Organ transplantation in Romania: challenges and perspectives.

Introduction: The interest in the field of organ transplantation and the first attempts at making experimental transplant interventions in Romania date from the very beginning of the 20th century. Nevertheless, the evolution of the donating activity and of organ transplantation in Romania has been confronted with a certain inconsistency and a lack of resources necessary to the development of the system.
Method: The aim of this study is to analyze the dynamics of the transplantation activity in Romania between 2000 and 2020. The study was accomplished through the analysis of available data corresponding to the above-mentioned period, which were published in the database of the National Transplant Agency, Eurostat and the Global Observatory on Donation and Transplantation. The data were processed using the MedCalc Statistical Software, version 14.8.1 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014).
Results: The activity of donation and organ transplantation in Romania has been maintained at a low level, with a rate of 3.44 donators pmp and a transplantation rate of 12.55 pmp, as reported for the year 2020. Romania remains at a transplantation rate of under 6.6 pmp, despite the considerable increase in the number of patients on the waiting lists, a fact which describes the picture of a relatively weak system, incapable of providing surgical interventions to cover the minimum needs that emerge within a calendar year.
Conclusions: Our study points to the fact that the transplantation system in Romania is confronted with a major deadlock. Romania holds the last-but-one place in the ranking of countries in the European Union on transplant activity. The major impediment is the donation rate, which continues to be way below the European average, in a society where the awareness of the necessity to donate is very low, bureaucracy is cumbersome and there is a high degree of mistrust in the medical system, where the equipment is lacking and the infrastructure is incapable of providing services adapted to the modern standards.