Factors that affect consent rate for organ donation after brain death: A 12-year registry.

Autor: Kananeh MF; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Brady PD; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Mehta CB; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Louchart LP; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Rehman MF; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Schultz LR; Henry Ford Hospital, Department of Neurology, Detroit, MI, USA., Lewis A; NYU Langone Medical Center, NY, New York, USA., Varelas PN; Albany Medical College, Albany, New York, USA. Electronic address: varelap@amc.edu.
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2020 Sep 15; Vol. 416, pp. 117036. Date of Electronic Publication: 2020 Jul 16.
DOI: 10.1016/j.jns.2020.117036
Abstrakt: Objective: To account for factors affecting family approach and consent for organ donation after brain death (BD).
Material and Methods: A prospective cohort study in a large, tertiary, urban hospital, where we reviewed the database of all brain-dead patients between January 2006 and December 2017 cross-matched with local organ procurement organization (OPO) records.
Results: Two-hundred sixty-six brain-dead patients were included (55% African Americans (AAs)). Two-hundred twenty-two were approached for donation. The reason for not approaching families was medical exclusion due to cancer or multi-organ failure. Patient demographics or religion were not associated with approaching families. Lower creatinine level was the only independent factor associated with higher approach. Consent rate for organ donation was 72.5%. Consent was significantly higher in Caucasians (89% vs 62% for AAs), younger patients (46.7 vs 52.5 years old), in patients with lower creatinine at time of death (1.7 vs 2.4 mg/dL), patients for whom apnea testing was completed (92% vs 80%) and patients with diabetes insipidus (DI) (72% vs 54%). There was no significant relationship between consent and patient gender, admission diagnosis, number of examinations or completion of a confirmatory test. In a logistic regression model, only AA race independently predicted consent for donation (odds, 95% CI, 0.27, 0.12-0.57 p < .001). In a different model, apnea test completion was an additional independent predictor (3.66, 1.28-10.5 p = .015).
Conclusions: Approaching families for organ donation consent was associated with medical suitability only and not with demographic or religious characteristics. AAs were 3.7 times less likely to consent for organ donation than non-AAs. Completion of apnea testing was associated with higher consent rates, an observation that needs to be explored in future studies documenting the effect on bedside family presence during this test.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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