Organ Donation Rates Research Articles

CDCDD-NRP is consistent with US legal standards for determining death

Donation after circulatory determination of death (DCDD) has increased organ donation rates in the US over the past decade within an established legal framework, which is consistent with and supports individual and family decisions regarding organ donation in the context of end-of-life care. A new application, controlled DCDD donation utilizing thoracoabdominal normothermic regional perfusion (NRP) protocols (cDCDD-NRP), provides the opportunity to maximize a donation decision by recovering additional organs for transplant, including the heart, and to limit the detrimental impact of warm ischemic time by perfusing organs in situ following the declaration of circulatory death. In this viewpoint, we narrate our rationale for why cDCDD-NRP is consistent within the existing legal framework for organ donation in the United States and recommend no changes to the Uniform Determination of Death Act.

Potential organ donors with primary brain tumours: missed opportunities for donation and transplantation identified in Australian cohort study 2010-2015.

Potential organ donors with primary brain tumours (PBT) frequently donate, however some may be declined due to uncertainty about tumour classification or transmission risk to transplant recipients. We sought to describe transmission risk and donation outcome of potential donors with PBT, including identifying missed opportunities for transplantation, and any PBT transmission events. We undertook a population-based cohort study in NSW of all potential donors 2010-2015. PBT potential donors were characterized according to tumour grade and transmission risk, and whether they donated organs. Data linkage was used to determine agreement of risk assessment of potential donors to that in the Biovigilance Register, and to identify any PBT transmissions. Of 2957 potential donors, 76 (3%) had PBTs. There was agreement of risk assessment in 44 (58%) cases. PBT potential donors had fewer comorbidities (1.6 vs. 2.1, P=0.006) than non-PBT potential donors. Forty-eight (63%) potential donors were declined for non-PBT reasons, 18 (24%) were declined because of perceived PBT transmission risk and 10 (13%) donated. All PBT donors had WHO-I or -II tumours, and none had a ventriculo-pertioneal shunt. No transmission events occurred. Donors with WHO-I/II PBT appear to have minimal risk of tumour transmission in solid organ transplantation; it is reassuring that no PBT transmission occurred. There is evidence of risk aversion to referrals with WHO-III/IV tumours. There exists opportunity to improve potential donor risk assessment at the time of referral using integrated data sets, and to increase organ donation and transplantation rates through greater utilization of PBT referrals.

Web-Based Perspectives of Deemed Consent Organ Donation Legislation in Nova Scotia: Thematic Analysis of Commentary in Facebook Groups.

The Canadian province of Nova Scotia recently became the first jurisdiction in North America to implement deemed consent organ donation legislation. Changing the consent models constituted one aspect of a larger provincial program to increase organ and tissue donation and transplantation rates. Deemed consent legislation can be controversial among the public, and public participation is integral to the successful implementation of the program. Social media constitutes key spaces where people express opinions and discuss topics, and social media discourse can influence public perceptions. This project aimed to examine how the public in Nova Scotia responded to legislative changes in Facebook groups. Using Facebook's search engine, we searched for posts in public Facebook groups using the terms "deemed consent," "presumed consent," "opt out," or "organ donation" and "Nova Scotia," appearing from January 1, 2020, to May 1, 2021. The finalized data set included 2337 comments on 26 relevant posts in 12 different public Nova Scotia-based Facebook groups. We conducted thematic and content analyses of the comments to determine how the public responded to the legislative changes and how the participants interacted with one another in the discussions. Our thematic analysis revealed principal themes that supported and critiqued the legislation, raised specific issues, and reflected on the topic from a neutral perspective. Subthemes showed individuals presenting perspectives through a variety of themes, including compassion, anger, frustration, mistrust, and a range of argumentative tactics. The comments included personal narratives, beliefs about the government, altruism, autonomy, misinformation, and reflections on religion and death. Content analysis revealed that Facebook users reacted to popular comments with "likes" more than other reactions. Comments with the most reactions included both negative and positive perspectives about the legislation. Personal donation and transplantation success stories, as well as attempts to correct misinformation, were some of the most "liked" positive comments. The findings provide key insights into perspectives of individuals from Nova Scotia on deemed consent legislation, as well as organ donation and transplantation broadly. The insights derived from this analysis can contribute to public understanding, policy creation, and public outreach efforts that might occur in other jurisdictions considering the enactment of similar legislation.

