Provision of transplant services.

To a large extent the success of any transplant programme depends ultimately on the expertise, skills and experience of the team of doctors, nurses and other health-care professionals. However, the logistics associated with the service will be the major factors determining the success of the programme. The service should be provided on the basis of epidemiological need, concentrating provision in an optimal number of units so that benefit is gained from the 'experience curve' effect of a relatively high throughput. The availability of the key resource for the programme, namely organs, depends on the willingness of the public to donate, and on the co-operation of other health-care professionals, not directly involved in transplantation, in identifying potential donors, encouraging relatives to consent and ensuring that the donor is maintained in an optimal condition. There are not many medical treatments that require such wide-ranging participation and co-operation as those needed for organ transplantation. All these factors have to be addressed for an organ transplant programme to be successful.