Attitude Favorability towards Organ Donation in Family Members of Brain Dead Organ Donors

Introduction Organ donation has been improving especially in the last decade. Doctors take care of patients and declare brain death. Coordinating nurses approach families for organ donation consent. Nurses have been trained in intensive courses of organ donation which are organized by The Thai Red Cross Organ Donation Centre. The main objective of this study was to analyze the attitude and participation of nurses in the organ donation process. Material and methods A retrospective descriptive analysis of questionnaires conducted during 3-day-transplant coordination training courses was done. These courses have been organized by The Thai Red Cross Organ Donation Centre 1‐2 times per year for 14 years (2003‐2016). The questionnaire specifically developed to measure the attitude of nurses and their participation in organ donation process. Results There were 794 nurses participated in this study. The majority of nurses (76.0 %) had experiences in caring for patients with brain death. Almost all of them (92.7%) took care of brain dead patients 1‐20 cases per year. A total of 88.7% of nurses understood the concept of brain death, 6.4 % did not, and 4.9 % did not sure what brain death was. Nurses agreed with the idea of donating organs from deceased donor in 93.7 %, did not agree with organ donation only 1.0 %, and 5.3% had doubts. Most of them (72.7%) didn’t register to be a donor yet but might be willing to do it in the future, only 25.7% had already registered, and 1.6% refused to apply for a donor card. A total of 75.7 % of nurses desired to donate their relatives’ organs if their relatives were brain death, only 1.3 % did not, 23.0% had doubts. However, 96.5 % of nurses were willing to participate in organ donation process because they knew patients were able to survive and had better quality of life with organ transplantation. Reasons why the rest of them did not want to participate were the following: 1) lack of skills regarding family approach for organ donation 2) increased workload 3) did not receive enough cooperation from their colleagues. Conclusions The role of the nurse in the donation process is relevant. Most of them have positive attitude and willing to participate in organ donation process.

Organ Donation Breakthrough Collaborative

Barriers to Deceased Donor Procurements: The Saudi Experience.

Life After Death: What Every Palliative Care Provider Should Know About Organ and Tissue Donation (FR412)

Introduction: advances in the area of health have been occurring in an accelerated and constant way, and the prolongation of life through organ donation, emphasizes the importance of the knowledge of health professionals on this subject. Brain dead donors are the main source of transplant organs, therefore, measures that promote early identification are essential for appropriate clinical support, Based on this context, it is known that the knowledge by the Intensive Care Unit (ICU) team regarding the pathophysiological alterations triggered by brain death (ME) and the adequate clinical management of the potential donor are associated with a greater number of transplantable organs per donor and the reduction of losses of potential donors due to cardiorespiratory arrest. Objective:identify and describe guidelines for donor care in ME, in addition to analyzing the importance of knowledge about the management of potential organ donors by the ICU team, in the scientific publications available in online databases. Method: data collection was carried out through a search of the online databases: SciELO (Scientific Electronic Library Online) and PUBMED. The articles were downloaded from the aforementioned platforms, and the Zotero was used to make the appropriate citations and references. The research will be made up of published and updated literatures that reflect the importance of knowledge about the management of the potential organ donor with brain death by the ICU team. Results and discusión:we included 17 studies that met the criteria related to the object of study. According to the results achieved, the study allowed to obtain a more detailed vision of the studies arising from the search for data, highlighting categories such as those that reflect the importance of the knowledge of the ICU team, on the proper management of a patient with brain death, which reflect positively on the process of organ and tissue donation. Conclusions: the analysis carried out shows that UC professionals have a low level of knowledge about the diagnosis and management of patients with brain death and the organ donation process, which is due, in part, to the little or no contact they have with this topic during graduation, therefore the need for the ICU team to be trained and prepared to identify physiological alterations and adequately address to the patient diagnosed with EM, in order to contribute to making organ and tissue donation viable. Reducing the time and suffering of those waiting for an organ on the transplant waiting list

This article went through the same peer review process as all articles do.

