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

Abstract

Background The last decade, there have been many initiatives worldwide to increase the number of organ donors. However, it is not clear which initiatives are most effective. The aim of this study is to provide an overview of interventions aimed at healthcare professionals in order to increase the number of organ donors. Methods We systematically searched PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library for English language studies published until April 24, 2019. We included studies describing interventions in hospitals aimed at healthcare professionals who are involved in the identification, referral, and care of a family of potential organ donors. After the title abstract and full-text selection, two reviewers independently assessed each study’s quality and extracted data. Results From the 18,854 records initially extracted from five databases, we included 22 studies in our review. Of these 22 studies, 14 showed statistically significant effects on identification rate, family consent rate, and/or donation rate. Interventions that positively influenced one or more of these outcomes were training of emergency personnel in organ donation, an electronic support system to identify and/or refer potential donors, a collaborative care pathway, donation request by a trained professional, and additional family support in the ICU by a trained nurse. The methodological quality of the studies was relatively low, mainly because of the study designs. Conclusions Although there is paucity of data, collaborative care pathways, training of healthcare professionals and additional support for relatives of potential donors seem to be promising interventions to increase the number of organ donors. Trial registration PROSPERO, CRD42018068185 Electronic supplementary material The online version of this article (10.1186/s13054-019-2509-3) contains supplementary material, which is available to authorized users.

Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan

“…Eightyfive participants were excluded because of missing information on exposure and covariates. Since there were no missing data on other characteristics, the participants who were included in the main analysis were the same as those with complete data (Figure 1 For the lowest (n=512), middle (n=428), and highest (n=250) tertile groups, the median (IQR) knowledge scores were 12 (11-13), 14 (14-15), and 16 (16)(17), respectively. Participants with the highest tertile of knowledge were more likely to be older female medical staff.…”

“…The major barriers to deceased organ donation are, in general, lack of knowledge about deceased organ donation and transplantation, religious and cultural perspectives, and mistrust about organ transplantation and the criteria applied for the definition of brain death [10][11][12]. These barriers could be potentially overcome through identification of potential organ donors and donation requests, family support in the intensive care unit, education, social media, and law enforcement (opt-out system) [13][14][15][16]. Among these, education of both the healthcare professionals and the general public is a key factor in enhancing organ donor registration [17][18][19].…”

Seeking consent for organ donation: Process evaluation of implementing a new Specialist Requester nursing role

“…A recent systematic review reiterated the lack of good evidence describing interventions for healthcare professionals that lead to higher numbers of organ donors (Witjes et al, 2019). Nonetheless, Designated Requesters continue to be actively promoted as a positive intervention to achieve desired consent rates at transplant conferences.…”

“…In summary, overall we found a lack of rigorous evidence to show that Designated Requesters are more effective than other types of health service personnel in gaining consent for organ donation. A recent systematic review reiterated the lack of good evidence describing interventions for healthcare professionals that lead to higher numbers of organ donors (Witjes et al., 2019). Nonetheless, Designated Requesters continue to be actively promoted as a positive intervention to achieve desired consent rates at transplant conferences.…”

Do we have to tell the patient's family everything concerning organ donation?

“… Background: Globally there have been many initiatives to enhance the number of organ donors. 1 The number of individuals waiting for a transplant is significantly higher than the number of available donated organs and the gap continues to widen. In the United States, it has been reported that over 106,000 individuals are awaiting organ donation.…”