Improving the request process to increase family consent for organ donation

Authors:
  • CBCarol Beasley
    Carol Beasley
  • ESEllen Sheehy
    Ellen Sheehy
  • BLBruce Lucas
    Bruce Lucas
  • LBLori Brigham
    Lori Brigham
  • AGAke Grenvik
    Ake Grenvik
  • RPRussel Patterson
    Russel Patterson
  • RGR. Garrison
    R. Garrison
  • PMPatrick McNamara
    Patrick McNamara
  • MEMichael Evanisko
    Michael Evanisko
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Abstract
The greatest impediment to organ donation is refusal of family consent. This study examined the impact of 3 modifiable elements of the donation request on family consent rates: (1) decoupling (i.e., the family understands and accepts brain death before discussion of organ donation is begun); (2) the procurement coordinator participates in the request for consent; and (3) donation is requested in a quiet, private place. Data on the request process were collected prospectively for 707 medically suitable potential donors who had been referred to 3 organ procurement organizations. The average rate of consent for donation was 62.2%. Higher consent rates were independently associated with the 3 characteristics studied. These components were summarized in the Request Process Scale. Multivariate regression analyses indicated that consent rates can be as high as 74% when all 3 process elements are present. Hospitals and organ procurement organizations should incorporate these elements into their standard of practice when requesting organ donation.

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