314.3: Impact of the COVID-19 Pandemic on the Rate of Organ Donation and Transplantation in the Central American And Caribbean Region

314.3: Impact of the COVID-19 Pandemic on the Rate of Organ Donation and Transplantation in the Central American And Caribbean Region

413.10: A Model for Increasing Organ and Tissue Donation: The Social Service in Medicine

Introduction: In Mexico organ donation rate is one of the lowest in latinamerican countries. Before COVID-19, deceased organ donor rate was 3.8 p.m.p. (2019) and for 2020, decreased to 1.2 p.m.p. This represent a major problem since waiting lists still growing; by march 2022 a total of 22,797 persons awaiting for any kind of transplant. Disparity between people waiting for a transaplant and real donors makes urgent to have programs that increase donation. In Mexico there is not an adecuate organization to procure organs (like UNOS), enough resources and personal dedicated to it, therefore most of the times, every hospital organize its own procurement team. Because of this, few hospital can have a dedicated and payed transplant coordinator available all time. In Sonora state, to have personal that can aid in this labor, trained medical students in their last year, whom are dedicated to social service according to our law. Mexico’s medical social service program, consists in last year students of med school attend a health center for medical consultation. The last 10 years there has been a variation in this program and students attend urban, research centers and universities, so they develop health programs to the community. We proposed students from medical social service to get involved in organ donations programs, within a hospital, so can develop skills and knowledge about the field as well as detecting potential donors that become real donors 24/7. Methods: We create an educational program along with four universities that include lectures about organ donation in several fields: conferences about legal framework, detecting a potential donors in hospitals, characterization of donors for tissue as well as solid organs, how to talk to the family about organ donation and all the process of it. At same time they spend time in the organ donation coordination office and divide hours during day and nights so detect potential donors. Results: From 2007 to 2016 we had an overall donation rate of 13.2 donors per year. From 2017, our program of medical social service started and in half of the time we duplicate donation rate to 30.4 donors per year, being 2021 with highest donors (total of 65). Conclusion: Pandemic reduced dramatically organ donation worldwide, and while some countries are doing better, still much work to do. Having young doctors doing medical social service in organ donation coordinations demonstrate can be a good, safe and low cost programs that allow increase organ donation rates significatively. In our hospital we end 2021 with a deceased organ donor rate of 17.2 donors p.m.p., much higher than national media of 1.2. We believe this kind of programs, making feasible to every region of latinamerican countries that have medical social service can help to increase organ donation and transplantation.

Differential impact of opt-in, opt-out policies on deceased organ donation rates: a mixed conceptual and empirical study

ObjectivesTo increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend...

P16.30: Assessment of the Impact of the COVID -19 Pandemic on the Number of Brain Deaths, Family Donations, and Organs Used Between 2019-2020 in the Bursa Regional Coordination Center With the Most Donors in Turkey

