Vascularized composite allotransplantation: Knowledge and attitudes of a national sample of organ procurement organization professionals

Abstract

The "exquisite capabilities" of vascularized composite allotransplantation (VCA) represent a significant turning point in the care of individuals with catastrophic injuries, which have not been optimally treated with traditional reconstructive surgical procedures. 1-6 VCA allografts are recovered from human donors as single anatomical or structural units containing multiple tissue types and requiring blood flow from surgical connections of blood vessels. 7 VCA allografts currently include the face, larynx, upper and

Evaluation of an eLearning System to Train Health Professionals to Communicate about Vascularized Composite Allotransplantation with Donor Families

“…[14][15][16][17][18] The training program was modified for discussions of hand and face donation by integrating formative research about the public's most common VCA-related concerns and questions, 19 as well as DPs' experiences with allograft discussions. 1 The results demonstrate the efficacy of the training program. Specifically, the intervention led to increases in VCA knowledge, as well as DPs' subjective feelings of preparation for and confidence and comfort in approaching families about face and hand donation.…”

“…To address this need, we developed the eLearning intervention, Communicating Effectively about Donation for Vascularized Composite Allotransplantation (CEaD-VCA). Based on a nationally tested training to enhance the communication quality and authorization rates for solid organ and tissue donation (Communicating Effectively about Donation [CEaD]), [14][15][16][17][18] formative research with solid organ donor families, the general public 19 and interviews with 157 DPs throughout the United States, 1 we adapted the CEaD for VCA allograft donation discussions. Focusing primarily on face and hand donation, content was developed through a rigorous scriptwriting and storyboarding process, in collaboration with Gift of Life Institute which ensured authenticity and relevance.…”

“…Vascularized composite allotransplantation (VCA) refers to the transplantation of anatomical units with multiple types of tissue, such as the face and hands. 1 Considered life-changing 2 by trauma patients for whom traditional reconstructive procedures have not been optimally successful, VCA transplants are novel. Approximately 200 to 300 VCAs have taken place around the world, 3 with 113 having been performed in the United States to date.…”

“…13 Our own national study of DPs employed by 39 OPOs confirmed wide variability in allograft request frequency and practices. 1 Over 70% of the sample reported no experience discussing VCA and allograft donation or limited experience 1 and nearly one-fifth reported feeling completely unprepared to discuss allograft donation with families. Self-assessed ratings for VCA knowledge, confidence in and comfort with making family approaches for allograft donation were also low, with about three-quarters of the sample indicating a need for comprehensive training on VCA and associated allograft donation requests.…”

“…Self-assessed ratings for VCA knowledge, confidence in and comfort with making family approaches for allograft donation were also low, with about three-quarters of the sample indicating a need for comprehensive training on VCA and associated allograft donation requests. 1 These DPs also identified training in content specific to VCA approaches, such as funeral arrangements for face and hand donors and addressing donor families’ concerns about potentially visible similarities between donors and recipients (L.A. Siminoff, PhD & H.M. Gardiner, PhD, unpublished data, September 2019).…”