Context Transplantation has become the therapy of choice for patients with organ
failure. However, the low rate of consent by families of donor-eligible patients
is a major limiting factor in the success of organ transplantation.
Objective To explore factors associated with the decision to donate among families
of potential solid organ donors.
Design and Setting Data collection via chart reviews, telephone interviews with health
care practitioners (HCPs) or organ procurement organization (OPO) staff, and
face-to-face interviews with family for all donor-eligible deaths at 9 trauma
hospitals in southwestern Pennsylvania and northeastern Ohio from 1994 to
Participants Family members, HCPs, and OPO staff involved in the donation decision
for 420 donor-eligible patients.
Main Outcome Measure Factors associated with family decision to donate or not donate organs
Results A total of 238 of the 420 cases led to organ donation; 182 did not.
Univariate analysis revealed numerous factors associated with the donation
decision. Multivariable analysis of associated variables revealed that family
and patient sociodemographics (ethnicity, patient's age and cause of death)
and prior knowledge of the patients' wishes were significantly associated
with willingness to donate (adjusted odds ratio [OR], 7.68; 95% confidence
interval [CI], 6.55-9.01). Families who discussed more topics and had more
conversations about organ donation were more likely to donate (adjusted OR,
5.22; 95% CI, 4.32-6.30), as were families with more contact with OPO staff
(adjusted OR, 3.08; 95% CI, 2.63-3.60) and those who experienced an optimal
request pattern (adjusted OR, 2.96; 95% CI, 2.58-3.40). Socioemotional and
communication variables acted as intervening variables.
Conclusions Public education is needed to modify attitudes about organ donation
prior to a donation opportunity. Specific steps can be taken by HCPs and OPO
staff to maximize the opportunity to persuade families to donate their relatives'