Introduction: The number of patients diagnosed with SARS-CoV2 worldwide in 2020 is 83,999,3791. According to the World Health Organization (WHO), 1,937,987 patients diagnosed with SARS-CoV2 died in 2020.2 In 2020, 2.3% of patients diagnosed with SARS-CoV2 died. The COVID 19 pandemic caused by SARS-CoV2 negatively impacts all sectors. One of the affected areas is organ supply and transplantation. The number of patients registered in the Transplant Dialysis Surveillance System (TDIS) waiting for solid organs in Turkey in 2020 is 23,923.3 Of the 1,391 reported brain death cases in 2020, 263 involved families donations. Of these, 1059 organs were used. This is 4.42% of the waiting patients.4 The inadequate supply of organs in our country Our study aimed to investigate the impact of the pandemic COVID -19 on the distribution of brain deaths reported in the regional coordination centers of Bursa, which has the highest number of brain deaths and family donations in Turkey by 2019 2020. Materials and Methods: Using the data from the Transplantation Dialysis Monitoring System of the Ministry of Health - Decision Support Unit (TDIS-KDS), the distribution of brain death, family donation, and organs used data reported between 2019 and 2020 in Turkey was studied. This distribution retrospectively assessed the impact of the COVID -19 pandemic. Results: According to the Transplant Dialysis Monitoring System (TDIS) data, there were 2,309 brain deaths in Turkey in 2019, patients with family donations: 619, and the number of organs used: 2504. The number of brain deaths in 2020: 1,391, the number of patients with family donations: 263, and the number of organs used: 1059.3 The number of brain deaths in 2019 Bursa Regional Coordination Center is 280, the number of patients with family donations: 117, the number of organs used: 222. The number of patients with brain death in 2020 is 208, the number of patients with family donations: 70 and the number of organs used: 104. In Turkey, the brain death rate in 2019 is 12.12%, the rate of patiens family donations: 18.90% and the rate of organs used: 8.86%. In Turkey, the brain death rate in 2020 is 14.95%, the rate of patients family donations: 26.61%, and the rate of organs used: 9.82%. The COVID 19 pandemic has had a negative impact on organ donation rates and organ supply for solid organ transplants. However, with organ donation training in the provinces of the Bursa Regional Coordination Center, an increase in brain death rates, family donations, and organs used was observed in Bursa Regional Coordination Centerin 2020. Conclusion: The COVID19 pandemic has adversely affected patients awaiting solid organ transplants. The demand for cadaveric organ transplants has increased in Turkey. Patients without living donors are losing their lives. Social activities and legal incentives encouraging organ donation are increasing organ donation.

237.2: Transplant Procurement Management: 30 Years of International Training Program in Organ and Tissue Donation

Background: The educational project called Transplant Procurement Management (TPM) was launched in 1991 as a specialised program which main goal is to train health professionals in the field of organ donation for transplantation. Since then, 376 courses have been developed in 44 countries training 15575 health care professionals. The objective is to analyse the impact of the training in the donation rates on those countries where the TPM training has been developed nationally as part of a continuous professional development plan. Methods: TPM offer is organized by levels (introductory, intermediate, advanced) and training modalities (face-to-face, online, blended), with a result of tailored-made courses according to each country needs. Its core program goes through the clinical process of donation for transplantation and its methodology combines theoretical sessions with hands-on workshops in small groups, simulations, cases discussion and debate. Special attention is given to innovative tools: for donor detection workshop, a videogame has been developed to practice how to detect and evaluate donors in a virtual hospital; to practice communication of bad news and family interview for donation consent, an immersive experience with virtual reality has been designed. The impact of the training has been measured through a retrospective study that includes the organ donation rates published in IRODaT during the period 2009-2019 in 8 countries and the number of participants registered in our database. Results: The number of participants trained in these countries from 2009 to 2019 has been as follows: China, 1395; Croatia, 166; Iran, 318; Italy, 2268; Portugal, 301; Slovenia, 263; Thailand, 189; UAE, 283. The donation rates in all countries have increased during the period 2009-2019 in the following: China, 108%; Croatia, 99%, Iran, 394%, Italy, 16%, Portugal, 9%, Slovenia, 24%, Thailand, 217%, UAE, 110%. Conclusions: An increment of the donation rates has been demonstrated in all countries of the study being higher in those countries with lower initial rates. Therefore, TPM courses have been proven effective in those countries with a national strategy to increase the donation activity that includes education. Education is, among other factors, crucial in the development of donation and transplantation systems at regional or national level. Throughout these 30 years TPM has contributed to the professionalization of health professionals involved in this development and will keep on this endeavour.

