Organ Donation: Are Family Members Honoring Patient Wishes?

Christmas, Britt; Burris, Gary W.; Schiffern, Lynn; Sing, Ronald F.

doi:10.1097/00003246-200612002-00504

Cited by 5 publications

(5 citation statements)

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“…3 Despite increasing opportunities to register for organ donation, many potential donors are lost due to lack of family knowledge regarding patient desires or of organ procurement processes as well as state laws nullifying previous donation registration if family denies consent. 4 As a result, much research has been focused on the subjective nature of family consent. Several studies have identified factors that affect familial approval, these include perceived quality of care, knowledge of brain death/prognostic implications, health care team approach to organ donation discussions, training level of organ transplantation team representative, age of patient, medical versus trauma-related death, and timing/ setting of discussion.…”

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confidence: 99%

Improving organ donation rates by modifying the family approach process

Ebadat

Brown

Ali

et al. 2014

Journal of Trauma and Acute Care Surgery

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confidence: 99%

Improving organ donation rates by modifying the family approach process

Ebadat

Brown

Ali

et al. 2014

Journal of Trauma and Acute Care Surgery

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“…First-person donor registration does not distinguish between mechanisms of death, and thus the decision not to uphold the registration status in DCD donation may be considered arbitrary. Several studies have explored next-of-kin denials in the presence of first-person authorization, 8,9 but no previous literature has specifically addressed this gap in potential DCD donors. Instituting national guidelines on first-person authorization in DCD would provide consistency across all states and OPOs and honor autonomous decision making.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of a High-Volume Organ Procurement Organization in the Era of Increasing Donation After Circulatory Death

Hobeika

Menser

Myer³

et al. 2022

Prog Transpl

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Introduction: Donation after circulatory death (DCD) is rapidly increasing in the United States. Detailed data outlining the process from referral to organ transplantation is lacking. Project Aims: We sought to quantify differences at each stage along the referral to donation pathway by donor type. Additionally, we examined factors associated with successful DCD organ utilization. Design: This program evaluation analyzed data from a single organ procurement organization in 2018 to assess demographic and clinical predictors of progression through the donation process, including the role of first-person authorization in DCD. Descriptive statistics were examined by donation stage for demographic characteristics using chi-square; univariate and multivariate logistic regression was used to model predictors of utilization and authorization by organ type, respectively. Results: There were 2466 organ donation referrals during 2018, including 575 donations after brainstem death (DBD), 1890 controlled DCD referrals, and 1 uncontrolled DCD referral. Univariate and multivariate logistic regression models highlighted differences in authorization rates by donor type (DCD vs DBD) and by age, race, and ethnicity. Next-of-kin authorization was declined in 23% of first-person authorized potential DCD, highlighting issues related to the role of donor registration in DCD. Pre-mortem heparin administration was predictive of DCD organ utilization; donor age and warm ischemia time of less than 30 min was statistically significantly associated with DCD extra-renal organ utilization. Conclusion: These results provided insight into strategies for increasing authorization and transplantation of organs from DCD donors and identified areas of improvement for process standardization and policy development.

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“…Patients’ families play a major role in the organ donation process and low authorization rates given by families remain as a critical barrier. Therefore, it is essential when a potential organ donor is identified that the request process is handled with extreme care and compassion; all the while, educating the family on the importance of the gifts that can be given and what it means for their loved one to be a donor (4).…”

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confidence: 99%