The European experience

This mini‐review on European experiences with tackling the problem of organ shortage for transplantation was based on a literature review of predominantly European publications dealing with the issue of organ donation from deceased donors. The authors tried to identify the most significant factors that have demonstrated to impact on donation rates from deceased donors and subsequent transplant successes. These factors include legislative measures (national laws and European Directives), optimization of the donation process, use of expanded criteria donors, innovative preservation and surgical techniques, organizational efforts, and improved allocation algorithms.

[1]  G. Mayer,et al.  Eurotransplant kidney allocation system (ETKAS): rationale and implementation. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[2]  M. Epstein Aging and the kidney. , 1996, Journal of the American Society of Nephrology : JASN.

[3]  H. V. van Houwelingen,et al.  The outcome of kidney grafts from multiorgan donors and kidney only donors. , 1996, Transplantation.

[4]  A. Rahmel,et al.  Kidney Donation and Transplantation in Eurotransplant 2006–2007: Minimizing Discard Rates by Using a Rescue Allocation Policy , 2009, Progress in transplantation.

[5]  J. Pascual,et al.  A systematic review of kidney transplantation from expanded criteria donors. , 2008, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[6]  R. Freeman,et al.  Report of the Paris consensus meeting on expanded criteria donors in liver transplantation , 2008, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[7]  A. Geerts,et al.  Improved results for adult split liver transplantation with extended right lobe grafts: could we enhance its application? , 2009, Transplantation proceedings.

[8]  D. Novitzky,et al.  Results of hormonal therapy in human brain-dead potential organ donors. , 1988, Transplantation proceedings.

[9]  M. Christiaens,et al.  Three years of experience with a 'presumed consent' legislation in Belgium: its impact on multi-organ donation in comparison with other European countries. The Leuven Collaborative Group for Transplantation. , 1991, Transplantation proceedings.

[10]  N. L. Johnson,et al.  Multivariate Analysis , 1958, Nature.

[11]  A. Tibell,et al.  From words to action – influence of two organ donation campaigns on knowledge and formal decision making , 2009, Clinical transplantation.

[12]  Michael J. Taylor,et al.  Current state of hypothermic machine perfusion preservation of organs: The clinical perspective. , 2010, Cryobiology.

[13]  R. Busuttil,et al.  Technical and logistical considerations of in situ split‐liver transplantation for two adults: Part II. Creation of left segment I‐IV and right segment V‐VIII grafts , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[14]  M. Strosberg,et al.  Presumed consent and other predictors of cadaveric organ donation in Europe. , 2003, Progress in transplantation.

[15]  G. Tufveson,et al.  Scandiatransplant: thirty years of cooperation in organ transplantation in the Nordic countries. , 1998, Clinical transplants.

[16]  D. Samuel,et al.  Domino liver transplants for metabolic disorders: experience with familial amyloidotic polyneuropathy. , 1999, Journal of the American College of Surgeons.

[17]  A. Rahmel,et al.  Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult lung and heart/lung transplantation report--2008. , 2008, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[18]  N. Cavallo,et al.  Single versus double lung transplantation in pulmonary fibrosis: a debated topic. , 2008, Transplantation Proceedings.

[19]  J. W. Fijter An old virtue to improve senior programs. , 2009 .

[20]  A. Sowden,et al.  Impact of presumed consent for organ donation on donation rates: a systematic review , 2009, BMJ : British Medical Journal.

[21]  C. Herfarth,et al.  Sequential (domino) transplantation of the liver in a transthyretin-50 familial amyloid polyneuropathy , 2000, Langenbeck's Archives of Surgery.

[22]  Alberto Abadie,et al.  The Impact of Presumed Consent Legislation on Cadaveric Organ Donation: A Cross Country Study , 2004, Journal of health economics.

[23]  W. Wicomb,et al.  Endocrine changes and metabolic responses. , 1988, Transplantation proceedings.

[24]  L. Roels,et al.  Joining efforts in tackling the organ shortage: the Donor Action experience. , 2002, Clinical transplants.

[25]  M. Ermani,et al.  Understanding of and attitude to xenotransplantation among Italian university students: impact of a 3‐yr university course , 2006, Xenotransplantation.

[26]  G. Verleden,et al.  The number of lung transplants can be safely doubled using extended criteria donors; A single‐center review , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[27]  P. Botha Extended donor criteria in lung transplantation , 2009, Current opinion in organ transplantation.

[28]  R. Novick,et al.  Impact of recipient age and procedure type on survival after lung transplantation for pulmonary fibrosis. , 2005, The Annals of thoracic surgery.

