Abstract
BackgroundA shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors.MethodsWe will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders’ beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design.DiscussionWe will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level.
Highlights
A shortage of transplantable organs is a global problem
The protocol described in this manuscript is part of project two and details a study that aims to develop and test a theory-based, multi-faceted knowledge translation intervention implemented at the hospital level to increase the number of donation after cardiocirculatory death organ donors for transplantation across Canada
This paper describes a study where we will assess the reasons for these discrepancies nationally to design, implement, and evaluate a theorybased knowledge translation intervention that will aim to increase the number of Donation after cardiocirculatory death (DCD) donors in Canada
Summary
A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. This dynamic research coalition integrates six projects and two comprehensive supporting cores: Project one: Ex vivo organ transplant protection and repair; Project two: Increasing solid organ and hematopoietic cell donation in Canada; Project three: Favoring engraftment and preventing rejection/graft-vs-host disease through targeted disruption of danger and death signals: from cells to patients; Project four: Translating strategies for immunomodulation and transplantation tolerance; Project five: Viral pathogenesis in transplantation: prediction, discovery and optimization of risk; Project six: Personalizing immunosuppression to improve age-related transplant outcomes; Core one: Ethical, economic, legal and social issues in transplantation; Core two: Platforms supporting transplant correlative studies, database registries, training and interventional clinical trials. The protocol described in this manuscript is part of project two (increasing solid organ and hematopoietic cell donation in Canada) and details a study that aims to develop and test a theory-based, multi-faceted knowledge translation intervention implemented at the hospital level to increase the number of donation after cardiocirculatory death organ donors for transplantation across Canada. While Canada has had 465 to 485 deceased donors yearly over the past five years [1], 4,500 Canadians remain active on transplant waiting lists [2,3]
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