The National Transplant Center was established by the authority of the Ministry of Health in 1994, with the purpose of creating an official and independent body for the management and coordination of organ donation and transplantation in Israel.
The Center is a unit within the Ministry of Health and its workers are civil servants. The National Transplant Center is the sole organization in Israel responsible for both the registration of donors awaiting transplantation and the allocation (distribution) of organs. Moreover, each organ transplant carried out in Israel, whether from a live or a deceased donor, requires authorization by the National Transplant Center - Ministry of Health. The activity of the National Transplant Center is regulated by the Organ Transplant Law of 5768 (2008).
The aims of the National Transplant Center are to:
- Increase the number of organ and tissue donations in Israel.
- Optimize the use of organs retrieved for transplantation.
- Implement an egalitarian and transparent organ allocation policy.
- Manage a Quality Assurance System in the field of organ donation.
- Raise of public awareness regarding the importance of organ donation.
- Increase the number of signees of a donor card (Adi).
- Support and guide families who have donated organs of their loved ones by means of memorials and support groups.
- Implement programs for transplantation from live donors, including a National Transplant Approval Committee.
Structure of the Center:
The chairman of the National Transplant Center is a senior medical personality appointed by the Minister of Health. The present chairman is Prof. Rafael Biar, Director of the Rambam Medical Center in Haifa.
The policy of the Center is formulated by the Steering Committee, headed by the chairman of the Center, and includes leading transplant surgeons as well as representatives from the fields of psychology, law, ethics and associations of patients waiting for and having undergone transplantation.
The functions of the Committee are to establish organ transplantation policy, implement and develop programs to promote transplantation and maintain a quality control mechanism.
Apart from the Steering Committee, specific organ committees, including the Heart and Lung Committee, Liver Committee and Kidney Committee, act within the Center. The members of these professional committees are transplant specialists whose role is to advise the Steering Committee regarding organ allocation, procedures, transplant promotion programs and quality control.
Quality Control Committee:
The Chairman of the Committee is the Chairman of the Steering Committee, and two of its members are also members of the Steering Committee, in accordance with the regulations of the Organ Transplant Law, 5768 – 2008. The objective of the Committee is to examine the quality of medical care of the medical centers authorized for organ retrieval and transplantation.
A specialist is appointed with the role of supervising the donation process, from the stage of donor detection until organ retrieval.
National Transplant Coordinator:
The National Transplant Coordinator of the Center is a nurse in charge of the actual implementation of the policy of the Center. This includes increasing the number of organ donations, coordination of retrieval procedures, coordination of transplant procedures and any matter related to the actual performing of organ donation and transplantation. The national transplant coordinator is in direct cooperation with the transplant coordinators in the hospitals, at all hours, day and night.
National Medical Advisor:
The Center employs a National Medical Advisor whose roles includes advising and approving potential organ donors, defining and updating donor management protocols, providing guidance to medical teams in charge of donor care. The medical advisor is available 24 hours a day to medical teams from all the hospitals in Israel.
Three core systems define the activity of the Center :
a. A system for organ donations from deceased donors; b. A system for patient registration and organ allocation; c. A system for guidance and information.
System for organ donations from deceased donors
A Transplant Coordinator, who is a nurse representing the National Transplant Center, is present in each medical center and hospital in Israel. Her role is to detect potential donors, to approach the families, and to provide maximum guidance and support during the entire decision-making process with regard to the donation.
The transplant coordinator is also responsible for the guidance of medical teams concerning the detection and management of organ donors and for the medical protocols necessary for the donation process and retrieval of organs. In this capacity, the coordinators are employees of the National Transplant Center, are professionally subordinated to the Center and receive full guidance and support from the Center in the execution of their duties.
Apart from the transplant coordinator, every hospital appoints a Transplant Trustee Physician whose role consists of coordinating the medical treatment of organ donors and the promotion of organ donation in the hospital.
The transplant coordinators and the transplant trustees have no connection whatsoever with patients awaiting transplantation. There is thus complete separation between the donation process and decision-making as to the transplant.
System for patient registration and organ allocation
The National Transplant Center is the only body in Israel responsible for and coordinating the registration of candidates for organ donation in the entire country. A patient is free to choose the hospital where the transplant will take place and the relevant transplant team is responsible for registering the patient. The transplant waiting list is managed by the Center by means of a computerized system. The position of each patient on the list is determined according to criteria decided upon by the Steering Committee and includes amongst others the age of the patient, medical urgency, tissue matching, waiting time on the list. The position of an individual patient on the waiting list constantly varies according to changes in the medical state of the patient, decrease or increase in the number of patients on the waiting list, etc.
Only after the transplant coordinator obtains consent for organ donation are the data of the donor transferred to the National Transplant Center and fed into the computerized system. The system cross-checks the data of the donor with those of potential recipients and detects the most suitable candidates by a computerized priority calculation.
The decision as to the allocation of the organ is the exclusive prerogative of the National Transplant Center.
System for guidance and information
The National Transplant Center is responsible for developing and organizing guidance and information activities in order to raise awareness of organ donation. The activity, targeted to the different communities and sectors of the general public, includes media campaigns for the promotion of the Adi donor card including facilitating accessibility. The activity, targeted to medical teams and opinion leaders of the different religions, includes lectures, workshops, and academic courses. In addition, the Center develops programs for encouraging the signing of the Adi donor card and manages and operates the national signatories' bank. This has resulted in a continuous increase in public awareness as to the need for organ donation and a significant growth in the number of signees of the Adi donor card.