237.1: ODISSeA: Organ Donation Innovative Strategies For Southeast Asia

Introduction: ODISSeA is an Erasmus+ project funded by the European Commission. An academic postgraduate programme on organ donation (OD) in 8 Southeast Asian (SeA) universities from Malaysia, Myanmar, Philippines and Thailand was designed and developed. The origin comes from the need for a specialized training that builds adequate knowledge, skills and attitude in OD to increase the well-trained specialists that will efficiently coordinate the process of OD in SeA. Methods: Training programmes and OD self-assessment (SA) of clinical knowledge (A/n21) and of non-clinical competencies (B/n18). SeA universities targeted 3 groups: university personnel, faculty members and potential postgraduate trainees. Train the trainers (TxT) blended programme for SeA trainers healthcare professionals (HCPs). Pre and post course evaluation results were compared. Multilevel blended Postgraduate Programme in Organ Donation (PPOD) targeting HCPs combining academic training (online training and local & international seminars) with bedside projects (On-the-job- projects and awareness events). Pre and post course evaluation results were compared. Results: Comparing SA results among trainers and trainees in group A 37% vs 54% scored poor to average while 30% vs 20% scored very good to excellent. The overall average score was 9.21 ± 0.39 SD vs 2.49 ± 0.31 SD respectively. In group B 19% vs 35% scored poor to average while 49% vs 25% scored very good to excellent. The overall average score was 3.43 ± 0.67 SD vs 2.83 ± 0.48 SD respectively. HCPs trained in TxT (n41) pre and post testing shows knowledge increase of 15.14% with an overall average score of 6.67 ± 0.96 SD in pre-test vs 7.68 ± 0.66 SD in post-test. HCPs trained in PPOD (n296) pre and post testing shows knowledge increase of 76.45% with an overall average score of 4.6 ± 0.57 SD in pre-test vs 8.12 ± 0.53 SD in post-test. Conclusion: The innovative approach of ODISSeA as a multilevel educational intervention revealed different results between trainers vs trainees on perception and attitude, clinical knowledge vs non-clinical competencies. Significant knowledge increase was reported upon completion of both, TxT and PPOD. ODISSeA comes to meet the needs identified in deceased organ donation in the SeA region. The project succeeded in establishing recognized academic training in OD in the 8 SeA universities, following the best practices from the most successful European models. Due to covid-19, organ donation decreased in almost all countries worlwide. Malaysia and Thailand were and exception, reporting an increment in the deceased organ donation rates 2020 vs 2019. This increase can be attributed to ODISSeA’s implementation and, in the case of Malaysia, to the creation of Organ and Tissue Procurement Units (UPOH) in 16 hospitals, which was translated to a 155% increment in the organ donation family consent rates since UPOH and ODISSeA postgraduate programme began in January 2020. Acknowledgement to ODISSeA Consortium.

P1.03: Knowledge Exchange Program to Increase the Organ Donation Rates in Saudi Arabia

P1.03: Knowledge Exchange Program to Increase the Organ Donation Rates in Saudi Arabia

Understanding organ donation processes and structures in ontario: A social network analysis approach

BackgroundTransplant rates in Ontario rose steeply in the decade prior to the COVID-19 pandemic. Reasons for that increase remain unclear, but the inter-organizational arrangement of organ donation programs may have contributed. However, there is a paucity of literature investigating these inter-organizational arrangements, with a limited understanding of how communication facilitates organ donation. Understanding these arrangements may help to re-establish rising organ donation rates post-pandemic. ObjectiveTo describe interprofessional interactions of Organ and Tissue Donation Coordinators (OTDCs) during organ donation cases, within organ donation programs in Ontario, from an organizational perspective (describing structure, context, process). MethodsMixed-method social network analysis (SNA) approach analyzing 14 organ donation cases just before the COVID-19 pandemic. ResultsStructure: Social network graphs depict the joint work performed by hospital staff and OTDCs, with a great part of the communication being processed through the OTDC. Context: Network density ranged from 0.05 to 0.24 across cases, and health care professionals perceived an atmosphere of shared vision and trust among team members. Process: Most networks had a degree centralization <0.50 suggesting a decentralized information flow, and participants perceived decisions being jointly made. The characteristic path length of cases ranged from 1.6 to 3.2, suggesting potential for rapid information diffusion. Overall, data reinforced the OTDC role of intermediator within the communication process, and hospital staff perceived OTDCs as central players. Hospital staff and OTDCs reported frustration with some aspects of the flow of information during the organ allocation processes. ConclusionFindings from this study provide a network map of communications within organ donation cases and reinforce the importance of the OTDC role. Opportunities for quality improvement within these processes are identified.

