Why is BRAVEST important? The perspective from Italy
Author: CNT
Introduction
Italy was the first European Union country to be hit by the COVID-19 pandemic, and it paid high prices in terms of the spread of the virus. The intensive care workers of our hospitals faced dramatic scenarios without time to prepare for the management of such an event. The Italian National Transplant Network has, therefore, demonstrated its solidity and ability to respond effectively to the critical issues that the spread of the virus has caused [1]. In this light, the BRAVEST project will foster a systematic and global approach to advance organ safety and supply in transplantation.
What type of crises can affect organ transplantation?
Predictably, any crisis can affect organ donation and transplantation activities, such as conflicts, floods, infectious disease outbreaks, and IT breakdowns. Taking the Covid-19 pandemic as a major example, it affected all transplant activities, such as living organ and tissue donor transplantation, as well as all outpatient activities usually performed before and after surgery. This situation has generated many critical issues and required a particular commitment of health facilities to organise different care pathways, such as covid-free areas to protect hospitalised patients and providing remote consultation for patient follow-up where possible. Additionally, the centralisation of intensive care units exclusively on covid management led to the reduction of transplantation activities.
How did the Covid-19 pandemic impact CNT?
Since the report of the first cases, CNT, supported by expert advice, governed the National Transplant Network. We did this by defining criteria that took account of donor safety, recipient safety, and risk of Covid-19 transmission; while strongly emphasising the need for institutions such as the Ministry of Health to support donations and transplants, to prevent the weakening of transplant services [1]. Ensuring communication with all stakeholders required more effort, but also demonstrated the importance of a strong network coordinated by the National Competent Authority.
Why did CNT join BRAVEST?
As the National Transplant Authority, CNT joined the effort of the BRAVEST consortium to contribute our expertise to a partnership representing countries with the highest transplant activity in Europe. Organ transplantation is an essential level of care which should be granted to patients on the waiting list since the possibility of using the organs of a deceased potential donor cannot be postponed to a later time. Being ready to face a future crisis that could impact patient care as heavily as COVID-19 did is the responsibility of all European countries to their patients.
