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Siminoff LA , Alolod GP , Wilson-Genderson M , Yuen EYN , Traino HM
A Comparison of Request Process and Outcomes in Donation After Cardiac Death and Donation After Brain Death: Results From a National Study
Am J Transplant. 2017 May;17(5) :1278-1285
PMID: 27753206    PMCID: PMC5395358   
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Abstract
Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of public reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semistructured telephone interviews yielded FDMs' sociodemographic data, donation attitudes, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with white FDMs more likely to authorize DCD or DBD than black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and refusal reasons. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar approach strategies and communication skills and the development of education campaigns about the public's acceptance of DCD.
Notes
1600-6143 Siminoff, L A Alolod, G P Wilson-Genderson, M Yuen, E Y N Traino, H M R01 DK081118/DK/NIDDK NIH HHS/United States Journal Article United States Am J Transplant. 2017 May;17(5):1278-1285. doi: 10.1111/ajt.14084. Epub 2016 Nov 21.