 (10) 2128 (2210)
Utilized deceased donors PMP 35 1993-1997 1998-2002 2003-2007* 2008-2012 2013-2017** 2018 2019 2020 2021 2022 2023 2024 30 Number of deceased donors 25 20 15 10 5 0 Denmark Finland Norway Sweden Iceland Estonia *Iceland: only numbers from 2004 and onwards **Estonia: only numbers from oct. 2017 and onwards
Yearly flow on the waiting list 3000 2500 Number of patients Entered during the year 2000 Transplanted recipients during the year 1500 On waiting list at end of year 1000 500 0 2000 2002 2006 2008 2010 2012 2014 2016 2018 2020 2022 2024 2004
Deceased donor organ exchange between centers in 2024 35% 30% 25% 20% 15% 10% 5% 0% Kidney Liver Heart Lung Notes: Only organs not used for combined transplantations are included Organs exchanged due to local/national agreements are not included
Kidney Transplantation 1989 2024 1400 1200 Number of transplants 1000 800 600 400 200 0 2001 1989 1991 1993 1995 1997 1999 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023 Deceased donors Living donors
Kidney exchange rate in % between centers 1969 - 2024 80 70 60 50 40 30 20 10 0 2021 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2023 Notes: Only organs not used for combined transplantations are included Organs exchanged due to local/national agreements are not included
Kidney Transplantation activity 2024 by centre 350 300 Number of transplants 250 200 Living donor Deceased Donor 150 100 50 0
Kidney Transplantation PMP 2024 60 50 40 Living donor Deceased donor 30 20 10 0 Denmark Finland Norway Sweden Iceland Estonia
Kidney Transplantation 2024 100% 90% 80% 70% 60% Living donor 50% 40% Deceased donor 30% 20% 10% 0%
Number of patients on the kidney waiting list at the end of the year 1995 - 2024 2500 2000 Number of patients 1500 1000 500 0 1997 1995 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023
Average months on kidney waiting list at end of year (including patients active and on hold) 40 1999-2004 35 2005-2009 30 Number of months 2010-2014 25 2015-2019* 20 2020 15 2021 10 2022 5 2023 2024 0 Denmark Finland Norway Sweden Estonia *Estonia: only numbers from oct. 2017 and onwards
Average months on kidney waiting list by immunisation status at end year 50 2002-2007 45 2008-2012 40 Number of months 2013-2017 35 2018 30 2019 25 2020 20 2021 15 2022 10 2023 5 2024 0 High immunized Immunized Prev. immunized Non immunized
Deceased donor kidney transplants 1994 - 2024 450 1994-1999 400 2000-2004 Number of transplants 350 2005-2009 300 2010-2014 250 2015-2019* 200 2020 150 2021 100 2022 50 2023 0 2024 Denmark Finland Norway Sweden Estonia Figures included from Estonia year 2017 starts from October 1st 201 *Estonia: only numbers from oct. 2017 and onwards
Living donor kidney transplants 1994 - 2024 180 1994-1999 160 2000-2004 140 Number of transplants 2005-2009 120 2010-2014 100 2015-2019* 80 2020 60 2021 40 2022 20 2023 0 2024 Denmark Finland Norway Sweden Iceland Estonia *Estonia: only numbers from oct. 2017 and onwards
Kidney exchange obligations Patient with STAMP-status that are ABO compatible with donor and where all donor HLA-A, -B, -C -DRB1, -DRB3/4/5, DQA1, -DQB1, -DPA1 -DPB1 antigens are either shared with the recipient or are among those defined as acceptable. Highly immunized (PRA 80%) patients who are HLA-A, -B, -DRB1 compatible with donor. Immunized patients (PRA 10% but below 80%) who are HLA-A, -B, -DRB1 compatible with donor. If organ donor is <50 years of age, at least one kidney is offered to recipient <16 years of age (counted from time of registration) if there is HLA-DRB1 compatibilitty and in addition not more than 2 HLA-A, B mismatches. Patients who are HLA-A, -B, -DRB1 compatible with donor unless the proposed recipient is > 30 years older than the donor. 1. 2. 3. 4. 5. Priority 1: Donors are matched ABO-compatible Priority 2-5: Donors are matched ABO-identical, with the exception of donors of blood group A, which also can be exchanged to recipients of blood group AB. Rota system for spare kidneys
Liver Transplantation 1989 - 2024 500 18 450 16 400 14 350 12 300 10 250 8 200 6 150 4 100 2 50 0 0 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023 Number (columns) PMP (line)
