Prevalence and Potential Correlates of Family Refusal to Organ Donation for Brain-Dead Declared Patients: A 12-Year Retrospective Screening Study

2020 ◽  
Author(s):  
Metin Leblebici
Keyword(s):  
Organ Donation ◽  
Screening Study ◽  
Brain Dead

Successful Organ Donation From Brain Dead Donors in a Chinese Organ Transplantation Center

2011 ◽  
Vol 11 (10) ◽  
pp. 2247-2249 ◽  
Author(s):  
W. G. Sui ◽  
Q. Yan ◽  
S. P. Xie ◽  
H. Z. Chen ◽  
D. Li ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Brain Dead ◽  
Transplantation Center

scholarly journals Perceived Support Among Families Deciding About Organ Donation for Their Loved Ones: Donor Vs Nondonor Next Of Kin

2010 ◽  
Vol 19 (5) ◽  
pp. e52-e61 ◽  
Author(s):  
Liva Jacoby ◽  
James Jaccard
Keyword(s):  
Quality Of Care ◽  
Organ Donation ◽  
Demographic Data ◽  
Quality Care ◽  
Family Members ◽  
Care Staff ◽  
Next Of Kin ◽  
Perceived Quality Of Care ◽  
Brain Dead

BackgroundFamilies’ experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families’ support needs during this traumatic time is an obligation and a challenge for critical care staff.Objectives(1) To elicit family members’ accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families’ donation decision.MethodsRetrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care.ResultsOne hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent.ConclusionsSpecific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.

Brain Death and Organ Donation

2018 ◽  
Author(s):  
Thomas I. Cochrane
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Donation After Brain Death ◽  
Brain Death Determination ◽  
Brain Dead ◽  
American Academy Of Neurology ◽  
Death Determination

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.

Brain Death, Organ Donation, and Transplantation

2018 ◽  
pp. 276-285
Author(s):  
Hilary H. Wang ◽  
David M. Greer
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Apnea Test ◽  
Unit Management ◽  
Legal Context ◽  
History Of ◽  
Brain Death Determination ◽  
Brain Dead ◽  
Death Determination

This chapter reviews the history of brain death determination, current guidelines for performing the brain death examination including the apnea test, details of apnea testing, the role of brain dead donors in organ donation, physiologic changes seen in brain dead patients, and the relevant challenges in intensive care unit management of such patients for donor organ optimization. The goal of this chapter is to provide clear guidance for a critical care provider to perform an accurate and thorough brain death examination and to further the reader’s understanding of the historical and legal context surrounding brain death and organ donation in the United States.

Transplant Coordination as the “Keystone” in Non—Heart-Beating Donations

2002 ◽  
Vol 12 (3) ◽  
pp. 181-184
Author(s):  
Joaquin Alvarez ◽  
Maria Rosario del Barrio
Keyword(s):  
Survival Rate ◽  
Organ Donation ◽  
Donor Pool ◽  
Heart Beating ◽  
Brain Dead

The shortage of donated organs has become a problem in the transplantation world. Transplant teams are continuously looking for new ways to increase and improve the donor pool. Non—Heart-beating donors could be a source for increasing the number of donors, even though in some countries legal, ethical, or logistical problems obstruct the development of that source. The good results obtained by some groups working with Non—Heart-beating donors should stimulate others to implement this type of policy in their hospitals. We describe the origin and development of our policy on Non—Heart-beating donation, which has become the main source for organ donation in our hospital. We have found that the 5-year survival rate for kidneys from these donors is similar to the survival rate for kidneys obtained from brain-dead donors, and this encourages us to continue to use kidneys from Non—Heart-beating donors.

scholarly journals Prior family communication and consent to organ donation: using intensive care physicians’ perception to model decision processes

2012 ◽  
Vol 1 (2) ◽  
pp. 19 ◽  
Author(s):  
Peter J. Schulz ◽  
Ann Van Ackere ◽  
Uwe Hartung ◽  
Anke Dunkel
Keyword(s):  
Intensive Care ◽  
Organ Donation ◽  
Family Communication ◽  
Cross Validation ◽  
Decision Processes ◽  
Potential Donor ◽  
Face To Face ◽  
Relative Information ◽  
The Family ◽  
Brain Dead

Generally, the Swiss hold favourable attitudes to organ donation, but only few carry a donor card. If no card is found on a potential donor, families have to be approached about donation. The aim of this paper is to model the role that some family communication factors play in the family decision to consent or not to organ donation by a brain dead relative. Information was gathered in face-to-face interviews, using a questionnaire and recording open answers and comments. Eight heads of intensive care units (ICU) of Swiss hospitals and one representative from <em>Swisstransplant</em> were interviewed. Questions asked respondents to estimate the prevalence and effect of communication factors in families facing a decision to consent to donation. Answers were averaged for modelling purposes. Modelling also relies on a previous representative population survey for cross-validation. The family of the deceased person is almost always approached about donation. Physicians perceive that prior thinking and favourable predisposition to donation are correlated and that the relatives’ predisposition is the most important factor for the consent to donation, up to the point that a negative predisposition may override an acknowledged wish of the deceased to donate. Donor cards may trigger family communication and ease the physicians’ approach to family about donation. Campaigns should encourage donate-willing people to talk to their families about it, make people think about organ donation and try to change unfavourable predispositions.

Outcomes of organ donation in brain-dead patient's families: Ethical perspective

2017 ◽  
Vol 26 (1) ◽  
pp. 256-269 ◽  
Author(s):  
Shamsi Ahmadian ◽  
Abolfazl Rahimi ◽  
Ebrahim Khaleghi
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Qualitative Content Analysis ◽  
Organ Procurement ◽  
Healthcare Providers ◽  
Traumatic Experience ◽  
Ethical Review ◽  
Ethical Perspective ◽  
Main Category ◽  
Brain Dead

Background: The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. Objective: The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. Methods: This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. Findings: The main category of the data was “Decision to organ donation: a challenge from conflict to transcendence.” This main category consisted of 10 subcategories and 3 general categories. The general categories were “challenging outcomes,” “reassuring outcomes,” and “transcending outcomes.” Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Conclusion: Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.

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