National Donation Network: what reality for heart transplantation?

The National Organ Donation Network is the structure that provides donation logistics for all transplant programmes currently functioning in Portugal (including cadaver donation, organs and tissues). In this article the authors present the Network, analyze the potential for heart donation, discuss the criteria for heart donor assessment and viability and suggest the adoption of recipient urgency grading schemes and the implementation of allocation criteria. In the coming years a realistic prediction for the maximum capacity of effective heart donation of the national network is 70-80 heart transplants per year, matching the figure of 7-8 heart transplants per million population and meeting 70-80% of the estimated needs for heart transplantation at national level. When this level is reached, it can be presumed that further improvement will necessitate expanding the donor pool, with less restrictive criteria for heart donor acceptance.