scholarly journals The Process of Organ Donation from Non-Living Donors: A Case-Based Journey from Potential Donor Identification to Organ Procurement

2018 ◽  
Author(s):  
Alyssa Green ◽  
Peter G. Thomas ◽  
Rebecca Wilde-Onia ◽  
Scott J. Kohler ◽  
Joan D. Sweeney ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Living Donors ◽  
Potential Donor ◽  
Donor Identification ◽  
Case Based

scholarly journals The Ethics of Organ Donation in Patients Who Lack the Capacity for Decision Making

2018 ◽  
Vol 24 (3) ◽  
pp. 186-190 ◽  
Author(s):  
Lauren Lee
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Organ Donation ◽  
Health Care Providers ◽  
Consensus Statement ◽  
Organ Procurement ◽  
Well Being ◽  
Living Donors ◽  
Care Providers ◽  
Best Interest

Free and informed consent is the legal and ethical basis for organ donation from living donors, and is a requirement for making an autonomous health decision. In clinical practice, health-care providers are required to respect four bioethical principles: respect for autonomy, beneficence, non-maleficence, and justice (Beauchamp & Childress, 2012), with the best interest of their patients in mind. Yet there are bioethical concerns behind organ procurement from living donors who have never attained capacity, do not yet have the capacity, or have permanently lost the capacity for decision making. A consensus statement by the Live Organ Donor Consensus Group (Abecassis et al., 2000) protects these donors’ well-being and autonomy, but there still is a need to raise ethical awareness about the decision-making process regarding vulnerable potential donors. Health-care providers who are staff members in transplant clinics should be aware of the current consensus statement, commit to essential bioethical principles surrounding organ donation, and advocate for vulnerable living donors.

An assessment of advance relatives approach for brain death organ donation

2017 ◽  
Vol 26 (2) ◽  
pp. 553-563
Author(s):  
Carine Michaut ◽  
Antoine Baumann ◽  
Hélène Gregoire ◽  
Corinne Laviale ◽  
Gérard Audibert ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Healthcare Professionals ◽  
Ethical Issues ◽  
Organ Procurement ◽  
Post Mortem ◽  
Potential Donor ◽  
Tissue Procurement ◽  
Study Population ◽  
Network Administrators

Background: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. Research design: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called ‘Prélor’. Participants: The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. Main findings: A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Conclusion: Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses’ attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.

scholarly journals Evaluating the Impact of COVID-19 Pandemic on Organ Donation and Transplantation Activities in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Marzieh Latifi ◽  
Farzaneh Bagherpour ◽  
Arefeh Jafarian ◽  
Amirali Hamidiyeh ◽  
Ehsan Javandoost ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Chief Executive ◽  
Time Intervals ◽  
Potential Donor ◽  
Before And After ◽  
The Impact ◽  
Family Consent ◽  
New Strategies

Background: Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on reducing organ transplantation activities. Objectives: The aim of this study was to determine the donation and transplantation activities before and after COVID-19 outbreak in Iran. Methods: This retrospective study compared the donation and transplantation activities in two specific 9-month periods (December 2018 to March 2019 vs. March-December 2020). The questionnaire included the numbers of brain death confirmations, family consents, organ recoveries, and transplanted solid organs. The questionnaire was sent by email to the chief executive of the organ procurement unit. Results: A total of 15 organ procurement units responded to the survey. The largest reduction was seen in tissue transplantations (62.5%) during two time intervals. Brain death due to head trauma significantly decreased in two time intervals and suicide increased by 14.44% during the COVID-19 pandemic compared to 2018-2019 period. Significant reductions between the median of donation (P = 0.0187), median of potential donor (P = 0.005), median of family consent (P = 0.002), and median of eligible donor (P = 0.009) were observed during the two time periods. Conclusions: A significant reduction was observed in organ donation and transplantation during COVID-19 pandemic. Developing protocols and establishing new strategies for evaluation of organ donation to ensure the safety of organ recipients and medical staff is necessary.

scholarly journals Experiencing organ donation: feelings of relatives after consent

2015 ◽  
Vol 23 (5) ◽  
pp. 895-901 ◽  
Author(s):  
Marli Elisa Nascimento Fernandes ◽  
Zélia Zilda Lourenço de Camargo Bittencourt ◽  
Ilka de Fátima Santana Ferreira Boin
Keyword(s):  
Organ Donation ◽  
Emotional Support ◽  
Management Practices ◽  
Organ Procurement ◽  
Organ Donor ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Potential Donor ◽  
Donation Process ◽  
The Family

Objective: to identify experiences and feelings on the organ donation process, from the perspective of a relative of an organ donor in a transplant unit.Method: this was exploratory research using a qualitative approach, performed with seven family members of different organ donors, selected by a lottery. Sociodemographic data and the experiences regarding the donation process were collected through semi-structured interviews. The language material was transcribed and submitted to content analysis.Results: poor sensitivity of the medical staff communicating the relative's brain death - the potential donor - and the lack of socio-emotional support prior to the situation experienced by the family was highlighted by participants.Conclusions: the study identified the need to provide social-emotional support for families facing the experience of the organ donation process. From these findings, other care and management practices in health must be discussed to impact the strengthening of the family ties, post-donation, as well as the organ procurement indexes.