Introduction: In a situation where a possibility to organ donation (OD) occurs, the bed-side professionals (physicians, nurses) are expected to act to realize the OD due to their professional ethics. Perioperative nurses play a vital role in the OD process which includes acting as the donor’s advocate, as well as upholding values to provide the best quality nursing for the donor during the organ procurement. Perioperative nurses work collaboratively within surgical teams by providing intraoperative assistance to procurement teams at the time these procedures are required. The research covering perioperative nurses work situation while participating in OD is limited. The aim of this study was to describe Swedish Nurse Anesthetists’ (NA) experiences and conceptions of participating in the OD process with brain-dead (BD) donors. Methods: A qualitative study was chosen; analysis of the semi-structured interviews was carried out with Phenomenography. Informants: 21 NA (4 male, 17 female); all had experience of OD from BD donors. In addition, 12 NA had experience of organ transplantation. Age 34-64 y (years); work experiences as NA 1,5-41 y; experience of OD 1 - >30 donors. Results: OD was performed with a professional approach but was associated with some challenges e.g. when there was a child donor. To trust and understand BD and to be aware of that the patient is dead was conceived as crucial. All NA had no doubt in the BD concept and the declaration of death, but some described that it was challenging to relate to death when the body was warm, and the heart was beating: “The patient was seen as dead while the body was alive.” Knowledge and experience were essential factors to obtain a sense of safeness in these situations. The results illuminated the importance of routines, including the departments attitudes toward OD. The NA took pride in saving lives and acting as the donor’s advocate. A dignified approach during organ procurement reduced the sense of stress. Conclusions: The benefit of OD was conceived as undebatable. The professional ethics were seen in the NA core values of dignity and respect towards the donor, and to fulfill the donor’s wish to donate. The NA professional pride was illuminated in the conception of that it was positive to be able to contribute to the donors “gift of life”. Experience and knowledge supported the NA and provided safeness in their professional role. Focusing on the positive (the recipients), was conceived as the winning approach.

This research aimed to know the perception of nurses on ethical conflicts in the process of donating organs and tissue for transplantation, as decisions are made and what is taken into account in decision-making in the face of ethical conflicts. We conducted an exploratory, descriptive and qualitative approach, using the content analysis proposed by Bardin. Eleven interviews were conducted with nurses who provided assistance to potential donors in professional practice for at least one year, allocated in the following units: adult and pediatric ICU, First Aid, surgical center, inpatient units and the Commission Intra Hospital Organ Donation and Tissues for Transplantation. After analyzing five categories: 1. Difficulty accepting brain death, 2. Non-acceptance of the multidisciplinary team to disconnect the ventilator patient's brain-dead organ donor is not 3. Difficulties of the multidisciplinary team during the process of organ donation 4. Situations that may affect the process of organ donation and 5. Decision making in the face of ethical conflicts in the process of organ donation. The results showed that nurses identify ethical conflicts in the process of organ donation, generated by several factors: the difficulty in accepting brain death as death of the individual, the resistance to accept the suspension of therapeutic support in brain death, the lack of knowledge and commitment during the donation process, neglect and inadequate care of the potential organ donor, the difficulty with the allocation of human and material resources including the release of ICU beds for the potential donor, religious beliefs and failures communication. Moreover, to make decisions in the ethical conflicts, they take into account the principle of beneficence, the legal duty, and especially the dialogue with colleagues. Thus, it became evident that the process of organ donation is permeated by ethical conflicts, demonstrating a need for reflection and discussion on the topic, including generating situations and decision making in the face of ethical conflicts.

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities.

