To achieve national self-sufficiency: recent progresses in deceased donation in Korea.

Background: The disparity between patients awaiting transplantation and available organs has widened, and resultant organ shortage became a world crisis. The transplantation community has made considerable progress in national organ donation system in Korea, and significant growth in the number of deceased donors has been witnessed.
Methods: After introduction of the Organ Transplant Act, which was enacted in 2000, transparency was established in organ allocation system in Korea. However, the number of deceased donor dwindled significantly from 162 in 1999 to 36 in 2002. To improve deceased donation, several strategies were pursued, and finally new national organ donation system was established through the amendment of the Organ Transplant Act.
Results: Organ incentive system, which was introduced in 2003, failed to increase the number of deceased donors (68 in 2003, 86 in 2004, and 91 in 2005). Monetary incentive to the bereaved family was introduced in 2006 and slightly increased the number of deceased donor (141 in 2006). However, this effect was not long-lasting (148 in 2007). After enforcement of the new Organ Transplant Act, which included nationwide independent organ procurement organization and mandatory report of potential brain death, the number of deceased donors significantly increased, reaching 368 in 2011. The growth continued and the number of deceased donors reached 409 (8.03 pmp) in 2012.
Conclusion: There has been a significant growth in the number of deceased donors in Korea since the appropriate deceased organ donation system was launched. A comprehensive national program is required to improve deceased donation and achieve self-sufficiency.