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Traino HM , Molisani AJ , Siminoff LA
Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation
Am J Transplant. 2017 Jun;17(6) :1620-1627
PMID: 27982508    PMCID: PMC5444960   
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Abstract
Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from nine partnering organ procurement organizations and interview data from 1339 family decision makers (FDMs) were compared across eight geographically distinct US donor service areas (DSAs). Authorization for organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process, discussion of the least donation-related topics, the highest levels of pressure to donate, and the least comfort with the donation decision. Organ procurement organization region predicted authorization (odds ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters' communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation.
Notes
1600-6143 Traino, H M Molisani, A J Siminoff, L A R01 DK081118/DK/NIDDK NIH HHS/United States Journal Article United States Am J Transplant. 2017 Jun;17(6):1620-1627. doi: 10.1111/ajt.14165. Epub 2017 Jan 23.