13th East‐West Immunogenetics Conference EWIC 2019 ‐ Building Bridges ‐ March 14‐16 2019, Zagreb, Croatia

Correspondence: mirela.busic@miz.hr There are several key elements common to all worldwide successful organ donation and transplantation systems. Croatia has successfully implemented these systems and adapted them to suit local health care systems. Despite a well-developed transplantation and immunogenetic period (1971-1998), the Croatian transplantation program, was challenged by an organ shortage twenty years ago. The Croatian Ministry of Health launched a set of reforms carried out in a 10-year stepwise approach (2001-2011). Those reforms have resulted in a 10-fold increase in deceased organ transplantation rates. In 2015 Croatia reached 40 donors per million people for the first time ever, thus ranked first in the world in deceased organ donation. Croatia is now among the few worldwide countries with the highest capacity in terms of the provision of organ donation and transplantation services. The Croatian transplantation program is grounded on principles of altruistic donation, solidarity and equity. The altruistic act of donation has been nourished for over three decades as a highly appreciated gesture of loving care for others. Over time organ donation has become widely embraced by the whole Croatian society as a valuable contribution to the community. Key donation person(s) selected among the most skilled and experienced senior intensivists have been appointed in each hospital to provide clinical leadership and intensive care expertise in the deceased organ donation pathway. That was of the utmost importance in raising overall confidence and positive attitude towards deceased organ donation among critical care professionals. The Deceased Organ Donation Pathway reveals several critical steps that should be timely and optimally addressed along the end of life care of the patient with a devastating brain injury; early identification of a patient who meets prognostic criteria for development of brain death; brain death determination; timely transition from a patient-oriented therapy to an organ-protective therapy—all should be facilitated under shared responsibility of critical care professionals and key donation person. Such operating protocols have been successfully implemented in all hospitals to ensure that organ donation is systematically imbedded into end-of-life practice, countrywide. A specific set of quality indicators for the assessment of hospitals' performance in deceased organ donation program is specified within the national quality system for transplantation program, and is the subject of the regular audits performed by the health inspection. Croatia joined Eurotransplant in 2007. Eurotransplant membership has provided a fine-tuned allocation system with a balanced exchange of organs between eight Eurotransplant member countries. Thus, since 2007, highly sophisticated computerized search for the best “organ match” has ensured optimal management of donated organs, evidence-based and fully transparent allocation process. Transplantation surgical and immunogenetic areas have been additionally advanced and positively influenced due to increased organ availability, Eurotransplant membership and multidisciplinary approach. The Croatian organ donation and transplantation program is comprehensively grounded on the highest professional and ethical standards that both positively reflect Croatian health-care standards and social values. Enhanced governing and clinical leadership provided in conjunction with stepwise implemented organizational measures, have effectively DOI: 10.1111/tan.13752