scholarly journals The role of transplant coordinators in ensuring quality of deceased organ donation

2016 ◽  
Vol 63 (2) ◽  
pp. 71-74
Author(s):  
Mirjana Lausevic ◽  
Milica Kravljaca ◽  
Miodrag Milenovic ◽  
Marijana Zivkovic ◽  
Voin Brkovic ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Deceased Donor ◽  
Multidisciplinary Teams ◽  
Deceased Organ Donation ◽  
Donor Identification ◽  
Organ Quality ◽  
Organ Recovery ◽  
Donor Characteristics

Organ quality depends on variety of factors, including donor characteristics, effects of brain death, donor maintanance, the type of organ perfusion, cold ishaemia time and surgical procedures during organ recovery. Brain death influences on donor hemodynamics, hormone disregulation and consecutive inflammation of donor organs, which leads to organ dysfunction after transplantation. Due to disparity between organ demand and supply, an improvement in the use of allografts from deceased donors that are older, with significant comorbidity, has been observed recently. Assessment regarding deceased donor organ quality is based on donor demographic and clinical characteristics that are related to early and late outcome after transplantation. The transplant coordinator has a role in donor identification and selection, obtaining family consent for organ donation and communication with multidisciplinary teams during organ recovery organisation, which leads to an increased number of available organs and also their quality.

scholarly journals Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maciej Kosieradzki ◽  
Anna Jakubowska-Winecka ◽  
Michal Feliksiak ◽  
Ilona Kawalec ◽  
Ewa Zawilinska ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Intensive Therapy ◽  
Clinical Signs ◽  
Deceased Donor ◽  
Limiting Factor ◽  
Brain Death Diagnosis ◽  
Donation Rate ◽  
Organ Recovery ◽  
Donation Activity

Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%;P<0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude.

scholarly journals Impact of Donation Physicians on Deceased Organ Donation: A Systematic Review

2021 ◽  
Author(s):  
Janet E. Squires ◽  
Laura D. Aloisio ◽  
Wilmer John Santos ◽  
Danielle Cho-Young ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Donation ◽  
Interrupted Time Series ◽  
Deceased Donor ◽  
Organ Donors ◽  
Consent Rate ◽  
Team Members ◽  
Study Selection ◽  
Before And After ◽  
Deceased Organ Donation

Abstract Background: An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Methods: A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020. Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by two team members; all discrepancies were resolved by consensus. Two team members independently extracted data from studies. Results: A total of 1,017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), three (25%) were cohort studies, and three (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8 to 143% (Mdn = 33%), an increase in actual organ donors from 15 to 113% (Mdn = 27%), an increase in donor consent rate from -3 to 258% (Mdn = 12%) and an increase in deceased donor transplants from 13 to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions: Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.

Beliefs and Brain Death

2017 ◽  
Author(s):  
Eelco F.M. Wijdicks
Keyword(s):  
United States ◽  
Native American ◽  
Brain Death ◽  
Cultural Diversity ◽  
Organ Donation ◽  
The United States ◽  
Neurological Injury ◽  
Brain Death Determination ◽  
Death Determination

Globalization has increased cultural diversity in many communities. This has immediate implications for care of patients with catastrophic neurological injury and later discussions of brain death and organ donation. While the major religions in the United States—Christianity, Islam, and Judaism—have taken a tolerant position in these matters, some denominations within them are vigorously opposed to it. This chapter presents a range of cultural and religious views of brain death determination and organ donation. In addition to the three major religions, Buddhist and native American views regarding brain death determination as well as organ donation are discussed. Conflict resolution over organ donation is discussed along with the role of clergy in mediating such conflicts between families and medical staff.

Donor identification and consent for deceased organ donation: summary of NICE guidance

BMJ ◽  
2012 ◽  
Vol 344 (jan12 4) ◽  
pp. e341-e341 ◽  
Author(s):  
K. Chamberlain ◽  
M. R. Baker ◽  
P. Kandaswamy ◽  
E. J. Shaw ◽  
G. McVeigh ◽  
...  
Keyword(s):  
Organ Donation ◽  
Nice Guidance ◽  
Deceased Organ Donation ◽  
Donor Identification

scholarly journals Role of intensive care nurses on guiding patients’ families/relatives to organ donation

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Ahmet Karaman ◽  
Neriman Akyolcu
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Transplant ◽  
University Hospitals ◽  
Intensive Care Nurses ◽  
Creative Commons ◽  
The Family ◽  
Using Data

Objective: The aim was to determine the role of intensive care nurses on guiding the families/relatives of brain-death patients to organ donation. Methods: This research is a descriptive study. While the population of the study consisted of 1710 nurses working in the intensive care units of public, private and university hospitals in the city of Istanbul, the sample consisted of 353 intensive care nurses selected with stratified random sampling method from the probability sampling methods from this population. The data were collected by using “Data Collection Form”. Results: It was determined that 74.5% of the intensive care nurses carefully listened the family/relatives of the patient with possible brain death or suffering from brain death and supported them to express their emotion and thoughts clearly; when the family/relatives of the patients hospitalised in the intensive care unit wanted to get information about organ donation, 20.7% of the nurses made the preliminary explanation themselves and then guided the patient to an organ transplant coordinator for detailed information and 3.1% of the nurses generally gave this information themselves. Conclusions: It was determined that the knowledge of the intensive care nurses about brain death and organ donation was partially adequate and the function of guiding the families/relatives of brain-death patients to organ donation was mostly done by the physician. doi: https://doi.org/10.12669/pjms.35.4.1285 How to cite this:Karaman A, Akyolcu N. Role of intensive care nurses on guiding patients’ families/relatives to organ donation. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1285 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Failure to Give

2020 ◽  
pp. 177-211
Author(s):  
James F. Childress
Keyword(s):  
Organ Donation ◽  
Financial Incentives ◽  
Cost Benefit ◽  
Deceased Donor ◽  
The United States ◽  
First Person ◽  
Presumed Consent ◽  
Opt Out ◽  
Deceased Organ Donation ◽  
Risk Cost

After considering the huge and persistent gap between the supply of deceased donor organs for transplantation and the number of patients on the waiting list for a transplant, this chapter considers different ethical frameworks for evaluating first-person failures to donate organs after death and then assesses selected public policies designed to overcome these failures. Policies to facilitate first-person deceased organ donation often seek to alter the individual’s risk/cost-benefit calculations in deciding whether to register as a donor (for instance, by providing financial incentives); financial incentives can be ethically justifiable under some circumstances if they encourage and facilitate donation but do not implicate the sale of organs. Other proposed policies seek to nudge the individual’s declaration of organ donation through mandated choice or required response or through opt-out policies, often called “presumed consent,” under which not opting out counts as a donative decision. Available evidence suggests that mandated choice, required response, and presumed consent would probably be ineffective and perhaps even counterproductive in the United States at this time, but that some carefully designed combination could possibly be both ethically acceptable and effective.

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