Organ donation decision-making in ICU patients: from the perspectives of organ coordinators and physicians in China – a qualitative study

Yang, Xi; Chen, ChaoQun; Geng, Kun; Jia, Xuedong; Si, FangYing; Lu, XiaoJing; Zhang, Wan; Du, Shuzhang; Zhang, Xiaojian; Guo, Wenzhi; Yin, Zhao

doi:10.1136/bmjopen-2023-075433

Cited by 2 publications

References 32 publications

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Reading the family: A constructivist grounded theory on organ donation conversations

Avilés

2024

PLoS ONE

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Approaching families to discuss deceased organ donation authorisation is considered one of the central stages of the organ donation process. In many countries, specialist nurses lead the organ donation process, approach and support families. However, how these encounters occur is not yet fully understood. A constructivist grounded theory methodology was used to conceptualise the process of approaching families from the perspectives of healthcare professionals and families. Data collected included six months of observations across two large hospitals in Chile, documents, interviews and focus groups with 71 participants including healthcare professionals involved in the organ donation process, and bereaved families who were approached for organ donation conversations. The theory Reading the family was developed to explain the relational process of how nurse organ donor coordinators approach families to negotiate organ donation authorization. It explains the sophisticated and skilled process of accessing, assessing and managing family’s emotions to negotiate organ donation authorization as a family unit. The theory has two dimensions, indirect and direct, which refers to when and how nurses read families emotions to lead organ donation conversations and support bereaved families’ decision-making process. These dimensions critically depend on the clinicians set of beliefs and communication processes. Understanding the complexities of approaching families is essential for practice and policymaking, particularly when there is a trend towards individual decision-making instead of understanding organ donation as a family affair. Reading the family could be eventually applied in other contexts and situations that involve navigating difficult conversations, and therefore, further research is needed and suggested to assess the feasibility of its application.

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Reading the family: A constructivist grounded theory on organ donation conversations

Avilés

2024

PLoS ONE

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Donor’s seral creatinine as a predictor of early allograft dysfunction after liver transplantation: A retrospective cohort study with propensity score analysis

Taipov,

Wang,

Hou

et al. 2024

Preprint

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Background: There are several risk factors for early allograft dysfunction (EAD) after donation after citizen death (DCD) liver transplantation. This study explored whether elevated donor’s seral creatinine increases the risk of EAD after DCD liver transplantation. Materials and Methods: The study enrolled 224 primary adult DCD liver transplantation recipients. Univariate and multivariate logistic regression analyses were performed, and receiver operating characteristic curves were constructed. Perioperative clinical and laboratory variables were assessed for their association with the prevalence of EAD using the inverse probability of treatment weighting (IPTW) and 1:3 propensity score (PS) matching (Group A, n=53; Group B, n=124) analysis. Results: Forty-eight recipients (21.4%) developed EAD. All cases were divided into two groups (Group 1 [donor’s seral creatinine > 170μmol/L, n = 55] and Group 2 [donor’s seral creatinine ≤ 170μmol/L, n = 169]). Multivariate logistic regression analyses revealed that the donor’s age >60 years old (OR 5.927, 95CI% 2.144-16.387, p=0.001), BMI >24 (OR 2.818, 95CI% 1.359-5.845, p=0.005), with hypertension (OR 2.308, 95%CI 1.086-4.902, p=0.030), ICU stay >7 days (OR 3.369, 95% CI 1.449-7.832, p=0.005), and seral creatinine >170 μmol/L (OR 2.841, 95%CI 1.309-6.164, p=0.008) were independent risk factors for EAD. Moreover, the donor’s seral creatine >170 μmol/L was associated with incidence of EAD after adjusting for IPTW (OR 2.714, 95%CI 1.407-5.234, p=0.003), and after 1:3 PS matching (34.0% vs 18.5%, OR 2.258, 95%CI 1.092-4.671, p < 0.05). Conclusions: Elevated donor’s seral creatinine increased the risk of postoperative EAD, which might be a novel predictor of EAD after DCD liver transplantation.

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Organ donation decision-making in ICU patients: from the perspectives of organ coordinators and physicians in China – a qualitative study

Cited by 2 publications

References 32 publications

Reading the family: A constructivist grounded theory on organ donation conversations

Reading the family: A constructivist grounded theory on organ donation conversations

Donor’s seral creatinine as a predictor of early allograft dysfunction after liver transplantation: A retrospective cohort study with propensity score analysis

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