Willingness to Donate Organs After Death

Abstract: Background: Despite the growing number of organ transplants, there is still a significant difference between the number of donated organs and the number of people waiting for them. Knowing the reason people decide to donate is the first step to increasing organ donation rates. Aims: The main aim of the present study was to develop and validate a new scale for organ donation. Method: In three studies, 3,585 participants ranging in age between 14 and 89 years were selected through systematic random sampling. In the first study, we created a scale following the organ donation model theoretical framework and submitted the scale to exploratory factor analysis. In the second study, we performed a confirmatory factor analysis to cross-validate the hypothesized factor structure. In the third study, the scale was related to some important variables involved in organ donation. Results: Exploratory factor analysis and confirmatory factor analysis with a good fit index and acceptable levels of validity and reliability guarantee the quality of the scale and stable factor solution. Limitations: The main limitations are connected to social desirability, the presence of systematic bias of the population that refused to take part in the study, and the use of the Caucasian population. Conclusion: The resulting scale consists of 21 items in a seven-factor model (bodily integrity, fear of death, familial beliefs, altruism, medical mistrust, trust in the health institution, and emotional support). We also observed the relationship between scale factors, religiosity, and knowledge of organ donation with the willingness to donate organs.

Knowledge and attitude regarding organ donation among medical students in Hong Kong: a cross-sectional study

ObjectivesThe rate of organ donation in Hong Kong is among the lowest in developed regions. Since medical students will play an important role in counselling patients for organ donation and...

Cost-Effectiveness and Budget Impact Analysis of Implementing a 'Soft Opt-Out' System for Kidney Donation in Australia.

IntroductionThere is a severe shortage of donor organs globally. There is growing interest in understanding how a 'soft opt-out' organ donation system could help bridge the supply and demand gap for donor organs. This research aims to estimate the cost-effectiveness and budget impact of implementing a 'soft opt-out' organ donation system for kidney donation.MethodsA decision-analytic model was developed to estimate the incremental costs from a health system’s perspective, quality-adjusted life-years (QALYs), and death averted of people who have kidney failure, comparing a ‘soft opt-out’ organ donation system to an 'opt-in' system. This study analysed three scenarios where the 'soft opt-out' system generated a 20%, 30%, and 40% increase in deceased organ donation rates over 20 years. A 5-year time horizon was adopted for the budget impact analysis.ResultsA 20% increase in organ donation rates could have a cost saving of 650 million Australian dollars (A$) and a 10,400-QALY gain. A 20% increase would avert more than 1500 deaths, while a 40% increase would avert 3200 deaths over a time horizon of 20 years. Over the first 5 years, a 20% increase would have a net saving of A$53 million, increasing to A$106 million if the donation rate increases by 40%.ConclusionA 'soft opt-out' organ donation system would return a cost saving for the healthcare system, a net gain in QALYs, and prevention of a significant number of deaths. Advantageous budgetary impact is important, but understanding the aversion for a ‘soft opt-out’ system in Australia is also important and remains a priority for further research.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40258-022-00747-8.