[29]  J. Chessare,et al.  US Organ Donation Breakthrough Collaborative Increases Organ Donation , 2008, Critical care nursing quarterly.

[30]  E. Reed,et al.  Assessing Relative Risks of Infection and Rejection: A Meta-analysis using an Immune Function Assay , 2006, Transplantation.

[31]  E. Heineman,et al.  Glutathione S-transferase as predictor of functional outcome in transplantation of machine-preserved non-heart-beating donor kidneys. , 1997, Transplantation.

[32]  H. Bismuth,et al.  Deleterious effect of extended cold ischemia time on the posttransplant outcome of aged livers. , 1995, Transplantation proceedings.

[33]  J. Punch,et al.  Organ Donation and Utilization in the United States, 1996–2005 , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[34]  D. Patrzałek,et al.  Nonexploited potential for organ donation: donor action pre intervention data and the Polish case. , 2003, Transplantation proceedings.

[35]  R. Friele,et al.  Consent systems for post mortem organ donation in Europe. , 2004, European journal of health law.

[36]  S. Steen,et al.  Transplantation of lungs from non-heart-beating donors after functional assessment ex vivo. , 2003, The Annals of thoracic surgery.

[37]  P. Neuhaus,et al.  Brain death associated ischemia/reperfusion injury. , 2003, Annals of transplantation.

[38]  A. Unterberg,et al.  Critical care management of potential organ donors: our current standard , 2009, Clinical transplantation.

[39]  B. Scandroglio,et al.  DECREASE IN REFUSALS TO DONATE IN SPAIN DESPITE NO SUBSTANTIAL CHANGE IN THE POPULATION'S ATTITUDE TOWARDS DONATION , 2010 .

[40]  R. Busuttil,et al.  The utility of marginal donors in liver transplantation , 2003, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[41]  Susan E. Morgan,et al.  The Intersection of Conversation, Cognitions, and Campaigns: The Social Representation of Organ Donation , 2009 .

[42]  C. Morris,et al.  Non-heart-beating organ donation. , 2005, European journal of anaesthesiology.

[43]  F. Delmonico,et al.  Hormonal resuscitation yields more transplanted hearts, with improved early function1 , 2003, Transplantation.

[44]  D. Cooper Hormonal resuscitation therapy in the management of the brain-dead potential organ donor. , 2008, International journal of surgery.

[45]  S. Takemoto,et al.  HLA matching. , 2020, Clinical transplants.

[46]  J. van der Zee,et al.  Donor education campaigns since the introduction of the Dutch organ donation act: increased cohesion between campaigns has paid off , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[47]  C. V. D. van der Vleuten,et al.  Requesting Organ Donation: The Case of Self-Efficacy – Effects of the European Donor Hospital Education Programme (EDHEP) , 2004 .

[48]  G. Lang,et al.  Extended donor criteria for lung transplantation--a clinical reality. , 2005, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[49]  J. Briceño,et al.  Influence of marginal donors on liver preservation injury , 2002, Transplantation.

[50]  Unilateral lung transplantation for pulmonary fibrosis. , 1986, The New England journal of medicine.

[51]  J. Chapman,et al.  Chronic renal allograft dysfunction. , 2005, Journal of the American Society of Nephrology : JASN.

[52]  F. Delmonico,et al.  Report of the Crystal City Meeting to Maximize the Use of Organs Recovered from the Cadaver Donor , 2002, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[53]  R. Busuttil,et al.  Technical and logistical considerations of in situ split‐liver transplantation for two adults: Part I. Creation of left segment II, III, IV and right segment I, V‐VIII grafts , 2001, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[54]  J. Smits,et al.  Donation Patterns in Four European Countries: Data From the Donor Action Database , 2008, Transplantation.

[55]  M. Christiaens,et al.  Three years of experience with a presumed consent legislation in Belgium : its impact on multi-organ donation in comparison with other european countries , 1991 .

[56]  K. Lopau,et al.  Prospective Age‐Matching in Elderly Kidney Transplant Recipients—A 5‐Year Analysis of the Eurotransplant Senior Program , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[57]  G. Verleden,et al.  Long-term Preservation With Interim Evaluation of Lungs From a Non-Heart-Beating Donor After a Warm Ischemic Interval of 90 Minutes , 2003, Annals of surgery.

[58]  한성민,et al.  WDR5 promotes the tumorigenesis of oral squamous cell carcinoma via CARM1/β-catenin axis , 2021, Odontology.

