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 25 February 2018

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Potential organ donation prevented by non-consenting relatives

This week's British Medical Journal finds that intensive care units are excellent in considering possible organ donation from suitable patients, but the biggest obstacle to improving donation rates is relatives who deny consent.

News image

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Dr Chris Rudge and colleagues from England determined the true potential for solid organ donation from deceased heartbeating donors.

The research team assessed the reasons for non-donation from potential donors.

The team undertook an audit of all deaths in intensive care units from 2003 to 2005.

The study was hierarchic, and commenced by seeking information on whether or not brain stem testing was carried out.

If brain stem testing was carried out, the team determined whether or not organ donation was considered.

In the event that organ donation was considered, the team explored whether or not the next of kin were approached.

Where the next of kin was approached, the researchers obtained information on whether or not consent was given.

And finally, in cases where consent was given, the team established whether or not organ donation took place.

The researchers assessed data from 341 intensive care units in 284 hospitals in the United Kingdom.

41% of the families of potential donors denied consent
British Medical Journal

The team identified 46,801 deceased patients, leading to 2740 potential heartbeating solid organ donors, and 1244 actual donors.

The main outcome measure included proportion of potential deceased heartbeating donors considered for organ donation.

Proportion of families who denied consent, and proportion of potential donors who became organ donors were also primary outcomes considered.

Over the 2 years of the study, the researchers observed that 41% of the families of potential donors denied consent.

The team found that the refusal rate for families of potential donors from ethnic minorities was twice that for white potential donors.

However, the age and sex of the potential donor did not affect the refusal rate.

In 15% of families of potential donors the team found no record of the next of kin being approached for permission for organ donation.

Dr Rudge's team commented, “Intensive care units are extremely good in considering possible organ donation from suitable patients.”

“The biggest obstacle to improving the organ donation rate is the high proportion of relatives who deny consent.”

BMJ 2006: 332: 1124-7
16 May 2006

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