Culturally Tailored and Community-Based Social Media Intervention to Promote Organ Donation Awareness among Asian Americans: “Heart of Gold”

Organ donation disparities among ethnic minorities have persisted for decades, especially among Asian Americans (AAs). AAs represent a substantial proportion of the national transplant waitlist but have historically had the lowest organ donation rate in the United States. Community based and culturally tailored (CBCT) interventions are needed to increase donor designation within AA communities. In collaboration with local AA organizations and representatives and national partners, we developed a culturally and linguistically tailored video using a family appeal to promote donor designation among AAs. The video was distributed on social media platforms in two stages from February 17 to September 17, 2021 and tracked Reaches, Impressions, Views, and Engagements as part of a larger evaluation. The results revealed higher social media activities and engagements on Facebook than on Instagram with and without paid advertisements, although the paid approach yielded 5 to 16 times higher viewer engagement. Over six months, the video reached 36,845 AAs and gained 53,308 Impressions, 20,139 Views, 2,455 Engagements, and 232 visits to the organ donation registration page. The findings indicated Facebook and CBCT approaches as effective communication strategies to potentially raise AAs’ organ donation awareness, especially among AA females over 45 years of age. Implications and limitations are discussed.

Knowledge and Attitude of MBBS Students Regarding Organ Donation

Background: The organ donation rate in India is much lower than the developed countries, which leads to long waiting for the recipient. Religious beliefs, misconceptions, and lack of awareness were a few of the reasons. The study was undertaken to assess the knowledge and attitude of undergraduate medical students regarding organ donation. Methodology: The study was conducted in a tertiary care center in eastern India from February to April 2019. A total of 285 undergraduate students were randomly selected and interviewed by using a pretested structured questionnaire. The data were entered and analyzed. Categorical data were presented as proportion or percentages. Results: Among the participants, 98.6% were aware of organ donation and television was the major source of knowledge for most of them. The participants were found to have a good knowledge regarding organ donation. However, their knowledge was poor regarding the legal framework. Despite knowledge, the attitude toward organ donation was poor among the students. Conclusion: Lack of complete knowledge among health-care providers and particularly doctors can affect the organ donation activity. In a country like India, where the organ donation rate is poor, health-care providers need to take initiative to encourage people. The subject of organ donation should be incorporated into the medical curriculum to improve the knowledge of medical students.

Nursing students faced with organ donation: Multicenter stratified national study

AimTo analyze the attitude of university nursing students at Spanish universities toward organ donation and transplantation and the factors affecting to their attitude. BackgroundThe opinion of future nurses toward organ transplant donation could have an important influence on the population. Knowing that opinion and what factors influence it is important to improve the attitude towards organ donation and transplantation. DesignA multicenter, sociological, interdisciplinary and observational study including university nursing diploma students in a complete academic year. MethodsSelected and randomized sample was taken of students from 52 of the 111 faculties and nursing schools and faculties in Spain with teaching activity ParticipantsA sample of 10,566 students was selected stratified by geographical area and year. Measurement instrumentThe instrument used was a validated questionnaire of attitude toward organ donation and transplantation, self-administered and completed anonymously. ResultsCompletion rate: 85 % (n = 9001). Of the students surveyed, 78 % (n = 7040) would donate their organs after dying. Variables related to a favourable attitude: (1) Interest in listening to a talk about organ donation and transplantation [Odds ratio 1.66, 95 % confidence interval 2.05–1.35]; (2) Family discussion [Odds ratio 2.30, 95 % confidence interval 2.79–1.90] or discussion with friends about organ donation and transplantation [Odds ratio 1.56, 95 % confidence interval 1.86–1.31]; (3) Knowing that one's father [Odds ratio 1.54, 95 % confidence interval 1.94–1.22], mother’s [Odds ratio 1.44, 95 % confidence interval 1.82–1.13] or partner [Odds ratio 1.28, 95 % confidence interval 1.60–1.03] has a favourable opinion; (4) Having a good self-assessment of information about organ donation and transplantation [Odds ratio 2.94, 95 % confidence interval 4.90–1.78]; (5) Not being worried about possible mutilation of the body after donation [Odds ratio 2.73, 95 % confidence interval 3.36–1.72]. ConclusionsNursing students in Spain tend to have a favourable attitude toward organ donation and transplantation although more than 20 % of those surveyed are not in favour. Tweetable AbstractTo maintain a high rate of organ donation for organ transplantation, it is necessary to improve the social awareness of future generations of nurses towards organ donation.