[59]  M. Stegall,et al.  Risk factors for primary dysfunction after liver transplantation--a multivariate analysis. , 1993, Transplantation.

[60]  G. Kootstra,et al.  In situ perfusion of kidneys from non-heart-beating donors: the Maastricht protocol. , 1993, Transplantation proceedings.

[61]  Gerhard Opelz,et al.  Effect of Human Leukocyte Antigen Compatibility on Kidney Graft Survival: Comparative Analysis of Two Decades , 2007, Transplantation.

[62]  M. Nicholson,et al.  Nonheart-beating kidney donation: current practice and future developments. , 2003, Kidney international.

[63]  J. Cecka,et al.  Could More Effective Use of Kidneys Recovered from Older Deceased Donors Result in More Kidney Transplants for Older Patients? , 2006, Transplantation.

[64]  R. Busuttil,et al.  CORRELATION BETWEEN DONOR AGE AND THE PATTERN OF LIVER GRAFT RECOVERY AFTER TRANSPLANTATION , 1995, Transplantation.

[65]  J. Fawcett,et al.  Outcomes of split versus reduced‐size grafts in pediatric liver transplantation , 2005, Journal of gastroenterology and hepatology.

[66]  T. Wahlers,et al.  Marginal donor grafts in heart transplantation: lessons learned from 25 years of experience , 2007, Transplant international : official journal of the European Society for Organ Transplantation.

[67]  S. Feng Donor Intervention and Organ Preservation: Where Is the Science and What Are the Obstacles? , 2010, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[68]  David Brinberg,et al.  More than nation and knowledge: cultural micro-diversity and organ donation in Switzerland. , 2006, Patient education and counseling.

[69]  R. Ploeg,et al.  Perspectives in Organ Preservation , 2007, Transplantation.

[70]  E. Furtado,et al.  Sequential liver transplantation. , 1997, Transplantation proceedings.

[71]  E. Fadel,et al.  Impact of donors aged 60 years or more on outcome after lung transplantation: results of an 11-year single-center experience. , 2007, The Journal of thoracic and cardiovascular surgery.

[72]  J. Chilcott,et al.  Pulsatile machine perfusion vs. cold storage of kidneys for transplantation: a rapid and systematic review , 2003, Clinical transplantation.

[73]  G. Kootstra,et al.  Non-heartbeating donation of kidneys for transplantation , 2007, Nature Clinical Practice Nephrology.

[74]  M. Morino,et al.  Emergency orthotopic liver transplantation in two patients using one donor liver , 1989, The British journal of surgery.

[75]  J. Emond,et al.  Split‐Liver Transplantation: A Review , 2003, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[76]  K. Jager,et al.  The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation , 1999, Transplant international : official journal of the European Society for Organ Transplantation.

[77]  R. Ploeg,et al.  Machine perfusion or cold storage in deceased-donor kidney transplantation. , 2009, The New England journal of medicine.

[78]  M. Manyalich,et al.  Training of health care students and professionals: a pivotal element in the process of optimal organ donation awareness and professionalization. , 2009, Transplantation proceedings.

[79]  M. Sterneck,et al.  Long-term Outcome of Split Liver Transplantation Using Right Extended Grafts in Adulthood: A Matched Pair Analysis , 2006, Annals of surgery.

[80]  F. Claas,et al.  Long-term results of solid organ transplantation. Report from the Eurotransplant International Foundation. , 1996, Clinical transplants.

[81]  Diethard Monbaliu,et al.  Machine perfusion of the liver: past, present and future , 2010, Current opinion in organ transplantation.

[82]  M. Kon,et al.  Repair of Damaged Organs in Vitro , 2005, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[83]  G. Verleden,et al.  Ex vivo reperfusion of human lungs declined for transplantation; a novel approach to alleviate donor organ shortage? , 2004 .

[84]  B. Miranda,et al.  Donor action in Spain: a program to increase organ donation. , 1999, Transplantation proceedings.

[85]  J. Morales,et al.  Lower rate of family refusal for organ donation in non-heart-beating versus brain-dead donors. , 2009, Transplantation proceedings.

[86]  W. Buurman,et al.  Biological modulation of renal ischemia–reperfusion injury , 2010, Current opinion in organ transplantation.

[87]  P. Macdonald,et al.  Organ preservation. , 2006, Methods in molecular biology.

[88]  G. Kootstra,et al.  Categories of non-heart-beating donors. , 1995, Transplantation proceedings.

[89]  D. Patrzałek,et al.  How local transplant coordinators might increase the number of potential donors: our experience in lower silesia. , 2000, Transplantation proceedings.

