Improving organ donation rates by modifying the family approach process

BACKGROUND The purpose of this study was to identify steps during family approach for organ donation that may be modified to improve consent rates of potential organ donors. METHODS Retrospective study of our local organ procurement organization (OPO) database of potential organ donors. Modifiable variables involved in the family approach of potential organ donors were collected and included race and sex of OPO representative, individual initiating approach discussion with family (RN or MD vs. OPO), length of donation discussion, use of a translator, and time of day of approach. RESULTS Of 1137 potential organ donors, 661 (58%) consented and 476 (42%) declined. Consent rates were higher with matched race of donor and OPO representative (66% vs. 52%, p < 0.001), family approach by female OPO representative (67% vs. 56%, p = 0.002), if approach was initiated by OPO representative (69% vs. 49%, p < 0.001), and if consent rate was dependent on time of day the approach occurred: 6:00 am to noon (56%), noon to 6:00 pm (67%), 6:00 pm to midnight (68%), and midnight to 6:00 am (45%), p = 0.04. Family approach that led to consent lasted longer than those declining (67 vs. 43 minutes, p < 0.001). Independent predictors of consent to donation included female OPO representative (odds ratio [OR], 1.7; p = 0.006), approach discussion initiated by OPO representative (OR, 1.9; p = 0.001), and longer approach discussions (OR, 1.02; p < 0.001). The independent predictor of declined donation was the use of a translator (OR, 0.39; p = 0.01). CONCLUSION Variables such as race and sex of OPO representative and time of day should be considered before approaching a family for organ donation. Avoiding translators during the approach process may improve donation rates. Education for health care providers should reinforce the importance of allowing OPO representatives to initiate the family approach for organ donation. LEVEL OF EVIDENCE Epidemiologic study, level IV. Therapeutic study, level IV.

[1]  L. Siminoff,et al.  Roles of Sex and Ethnicity in Procurement Coordinator—Family Communication during the Organ Donation Discussion , 2010 .

[2]  L. Siminoff,et al.  Roles of sex and ethnicity in procurement coordinator--family communication during the organ donation discussion. , 2010, Progress in transplantation.

[3]  Eric J. Ley,et al.  The combination of an online organ and tissue registry with a public education campaign can increase the number of organs available for transplantation. , 2010, The Journal of trauma.

[4]  E. Ley,et al.  Contributing factors for the willingness to donate organs in the Hispanic American population. , 2010, Archives of surgery.

[5]  Carlos V. R. Brown,et al.  Barriers to obtaining family consent for potential organ donors. , 2010, The Journal of trauma.

[6]  E. Sotillo,et al.  Identification of variables that influence brain-dead donors' family groups regarding refusal. , 2009, Transplantation proceedings.

[7]  J. D. Young,et al.  Modifiable factors influencing relatives’ decision to offer organ donation: systematic review , 2009, BMJ : British Medical Journal.

[8]  A. Christmas,et al.  Organ donation: family members NOT honoring patient wishes. , 2008, The Journal of trauma.

[9]  Laura A. Siminoff,et al.  Racial disparities in preferences and perceptions regarding organ donation , 2007, Journal of General Internal Medicine.

[10]  A. Spital.  Estimating the number of potential organ donors in the United States. , 2003, The New England journal of medicine.

[11]  R M Arnold,et al.  Factors influencing families' consent for donation of solid organs for transplantation. , 2001, JAMA.

[12]  D. Alden,et al.  Cultural attitudes of Asian-Americans toward death adversely impact organ donation. , 1998, Transplantation proceedings.