Attitudes to Organ Donation and Transplantation: An Insight From Jordan.

Organ donation rates in the Arabicspeaking world remain low; however, little is known about why. This study adapted an existing questionnaire into Arabic to improve understanding of perceived barriers to donation as a step toward increasing donation rates. We developed and validated an Arabic version of a published questionnaire, and we used this to collect data on knowledge and attitudes toward organ and tissue donation and transplantation, as well as reasons for the beliefs among adults in Jordan. The questionnaire was circulated through various Facebook groups. The questionnaire was completed by 404 Jordanian adults. Factor analysis indicated that a 3-factor model was suitable for the present study. These factors were Organ Donation Attitude, Organ Transplantation Attitude, and Fear of Health Outcomes. Generally, knowledge of organ donation was good, although only some respondents were aware of the opt-out system. Attitudes toward donation were favorable, with very few respondents reporting that religious or cultural beliefs would prevent them from donating organs. One surprising finding was that one-third of respondents expressed some degree of distrust of health services. Efforts to improve organ donation in the Arab world remain in development. We found a substantial awareness of organ donation and largely favorable views of it among selected adults in Jordan. This indicates a need to shift focus away from education and perceived religious and cultural barriers and refocus instead on the concerns regarding distrust of health services by the general population.

Family Interview Evaluation for Organ Donation: Communication of Death and Information About Organ Donation

The aim of this study was to identify variables related to organ donation that can contribute to the development of best practices in planning and conducting family interviews by health professionals. This descriptive and prospective study of quantitative approach was conducted at 2 southern Brazil health institutions referenced in organ donation. Data collection occurred between 2018 and 2019 by health professionals who conduct family interviews using validated instruments that assessed the stages of the interview. Analysis was performed by means of the proportions of the studied variables associated with the donation authorization categories per the χ2 test. The significance level adopted was 0.05. The variables that presented the highest level of significance in the correlation with the prevalence of family authorization for organ donation included the following: communication with the family about the results of each test in the brain death diagnostic protocol; identification of whether the family understood the information about the death; presence of a member of the transplantation commission who had training to communicate information about organ donation; presence of a family member who had power to authorize the donation; and the interval between the communication of death and information about organ donation. The study presents important gaps that can be filled by health teams and hospitals in order to improve the welcoming and respect for families, as well as the organ donation rates. It is important to understand that each family is unique when facing mourning, and to distance the communication of death from the discussion about organ donation is an act of respect and empathy.

Organ donation in a developing Caribbean country: a single centre experience in Trinidad and Tobago

ABSTRACT Objectives The National Organ Transplant Unit was established in 2006 with the aim of providing renal and corneal transplants services. This study assessed the current state of the National Organ Transplant Unit and the organ donation experience at a single centre intensive care unit in Trinidad. Methods A review of legal, human and material resources and a retrospective chart review of the current status of organ donation and transplantation in Trinidad and Tobago was conducted. Data were collected from medical records of deceased donors for the period January 2006 to December 2020. The organ donor experience in the Adult Intensive Care Unit at a tertiary care hospital in Trinidad was also evaluated. Data were collected from medical records of all patients in the adult intensive care unit for the period October 2016 to December 2016. Results Trinidad and Tobago has four donor hospitals, one transplant centre, and one surgical team consisting of three surgeons, approximately 100 trained Transplant Procurement Managers and one trained laboratory technician. The deceased donation rate was 0.77 donor per million population in 2006, peaked in 2014 at 3.85 and then remained at 0.77. Donor potentiality for the adult intensive care unit was 66.7% with a donation rate of 5.3%. Conclusions Organ donation in Trinidad and Tobago mostly relies on living donors. Despite increases in organ donation and conversion rates, the country has not yet achieved self-sufficiency. The implementation of a taskforce dedicated to developing action plans to improve organ donation services may assist the country in achieving self-sufficiency.