[90]  V. Rao,et al.  Non-utilization of hearts and lungs after consent for donation: a Canadian multicentre study , 2006, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[91]  J. Bragg-Gresham,et al.  Characteristics Associated with Liver Graft Failure: The Concept of a Donor Risk Index , 2006, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[92]  H. Bouma,et al.  Signal Transduction Pathways Involved in Brain Death‐Induced Renal Injury , 2009, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[93]  J. Emond,et al.  Application of Reduced‐size Liver Transplants as Split Grafts, Auxiliary Orthotopic Grafts, and Living Related Segmental Transplants , 1990, Annals of surgery.

[94]  R. Kelly,et al.  Effect of preoperative pulmonary artery pressure on early survival after lung transplantation for idiopathic pulmonary fibrosis. , 2005, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[95]  M. Büchler,et al.  Rescue allocation for liver transplantation within Eurotransplant: the Heidelberg experience , 2009, Clinical transplantation.

[96]  G. Santori,et al.  Innovative strategies to expand cadaveric donor pool for liver transplantation (SITF project): a network between Italian transplantation centers supported by the Ministry of Health. , 2005, Transplantation proceedings.

[97]  L. Bennett,et al.  The expanded donor , 1997 .

[98]  H. Ekberg,et al.  Medical-record review of potential donor pool in the Czech Republic suggests a possible increase to more than double the number of donors , 2003, Transplant international : official journal of the European Society for Organ Transplantation.

[99]  Steven Laureys,et al.  Organ procurement after euthanasia: Belgian experience. , 2009, Transplantation proceedings.

[100]  E. Heineman,et al.  Viability assessment of non-heart-beating donor kidneys during machine preservation. , 1995, Transplantation proceedings.

[101]  G. Persijn Allocation of organs, particularly kidneys, within Eurotransplant. , 2006, Human immunology.

[102]  P. Brousse,et al.  Split liver transplantation , 2002, Steinkopff.

[103]  J. Smits,et al.  Critical Care staffs’ attitudes, confidence levels and educational needs correlate with countries’ donation rates: data from the Donor Action® database , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[104]  R. Alarcón,et al.  Assessment of an educational program for adolescents about organ donation and transplantation. , 2008, Transplantation proceedings.

[105]  A. Saviozzi,et al.  Summary: the quality improvement program in organ donation of the Tuscany region. , 2004, Transplantation proceedings.

[106]  J. D. de Fijter An old virtue to improve senior programs , 2009, Transplant international : official journal of the European Society for Organ Transplantation.

[107]  J. Behr,et al.  Potential functional and survival benefit of double over single lung transplantation for selected patients with idiopathic pulmonary fibrosis , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[108]  R. Merion,et al.  Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor JL. Ann Surg 1990;212:368–375 , 1991 .

[109]  R. Meyboom Letter: Practolol and sclerosing peritonitis. , 1975, Lancet.

[110]  G. Piccoli,et al.  Efficacy of an educational programme for secondary school students on opinions on renal transplantation and organ donation: a randomized controlled trial. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[111]  H. Bismuth,et al.  Reduced-sized orthotopic liver graft in hepatic transplantation in children. , 1984, Surgery.

[112]  Joan Costa-Font,et al.  Does organ donation legislation affect individuals' willingness to donate their own or their relative's organs? Evidence from European Union survey data , 2008, BMC health services research.

[113]  J. Tuttle-Newhall,et al.  Organ Donation and Utilization in the United States, 1997–2006 , 2008, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[114]  G Opelz,et al.  HLA compatibility and organ transplant survival. Collaborative Transplant Study. , 1999, Reviews in immunogenetics.

[115]  L. Roels,et al.  Donor Action: A Quality Assurance Program for Intensive Care Units That Increases Organ Donation , 2000 .

[116]  J. Smits,et al.  An analysis of critical care staff's attitudes to donation in a country with presumed-consent legislation. , 2008, Progress in transplantation.

[117]  S. Dorney Liver transplantation in children , 1991, The Medical journal of Australia.

[118]  D. Mirza,et al.  The marginal liver donor – an update , 2008, Transplant international : official journal of the European Society for Organ Transplantation.

[119]  R. Evans,et al.  The cost-effectiveness of organ preservation methods in renal transplantation: US projections based on the machine preservation trial. , 2009, Transplantation proceedings.

[120]  Dirk Van Raemdonck,et al.  Lung donor selection and management. , 2009, Proceedings of the American Thoracic Society.

