An Integrative Review of the Physical Examination Performed on Deceased Potential Organ and Tissue Donors

Abstract

Introduction: Physical examination of the deceased potential donor is used in conjunction with information obtained from the family and donor’s General Practitioner. The findings of these assessments are used to determine the degree of risk their organs and tissues could pose to a recipient. Objective: To review the international practices of performing the physical examination on deceased potential organ and tissue donors. Method: A systematic search of the databases PubMed, CINAHL, Embase, and MedLine and grey literature was conducted. The search was limited to English-language articles, published between 2000 and 2017. Results: The integrative review included 14 of 1223 articles identified. We found that, although a physical examination is considered a routine component of international donor screening practices and standards, supportive evidence for this is lacking. A systematic head to toe approach to the physical examination is consistently advocated, but guidance on the components and processes of such an examination is limited. The literature demonstrates some commonalities regarding what constitutes a high-risk finding, but there is some variation in its completeness, and information on how many donors are declined because of such findings was found in only 1 article. The training and education of staff were considered essential to enable an accurate and thorough physical examination, yet details of constituents of education and training programs were sparse. Conclusion: More research is needed into the components of the physical examination that potentially would reduce risk to recipients. A review of current practice may identify opportunities for practice improvement, education, and training.