The number of notifications received at the Korea Organ Donation Agency (KODA) call center, is increasing every year from 1,126 cases in 2012 to 2,083 in 2016. But more than one fourth of them who were contacted by OPC (organ procurement coordinator) were rejected organ donation of their loved one. So we want to analyze the reasons of the rejection and use it for activation of organ donation campaign. Method Of 8,120 cases reported to KODA from 2012 to 2016, 3,322 cases were provided information about brain death and organ donation using FCTT (Family Communication Tracking Tool). In FCTT, agreement of brain death organ donation and reasons for rejection were recorded. The reasons for rejection were classified into 10 items such as family members’ understanding of brain death, attitude toward organ donation, procedural problems, religious problems, etc. Results Among the total reported cases, the number of families that can be provided information and conducted counseling related to organ donation were 56% in 2012, 52.4% in 2013, 52% in 2014, 46.1% in 2015, and 42.1% in 2016. However, after performing organ donation counseling, 30.5% of donor’s family in 2012, 25.7% in 2013, 26.8% in 2014, 27.9% in 2015 and 28.1% in 2016 rejected organ donation, so we could not proceed organ donation. The frequent reasons for rejecting the donation was 'they could not accept brain death status and want active treatment' in 34.7%, 'disagreement between family members’ in 26.3%, 'ignorance about organ donation' (16.3%) and 'others' (7.5%). Other reasons even a small number were 'they do not want to damage the body of deceased family' (6.9%), 'we don’t know the will of the deceased' (3.9%), 'misunderstanding about brain death and organ donation' (1,4%), 'too complex about organ donation process' (1.3%), 'transfer the body to large hospital' (1.0%), and 'religious reasons’ (0.6%) in that order. Conclusion As seen from the results, many of the family members do not agree with the brain death state, and refuse the consent. This result is caused by present brain death definition in our domestic law. If the brain death is to be recognized as death regardless of organ donation, the donation rate can be expected to increase. In addition, if we respect the consent of next to kin, the number of rejection by disagreement between family members will be far decreasing. In order to effective public campaign and education, we can use these results and can change some of our national donation structure.

End-of-Life Decision Making, Organ Donation, and Critical Care Nurses

Organ donation after cardiac death: a new trend in pediatrics.

Organ Donation and the Medicolegal Aspects

Interventions to Improve the Quality in the Organ and Tissue Donation Process

Introduction Diagnosis of brain death and organ donation are a complex process that requires a rapid organization among donor hospital, transplant center, regional coordination center and national coordination center. The aim of this study was to determine the factors affecting the timing of brain death diagnosis and cadaveric organ donation in a university hospital in Turkey. Methods Cases, who were diagnosed with brain death between the years 2015 and 2017 in the intensive care units at the Ondokuz Mayis University Hospital, were enrolled. The cases who were examined retrospectively were evaluated in terms of some factors such as demographics, blood group, being an organ donor, donation time, donation day, donation hour, receiver center and transport time. Results Of the 68 cases, 24 (35.3%) were in the 0-18 age group and 32 (47%) were in the 36-65 age group. Thirty-two (47.1%) cases were diagnosed with subarachnoid hemorrhage. Twenty-one (30.9%) cases were reported to be a forensic case. Fifty-two (76.5%) cases who were diagnosed with brain death were found eligible to donate organs. The process for brain death diagnosis was completed over 24 hours in 61 (89.7%) cases. The declaration was made within the first hour after the diagnosis in 66 (97.1%) cases. The family interview was conducted within the first hour after the declaration in 64 (94.1%) cases. Twenty-one (30.9%) cases became donors. Eleven (52.4%) of the forensic cases became donors and 10 (21.3%) of the non-forensic cases became donors. These ratios were found to be statistically significant (p = 0.01). The interval between organ donor brain death and organ harvesting was between 11 and 24 hours in 10 (14.7%) cases. The harvesting team was outside of the region in 15 (71.4%) of the donors. The waiting period for the harvesting teams outside the region was determined to be 5-8 hours in 8 (11.8%) cases. Conclusion The cadaveric organ donation rate in the Ondokuz Mayis University Hospital was 30.9%. This rate was above the general average of Turkey. Donation occurs up to 24 hours of harvesting, donor organs can be lost and prolonged processes may affect the viability of organs. Since Turkey is a large country with a wide variety of geographical features, it is not always possible that donors and recipients live in the same region. However, we think that this problem can be overcome as the Ministry of Health supports the use of resources for cadaveric organ donation.