Dr Arabella Simpkin and colleagues from the United Kingdom investigated modifiable factors that influence relatives’ decision to allow organ donation.
There were 3 authors that independently assessed the eligibility of the identified studies.
The researchers excluded studies that examined only factors affecting consent that could not be altered, such as donor ethnicity.
The team extracted quantitative results to an electronic database.
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For data synthesis, the team summarized the results of studies comparing similar themes.
The researchers included 20 observational studies and audits.
There were no randomized controlled trials.
The main factor associated with reduced rates of refusal was the provision of adequate information on the process of organ donation and its benefits.
High quality of care of potential organ donors, and ensuring relatives had a clear understanding of brain stem death were also factors associated with reduced rates of refusal.
Separating the request for organ donation from notification that the patient had died, making the request in a private setting, and using trained and experienced individuals to make the request reduced rates of refusal.
Dr Simpkin's team concluded, “Limited evidence suggests that there are modifiable factors in the process of requests for organ donation.”
“In particular the skills of the individual making the request and the timing of this conversation, that might have a significant impact on rates of consent.”