Factors affecting organ donation

Abstract

Purpose: Family consent is a legal requirement in our country when harvesting organs from a cadaveric donor, a fundamental organ source for transplantation. In our study we investigated the correlation bet-ween the rate of consent received and demographic data concerning the patients with brain death in our institution in 2004 and 2005 and those relatives whose consent was requested.

Patients and Methods: In the years 2004 and 2005, our transplant coordinators asked for consent from the relatives of patients who developed brain death in our hospital's intensive care units and were medically fit to be organ donors. The two groups of patients and their relatives, one consented for organ donation and the other denied were compared with respect to the patient's age, this person's degree of relation to the patient, his level of education, patient's age and the cause of death of the patient.

Results: 54 brain deaths were confirmed in our hospital's intensive care units in the years 2004 and 2005. The transplant coordinators asked the relatives of 53 of these brain death patients for their consent for organ donation. One patient's relatives could not be reached. For 30 of the 53 patients (56.6 %) consent for multiple organ harvesting was taken. 15 of the 53 patients (28.3 %) were below the age of 20, with a rate of consent of 37.5 %. For patients older than 20 years, the rate of consent was found to be 52.6 % while it was 66.7 % in the younger patients (p=0.539). The rate of consent increased as the level of education of the relatives increased, although without statistical significance. The patient's cause of death, the age, degree of relation to the patient, degree of education and job of the closest relative contacted did not have any effect on the giving of consent. Declaration of the brain death by the intensive care unit nurse or patient's attending doctor resulted with a higher rate of consent when compared to cases found out during the coordinators' visit to the intensive care unit (p= 0.011). It was also seen that when the first contact about organ donation with the patient's relatives was made by the coordinators, the chance of concenting was higher.

Conclusion: Finding out and declaration of the brain death by the attending health personnel but first contact and discretion to the family by the coordinators resulted with a higher rate of consent. Our transplant coordinators' work has resulted in a rate of organ donation remarkably higher than our country's standards.