The Living Organ Donor as Patient

2021 ◽  
Author(s):  
Lainie Friedman Ross ◽  
J. Richard Thistlethwaite, Jr.
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Living Donor ◽  
Organ Procurement ◽  
Well Being ◽  
Living Donors ◽  
Solid Organ ◽  
Organ Donors ◽  
Ethics Framework ◽  
Special Obligations

This is a book about living solid organ donors as patients in their own right. This book is premised on the supposition that the field of living donor organ transplantation is ethical, even if some specific applications are not, eg, pre-mortem organ procurement of an imminently dying patient. When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, however, the goal of adequate organ supply without living donors remains elusive. If anything, the supply:demand ratio is worse. In this book, a five-principle living donor ethics framework is developed and used to examine the ethical issues raised by living donor selection demographics, innovative attempts to increase living organ donation, and living donor decision-making and risk thresholds. This ethics framework uses the three principles of the Belmont Report modified to organ transplantation (respect for persons, beneficence, and justice) supplemented by the principles of vulnerability and of special relationships creating special obligations. The approach requires that the transplant community fully embraces living organ donors (and prospective living organ donors) as patients to whom special obligations are owed. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral boundaries of living solid organ donation be determined and realized. This book provides theoretical arguments and practice guidelines, complemented by case studies, to ensure that living donors are given the full respect and care they deserve.

Family perspectives on organ and tissue donation for transplantation: A principlist analysis

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Sao Paulo ◽  
Tissue Donation ◽  
São Paulo ◽  
Ethical Considerations ◽  
Donation Process ◽  
The Family ◽  
Organ Procurement Organizations ◽  
Family Interview

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

The Ethics of Organ Donation by Living Donors

2005 ◽  
Vol 353 (5) ◽  
pp. 444-446 ◽  
Author(s):  
Robert D. Truog
Keyword(s):  
Organ Donation ◽  
Living Donors

Comparison of 1 vs 2 Brain Death Examinations on Time to Death Pronouncement and Organ Donation

Neurology ◽  
2021 ◽  
Vol 96 (10) ◽  
pp. e1453-e1461
Author(s):  
Panayiotis N. Varelas ◽  
Mohammed Rehman ◽  
Chandan Mehta ◽  
Lisa Louchart ◽  
Lonni Schultz ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Brain Function ◽  
Brain Injuries ◽  
Organ Procurement ◽  
Tertiary Hospital ◽  
Consent Rate ◽  
Organ Procurement Organization ◽  
Time To Death ◽  
Elapsed Time

ObjectiveTo fill the evidence gap on the value of a single brain death (SBD) or dual brain death (DBD) examination by providing data on irreversibility of brain function, organ donation consent, and transplantation.MethodsTwelve-year tertiary hospital and organ procurement organization data on brain death (BD) were combined and outcomes, including consent rate for organ donation and organs recovered and transplanted after SBD and DBD, were compared after multiple adjustments for covariates.ResultsA total of 266 patients were declared BD, 122 after SBD and 144 after DBD. Time from event to BD declaration was longer by an average of 20.9 hours after DBD (p = 0.003). Seventy-five (73%) families of patients with SBD and 86 (72%) with DBD consented for organ donation (p = 0.79). The number of BD examinations was not a predictor for consent. No patient regained brain function during the periods following BD. Patients with SBD were more likely to have at least 1 lung transplanted (p = 0.031). The number of organs transplanted was associated with the number of examinations (β coefficient [95% confidence interval] −0.5 [−0.97 to −0.02]; p = 0.044), along with age (for 5-year increase, −0.36 [−0.43 to −0.29]; p < 0.001) and PaO2 level (for 10 mm Hg increase, 0.026 [0.008–0.044]; p = 0.005) and decreased as the elapsed time to BD declaration increased (p = 0.019).ConclusionsA single neurologic examination to determine BD is sufficient in patients with nonanoxic catastrophic brain injuries. A second examination is without additional yield in this group and its delay reduces the number of organs transplanted.

Sign in / Sign up

Export Citation Format

Share Document