Family Informed Consent to Organ Donation—Who Performs Better: Organ Procurement Organizations, In-Hospital Coordinators, or Intensive Care Unit Professionals?

Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review

“…The trained donation practitioners are always available, 24 h a day, and guide the relatives through the donation decision process.NursesXYesKrekula et al [22]Training of nursesThe donation specialist nurse (DOSS) on call supports the local team with the medical care of the donors and with the actual donation request, primarily together with the local physician. The DOSSes also promote adherence to standard routines concerning organ donation and take responsibility for the follow-up with DR at their local hospitals.NursesXYesLenzi et al [23]Donation request by trained professionalPerformances in obtaining informed consent from potential donors’ families were compared according to the type of healthcare professional conducting the interviews: OPO, In-hospital coordinator or ICU physician (not trained).OPO, in-hospital coordinators, ICU physiciansXNR (yes a )Linyear et al [24]Family communication protocolA standard family communication protocol was developed to ensure consistent identification of all patients with devastating neurological insults who might progress to brain death, optimal family communication and support, and a request for organ donation in accordance with best-demonstrated practices.Nurses and physicians from the ICUs, as well as hospital administrators, chaplains, and LifeNet representativesXXNR (no a )Manyalich et al [25]Training of healthcare professionalsThree educational initiatives were designed and implemented: 1) essentials in organ donation 2) professional training for junior transplant coordinators and 3) organ donation quality management. A public website, a private virtual platform and an e-learning campus were used as communication tools.Professionals in ICUs, postoperative recovery, emergency rooms, etc.…”

“…In total, nine studies focused on education of healthcare professionals [15, 19, 20, 23, 25, 26, 28–30]. A cohort study by Ismail et al [20] showed that advisory support by a trained psychologist for requesters who are about to request for donation increased the family consent rate from 35 to 58% (< 0.001).…”

“…A cohort study by Ismail et al [20] showed that advisory support by a trained psychologist for requesters who are about to request for donation increased the family consent rate from 35 to 58% (< 0.001). A retrospective cohort study by Lenzi et al [23] showed that when family conversations were done by an OPO representative or in-hospital coordinator, this led to significantly higher consent rates than when this was done by non-trained ICU physicians (respectively 64.5%, 53.7%, and 20.4%). In the study by Manyalich et al [25], an advanced training program was implemented in 220 hospitals in 16 countries, which was adapted to the country’s needs.…”

Never Declared Brain Dead Potential Organ Donors—An Additional Source of Donor Organs?

“…Lenzi and colleagues documented the detrimental effect of untrained requestors in achieving authorization for organ donation, corroborating our findings. 11 When MTN tracked the outcome of meeting all of the criteria for an effective request process, we found that when all criteria are met there is a much higher rate of authorization for donation, 79% versus 55%. Working with donor hospitals to establish and follow an effective request process is crucial to ensuring donation opportunities are maximized.…”

Challenges of paediatric organ donation

“…Some evidence suggests consent rates to donation are improved by trained requestors compared to those untrained. However, whether this applies to paediatrics is not known …”