Impact of Culture and Policy on Organ Donation: A Comparison between Two Urban Trauma Centers in Developed Nations
| Autor: | Maureen McCunn, Walter Mauritz, Charles Alexander, Christopher Handley, Thomas M. Scalea, Richard P. Dutton |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Cross-Cultural Comparison Gerontology medicine.medical_specialty Traumatic brain injury Critical Care and Intensive Care Medicine Trauma Centers Surveys and Questionnaires Epidemiology medicine Humans Organ donation Aged business.industry Developed Countries Health Policy Public health Trauma center Glasgow Coma Scale Organ Transplantation Middle Aged medicine.disease Tissue Donors Austria Donation Baltimore Emergency medicine Wounds and Injuries Surgery business Developed country |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 54:995-999 |
| ISSN: | 0022-5282 |
| DOI: | 10.1097/01.ta.0000022461.76930.4e |
| Popis: | Background: The similarities and differences in organ donation policies, consent rates, and number of organs transplanted from patients declared brain dead after traumatic injury in different countries has not been previously reported. Methods: An international trauma survey questionnaire was developed. Analysis of two responding centers with regard to organ donation practices between urban, free-standing adult trauma hospitals is presented: the R Adams Cowley Shock Trauma Center (STC) in Baltimore, Maryland, and the Lorenz Bohler Hospital (LBH) in Vienna, Austria. Results: Hospital admissions resulting from traumatic brain injury (TBI) account for a significantly greater number of admissions at the STC than at the LBH (761 vs. 276), and the STC has a higher number of patients admitted with severe TBI (Glasgow Coma Scale score < 8). Of 39 medically suitable brain-dead patients at the STC, 18 went to organ donation. At the LBH, 16 patients were declared brain-dead, 7 were considered to be medically suitable, and all 7 went to donation. A presumed consent organ donation policy in Austria resulted in 100% of medically suitable patients going to donation at the LBH. With a volunteer donation policy at the STC, 46% of patients went to donation. Of those families who refused donation at the STC, 9 of 16 eligible African Americans (56%), 10 of 21 eligible Caucasians (48%), 1 Hispanic, and 1 Native American Indian family declined donation. Conclusion: Presumed organ donation in Austria led to 4 organs transplanted per trauma brain-death at the LBH, as compared with 3.8 organs per brain-death at the STC. The greater number of patients with severe TBI at the STC accounts for a similar organ donation rate compared with the LBH, despite the fact that the consent at the STC is voluntary and at the LBH is presumed. A higher organ donation rate in the United States would result in a greater number of organ transplants from patients who die after traumatic injury and a resultant increase in potential lives saved. There does not appear to be a significant difference in ethnicity between families who accept and those who refuse organ donation after traumatic brain death declaration at the declaration at the STC. |
| Databáze: | OpenAIRE |
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