Liver Transplantation 1994-2024 250 1994-1999 2000-2004 200 Number of transplants 2005-2009 2010-2014 150 2015-2019* 100 2020 2021 50 2022 2023 0 2024 Denmark Finland Norway Sweden Estonia Figures included from Estonia year 2017 starts from October 1st 20 *Estonia: only numbers from oct. 2017 and onwards
Exchange criteria Liver Exchange obligation to highly urgent patients: acute liver failure acute liver re-transplantation highly urgent patients that need to be transplanted within 72 hours Exchange obligation to pediatric (<18 years at entry on liver waiting list) and visceral recipients if donor liver fulfils split criteria Return (payback) liver to donor centre Rota system for spare livers
Thoracic Transplantation
Thoracic transplantation 2024 60 Number of transplants 50 40 Heart 30 Lung 20 Heart-Lung 10 0 Denmark Finland Norway Sweden Estonia
Heart Transplantation 1989 - 2024 180 7.0 160 6.0 140 5.0 120 4.0 100 80 3.0 60 2.0 40 1.0 20 0 0.0 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023 Number PMP
Heart transplantation 2024 60 Number of transplants 50 40 30 20 10 0 Denmark Finland Norway Sweden
Heart Transplantation 1994 - 2024 80 1994-1999 70 2000-2004 Number of transplants 60 2005-2009 50 2010-2014 2015-2019 40 2020 30 2021 20 2022 10 2023 0 2024 Denmark Finland Norway Sweden
Number of patients on the heart waiting list at the end of the year 1989 - 2024 140 120 Number of patients 100 80 60 40 20 0 2007 1989 1991 1993 1995 1997 1999 2001 2003 2005 2009 2011 2013 2015 2017 2019 2021 2023
Exchange criteria Heart Exchange obligation to highly urgent patients on waiting list: Patient on short-term assist devices (ECMO, centrifugal pump). Patient on para corporeal or implantable blood pump with device failure or uncontrollable device infection. Patients below 16 years on continuous inotropic support (also including home treatment) or more than 12 months support on implantable long-term VAD (in-hospital or at home). Hospital-bound patients < 25 kg supported by long- term VAD may be priority 0 listed 90 days after implantation, even in the absence of major VAD complications. Rota system for exchange of hearts between the countries.
Lung transplantation 1990 - 2024 including heart-lung 200 180 Number of transplants 160 140 120 100 80 60 40 20 0 1998 2020 1990 1992 1994 1996 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2022 2024
Lung Transplantation 1994 - 2024 100 1994-1999 90 2000-2004 80 Number of transplants 2005-2009 70 2010-2014 60 50 2015-2019* 40 2020 30 2021 20 2022 10 2023 0 Denmark Finland Norway Figures included from Estonia year 2017 starts from October 1st 201 Sweden Estonia 2024 *Estonia: only numbers from oct. 2017 and onwards
Number of patients on the Lung waiting list at the end of the year 1990 2024 160 140 Number of patients 120 100 80 60 40 20 0 2014 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2016 2018 2020 2022 2024
Exchange criteria Lung Exchange obligation to highly urgent patients on waiting list Priority 0: Patient on extra-corporeal circulatory support (ECMO, Novalung or other device) or ventilatory support*. Priority 1: Patient with a rapid progression of organ failure with poor prognosis in a short time defined by the responsible centre*. *max. three patients per center per year (Tartu one per year). Rota system for exchange of lungs between countries.
Pancreas and Islet Transplantation
Exchange recommendations Pancreas If there is no suitable recipient in own center, the pancreas (and kidney if SPK) is recommended to be offered to AB0 compatible recipients in other centers. The center at the highest position on the rota list accepting the pancreas will receive it and be placed last. Shipment of a kidney is only performed if no other kidney exchange obligation with higher priority (as defined by Scandiatransplant) exists. The receiving center has the responsibility for the pancreas procurement. The receiving center has to payback as soon as possible with an AB0 identical kidney of a quality acceptable to the recipient center. There is no mandatory payback for the pancreas.
Pancreas Transplantation 1988 2024 100 3.5 90 3.0 80 2.5 70 60 2.0 50 1.5 40 30 1.0 20 0.5 10 0 0.0 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020 2022 2024 Number PMP
Islet Transplantation 1997-2024 25 1 0.9 20 0.8 0.7 15 0.6 0.5 10 0.4 0.3 5 0.2 0.1 0 0 2012 2019 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2013 2014 2015 2016 2017 2018 2020 2021 2022 2023 2024 Number PMP
