Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

Abstract

Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P < 0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude.

Current Status of Organ Donation in a University Hospital in İzmir: Identifying Obstacles and Possible Future Solutions

“…It was previously reported that the difference in attitude of physicians might be an obstacle for BD diagnosis. A study of Kosieradzki et al (14) showed that in Polish physicians difference in BD diagnosis procedure was considered as an important barrier especially in centers with low rates of organ donation. Varelas et al (15) reported that BD certified with a single physician is easier, faster and more cost effective when compared to diagnosis with two physicians.…”

Training, work, and lifestyle of transplant physicians and surgeons in Germany

“…8 The respondents showed a greater willingness to donate their own organs than the general population or other cohorts of medical employees. [20][21][22][23][24] However, activity in this field of medicine naturally leads to familiarity with the theoretical prerequisites and necessary procedures, which is known to be a key factor for a positive attitude toward organ donation. 25,26 Furthermore, the practice of transplant medicine implies ethical approval of organ donation.…”

Early identification and referral of organ donors in five private hospitals: A survey to determine the knowledge and views of critical care professional nurses pre and post a PowerPoint training intervention

“…[3][4][5] CCPNs experience uncertainty, insecurity and a lack of clarity regarding their roles in organ donation; therefore a nationally endorsed protocol could solve this problem. [11][12][13] International studies have reported barriers or challenges to donor identification and the donation process, [14][15][16] which include unfamiliarity with BSD diagnosis and the donor process, and inadequate training in stressful experiences such as discussing BSD and organ donation with donor families. [15] A Polish study concluded that poor physician communication and skills and fears about the procurement process may have affected involvement in organ procurement practice, with formal BSD diagnoses not being made by 41% of physicians owing to a lack of experience.…”

“…[11][12][13] International studies have reported barriers or challenges to donor identification and the donation process, [14][15][16] which include unfamiliarity with BSD diagnosis and the donor process, and inadequate training in stressful experiences such as discussing BSD and organ donation with donor families. [15] A Polish study concluded that poor physician communication and skills and fears about the procurement process may have affected involvement in organ procurement practice, with formal BSD diagnoses not being made by 41% of physicians owing to a lack of experience. [15] Many missed opportunities for identification of organ donors have been linked to behaviours of healthcare professionals.…”

“…[15] A Polish study concluded that poor physician communication and skills and fears about the procurement process may have affected involvement in organ procurement practice, with formal BSD diagnoses not being made by 41% of physicians owing to a lack of experience. [15] Many missed opportunities for identification of organ donors have been linked to behaviours of healthcare professionals. [6,14,15,17] Floden et al [16] reported that 39% of CCPNs had experienced occasions where the subject of organ donation was never raised with the families of BSD patients.…”