ORGAN DONATION: Resource Requirements and Consent for Donation

Abstract

SUMMARY The supply of donated organs is falling behind the rapidly increasing demand as more patients with organ failure are becoming candidates for transplantation. The lists of those awaiting a transplant are lengthening and as a result some patients with renal failure are left on dialysis for years until a suitable kidney becomes available. More tragically, 30% of patients requiring a heart or liver transplant die while waiting for a donor. There is a potential for reversing the organ shortage by identifying the 70% of potential donors that are currently not being converted to actual donors. Of the various steps in the organ donation process, identification of a potential donor is the most critical. Most donors are missed because of a failure to consider dying patients as potential organ donors. To improve the supply of organs for transplantation, increased and ongoing public awareness programs are required. Also, policies and procedures now in place in most hospitals to facilitate organ donation should be activated and expanded using a full or part-time organ donor coordinator (donor advocate), depending on the hospital size. This individual, as well as other members of the health care team, also can help provide emotional support to the potential donor's family during the donation process. A positive outcome in the request for organ donation is most likely to occur if the individual requesting consent has developed a good rapport with the family and discusses the issues in a compassionate manner using clear and simple language. Ideally, the consent should be requested by someone with experience and who is able to convey in a positive way the benefits of organ donation.