Anthony Cignarella1, Bernice Redley2, Tracey Bucknall3. 1. The Alfred Hospital Intensive Care Unit, Alfred Health, 55 Commercial Road Prahran, 3004, Victoria, Australia. Electronic address: a.cignarella@alfred.org.au. 2. School of Nursing and Midwifery, Faculty of Health, Deakin University, Locked Bag 2000, Geelong, Victoria, 3220, Australia; Centre for Quality and Patient Safety Research - Monash Health Partnership, 246 Clayton road, Clayton, 3168, Victoria, Australia. Electronic address: bernice.redley@deakin.edu.au. 3. School of Nursing and Midwifery, Faculty of Health, Deakin University, Locked Bag 2000, Geelong, Victoria, 3220, Australia; Centre for Quality and Patient Safety Research - Alfred Health Partnership, 55 Commercial Road Prahran, 3004, Victoria, Australia. Electronic address: tracey.bucknall@deakin.edu.au.
Abstract
BACKGROUND: Despite many Australians supporting organ donation, national posthumous organ donation rates have not increased as expected over the last three decades. Little is known about the barriers to organ donation for patients in intensive care that meet the criteria for organ donation. OBJECTIVE: The aim of this study was to describe the characteristics of patients identified as potentially suitable for organ donation and to explore the variables associated with the success, or failure, of solid organ donation within the context of an Australian public hospital intensive care unit (ICU). METHODS: A retrospective audit examined electronic records of 280 potential organ donors aged 18-80 years, admitted into the ICU between 1 July 2012 and 30 June 2016. Data extracted from three separate electronic hospital databases were amalgamated for analysis. RESULTS: Of the 280 potential organ donors identified, conversations with families of 182 (65%) patients resulted in their agreement to organ donation. Consent to organ donation was most often provided by the patient's spouse (65, 35.7%); however, only 63.7% (n = 116) were successful organ donors. The remaining 36.3% (n = 66) of patients did not donate organs for medical reasons. Compared with those who did not donate, the typical organ donor was significantly younger (M 49.9 years, p = 0.020), Australian-born (p = 0.031), and had a shorter length of ICU stay (M 64.9 h, p = 0.002). The most frequently donated organs were kidneys (103, 88.8%), lungs (59, 50.9%), and livers (52, 44.8%). CONCLUSION: This study provided insights into patient, family, and organisational factors contributing to the success of organ donation outcomes in the ICU. Two factors that adversely impacted donation outcomes were the following: (1) the family did not consent to organ donation on behalf of the patient and (2) consent was provided, but donation did not proceed for medical reasons. Although the focus on the consenting process has been raised, this study highlights the additional impact of medical suitability on rates of organ donation. Family members may experience significant disappointment after consent that may have repercussions on their health and also future donation considerations. This study also highlighted some deficiencies in the databases that, if addressed, could better inform organisational processes in the consent and support of those making decisions about consent.
BACKGROUND: Despite many Australians supporting organ donation, national posthumous organ donation rates have not increased as expected over the last three decades. Little is known about the barriers to organ donation for patients in intensive care that meet the criteria for organ donation. OBJECTIVE: The aim of this study was to describe the characteristics of patients identified as potentially suitable for organ donation and to explore the variables associated with the success, or failure, of solid organ donation within the context of an Australian public hospital intensive care unit (ICU). METHODS: A retrospective audit examined electronic records of 280 potential organ donors aged 18-80 years, admitted into the ICU between 1 July 2012 and 30 June 2016. Data extracted from three separate electronic hospital databases were amalgamated for analysis. RESULTS: Of the 280 potential organ donors identified, conversations with families of 182 (65%) patients resulted in their agreement to organ donation. Consent to organ donation was most often provided by the patient's spouse (65, 35.7%); however, only 63.7% (n = 116) were successful organ donors. The remaining 36.3% (n = 66) of patients did not donate organs for medical reasons. Compared with those who did not donate, the typical organ donor was significantly younger (M 49.9 years, p = 0.020), Australian-born (p = 0.031), and had a shorter length of ICU stay (M 64.9 h, p = 0.002). The most frequently donated organs were kidneys (103, 88.8%), lungs (59, 50.9%), and livers (52, 44.8%). CONCLUSION: This study provided insights into patient, family, and organisational factors contributing to the success of organ donation outcomes in the ICU. Two factors that adversely impacted donation outcomes were the following: (1) the family did not consent to organ donation on behalf of the patient and (2) consent was provided, but donation did not proceed for medical reasons. Although the focus on the consenting process has been raised, this study highlights the additional impact of medical suitability on rates of organ donation. Family members may experience significant disappointment after consent that may have repercussions on their health and also future donation considerations. This study also highlighted some deficiencies in the databases that, if addressed, could better inform organisational processes in the consent and support of those making decisions about consent.
Keywords:
Collaborative request; Consent; Critical care nursing; Decision-making; Family agreement; Intensive care unit; Organ donation; Retrospective audit
Authors: Christopher Weiyang Liu; Lynn N Chen; Amalina Anwar; Boyu Lu Zhao; Clin K Y Lai; Wei Heng Ng; Thangavelautham Suhitharan; Vui Kian Ho; Jean C J Liu Journal: BMJ Open Date: 2021-11-16 Impact factor: 2.692
Authors: Daniel Oehler; Charlotte Böttger; Moritz Benjamin Immohr; Raphael Romano Bruno; Jafer Haschemi; Daniel Scheiber; Patrick Horn; Hug Aubin; Igor Tudorache; Ralf Westenfeld; Payam Akhyari; Malte Kelm; Artur Lichtenberg; Udo Boeken Journal: Life (Basel) Date: 2022-07-14