[121]  B. Ericzon,et al.  Domino liver transplantation. , 2008, Journal of hepato-biliary-pancreatic surgery.

[122]  J. D. De Meester,et al.  The relative impact of presumed-consent legislation on thoracic organ donation in the Eurotransplant area. , 1996, Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization.

[123]  R. Pichlmayr,et al.  [Transplantation of a donor liver to 2 recipients (splitting transplantation)--a new method in the further development of segmental liver transplantation]. , 1988, Langenbecks Archiv fur Chirurgie.

[124]  M. Metcalfe,et al.  Case‐matched comparison of long‐term results of non‐heart beating and heart‐beating donor renal transplants , 2009, The British journal of surgery.

[125]  Ulrich Frei,et al.  Expanding the donor pool to increase renal transplantation. , 2005, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[126]  R. Matesanz Organ donation, transplantation, and mass media. , 2003, Transplantation proceedings.

[127]  A. Rahmel,et al.  Long Term Cost-Effectiveness of Hypothermic Machine Perfusion Versus Static Cold Storage in Kidney Transplantation. , 2009 .

[128]  J. Wallwork,et al.  Transforming the "unacceptable" donor: outcomes from the adoption of a standardized donor management technique. , 1995, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[129]  P. Clavien,et al.  Small‐for‐Size Syndrome After Partial Liver Transplantation: Definition, Mechanisms of Disease and Clinical Implications , 2005, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[130]  P. Friend,et al.  Ex-vivo normothermic liver perfusion: an update , 2010, Current opinion in organ transplantation.

[131]  T. Pruett Effects of Donor Pretreatment With Dopamine on Graft Function After Kidney Transplantation: A Randomized Controlled Trial , 2010 .

[132]  H. Bismuth,et al.  Split-Liver Transplantation for Two Adult Recipients: Feasibility and Long-Term Outcomes , 2001, Annals of surgery.

[133]  M. Denton,et al.  Outcome of transplantation of non-heart-beating donor kidneys , 1995, The Lancet.

[134]  Ulrich Frei,et al.  Evaluation of the Eurotransplant Senior Program. The Results of the First Year , 2002, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[135]  G. Gubernatis,et al.  Transplantation einer Spenderleber auf zwei Empfänger (Splitting-Transplantation) - Eine neue Methode in der Weiterentwicklung der Lebersegmenttransplantation , 2005, Langenbecks Archiv für Chirurgie.

[136]  J. de Ville de Goyet Split liver transplantation in Europe--1988 to 1993. , 1995, Transplantation.

[137]  Rachel J. Johnson,et al.  Analysis of factors that affect outcome of primary cadaveric renal transplantation in the UK , 1999, The Lancet.

[138]  D. Goldfarb,et al.  Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors. , 2003, The Journal of urology.

[139]  J. Klempnauer,et al.  Split liver transplantation: a reliable approach to expand donor pool. , 2005, Hepatobiliary & pancreatic diseases international : HBPD INT.

[140]  Qiuming Liao,et al.  First human transplantation of a nonacceptable donor lung after reconditioning ex vivo. , 2007, The Annals of thoracic surgery.

[141]  D. Hadjiliadis,et al.  Controversies in lung transplantation: are two lungs better than one? , 2006, Seminars in respiratory and critical care medicine.

[142]  A. Caplan,et al.  Health care professional attitudes toward donation: effect on practice and procurement. , 1995, The Journal of trauma.

[143]  R. Bullock,et al.  Use of low dose arginine vasopressin to support brain-dead organ donors. , 1995, Transplantation.

[144]  C. Ballesté,et al.  The PIERDUB project: International Project on Education and Research in Donation at University of Barcelona: training university students about donation and transplantation. , 2010, Transplantation proceedings.

[145]  R. Matesanz,et al.  Organ donation--the role of the media and of public opinion. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[146]  G. Burch,et al.  How normal is the donor heart? , 1969, American heart journal.

[147]  H. Delooz,et al.  Effect of triiodothyronine replacement therapy on maintenance characteristics and organ availability in hemodynamically unstable donors. , 1999, Transplantation proceedings.

[148]  H. Popper Aging and the liver. , 1986, Progress in liver diseases.

[149]  G. Sirchia,et al.  Split liver is an effective tool to transplant paediatric patients , 2000, Transplant international : official journal of the European Society for Organ Transplantation.

[150]  K. Höckerstedt,et al.  Substantial increase in cadaveric organ donors in hospitals implementing the donor action program in Finland. , 2005, Transplantation proceedings.