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Factors influencing families' consent for donation of solid organs for transplantation

Public education is required to maximize the number of families who donate their relatives' organs for transplantation, according to research published in this week's Journal of the American Medical Association.

News image

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A team from Ohio and Pennsylvania, USA, examined the factors associated with the decision to donate among families of potential solid organ donors.

Data was collected on 420 donor-eligible patients, from 9 trauma hospitals between 1994 and1999. This was done via chart reviews, telephone interviews with health care practitioners (HCPs) or organ procurement organization (OPO) staff, and face-to-face interviews with family for all donor-eligible deaths.

A total of 238 of the 420 cases led to organ donation.

Univariate analysis revealed numerous factors associated with the donation decision.

Factors associated with donation decision:
- Family socio-demographics
- Prior knowledge of patient's wishes
- Family discussions
- Contact with health staff
Journal of the American Medical Association

Multivariable analysis of associated variables was also performed. This revealed that family and patient socio-demographics (ethnicity, patient's age, and cause of death), and prior knowledge of the patients' wishes, were significantly associated with willingness to donate (adjusted odds ratio [OR], 7.68).

Families who discussed more topics and had more conversations about organ donation were more likely to donate (adjusted OR, 5.22). This was also true for families with more contact with OPO staff (adjusted OR, 3.08), and those who experienced an optimal request pattern (adjusted OR, 2.96).

The researchers found that socio-emotional and communication variables acted as intervening variables.

Dr Laura A. Siminoff, of the Case Western Reserve University School of Medicine, Cleveland, Ohio, concluded on behalf of the group, "Public education is needed to modify attitudes about organ donation prior to a donation opportunity.

"Specific steps can be taken by HCPs and OPO staff to maximize the opportunity to persuade families to donate their relatives' organs."

JAMA 2001; 286: 71-7
06 July 2001

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