AHA reviewed and subsequently compared the key structural features of the organ and tissue donation sectors in Australia and five comparable countries.

The international component of this project involved AHA:

• Identifying the five most comparable overseas countries to Australia with the highest organ and tissue donation rates. These were found to be Canada, Italy, Spain, the United Kingdom and USA
• Identifying key national organisational features of the selected countries’ approach to the procurement and eventual transplantation of solid organs and tissues
• Conducting a detailed examination of national structures for managing organ procurement and transplantation, identifying the agency or agencies involved
• Determining the detailed governance structures of the relevant national organisations including the degree of involvement of the general community, government and professional medical representatives in the various layers of governance
• Identifying the following mechanisms and processes which support best practice in organ and tissue donation processes:
  • Data collection and reporting, including the degree to which they are mandated and supported nationally
  • Policies and procedures for organ allocation and the accompanying safety and quality monitoring processes
• Comparing the degree of similarity in these countries to the Australian legal framework for gaining consent to donation (opt-out/opt-in), and whether there is a process for intending donors to register prior informed consent, through a national donor register or donor cards
• Determining the availability of current analysis, by any or all of the countries, of the impediments to optimising organ and tissue donation for transplantation, which may be relevant to Australia.

The Australian component of this project involved AHA:

• Mapping and describing all organisations involved in the pathway from organ donation and procurement through to transplantation and follow-up of transplant recipients
• Identifying the functions, roles and responsibilities of all relevant government and non-government organisations
• Examining the interactions between organisations
• Mapping funding flows within the sector
• Undertaking detailed examination of the governance structures (including the degree of involvement of the general community, government and professional medical representatives in the various layers) and lines of accountability.

A comprehensive report summarising the findings of the review was provided to the Department to inform policy decisions and future directions within the organ and tissue sectors.