Multi-organ Transplantation Center in Romania: a story of persuasion for a controverted issue

Many countries built their own models of transplantation, collaborating to exchange knowledge and donor organs for effectively help their patients in need. Despite great clinical research on transplantation, literature regarding its management is scarce. Transplantation is quite a controverted issue in Romania, without a culture of donation, within a poor healthcare system. Yet, first attempts were in early 20^th century, and modern transplantation started since 1995. There was always a shortage of organs, but after recent press scandals, people became more reluctant to donate, therefore transplantations went down, dramatically impacting patients.Our objective is to emphasize opportunity, need and sustainability for developing a multi-organ transplantation center in Romania, of regional importance, in order to better serve our patient needs in an effective and efficient manner. This research used descriptive analysis, secondary data compilation and review, legislative diagram, case study. Currently there are 68 transplantation centers accredited in Romania with 13,702 transplants accomplished (organs, tissues, cells), at a rate of 19.3/million, covering 19.4 millions of people living just 75.5 years in average (EU=80.2). But 5,400 Romanian patients wait for a transplant, while 550 died waiting... After modernization and building a great surgical center and team, Clinical Hospital St. Maria of 300 beds started complex surgery and successful liver transplantation in 2014, continued with lung transplant in 2018 – Romanian premiere, after many struggles. Next step is a modern multi-organ transplantation center. Vision, persuasion and effective leadership are crucial. Romanian potential for overspecialized surgery is greater than actual practice. Experience indicates that multi-organ transplantation centers are more effective and efficient than separated ones, by concentrating the best specialists, technology, knowledge and resources available for harvest, transplant and care, thus improving health outcomes (donors, successful transplants, lives saved, quality of life), prestige, retention of excellent professionals, and trust in healthcare system, at lower costs than in developed countries.