Related Experiment Videos
Organ and tissue donation from the emergency department
Insights
Emergency departments (EDs) have many potential organ and tissue donors, but physicians rarely document donation considerations. Improving recognition and referral processes is crucial for increasing organ recovery from these patients.
Area of Science:
- Medical Science
- Transplantation Medicine
- Emergency Medicine
Background:
- Organ and tissue donor shortages significantly limit transplantation worldwide.
- The potential for organ and tissue donation from emergency department (ED) patients is largely unquantified.
- Existing legislation mandates donation requests, yet gaps in practice persist.
Purpose of the Study:
- To evaluate the potential for organ and tissue donation among patients who died in an emergency department.
- To assess physician documentation practices regarding organ and tissue donation inquiries in the ED.
- To identify barriers and opportunities for improving donor referral from ED settings.
Main Methods:
- Retrospective chart review of patients deceased in the ED.
- Analysis of patient demographics, cause of death, and suitability for organ/tissue donation (corneas, bones, heart valves, kidneys).
- Examination of physician documentation for donation inquiries, family discussions, and referrals to Organ Procurement Organizations.
Main Results:
- Out of 155 reviewed charts, significant potential for donation was identified: 99 for corneas, 61 for bones, 42 for heart valves, and 3 for kidneys.
- Physician documentation of donation consideration was notably absent in 84% of charts.
- Donor request forms were frequently incomplete or blank (92% of 37 forms), and only 2.6% mentioned donation in the narrative.
Conclusions:
- Physicians seldom document organ or tissue donation considerations for patients dying in the ED.
- The number of potential donors identified far exceeds the number of referrals or actual organ recoveries.
- Enhanced strategies are needed to improve the recognition and referral of potential organ and tissue donors from emergency departments to increase transplant availability.
Abstract:
Despite mandatory request legislation, the lack of available donor organs and tissues continues to limit transplant efforts. The potential contribution from emergency department (ED) patients remains undefined. We reviewed the charts of patients dying in our ED for organs and tissues potentially suitable for transplantation, age, cause of death, and physician documentation of donation inquiry. Of 155 charts reviewed, potential donors were identified for corneas (99), bones (61), heart valves (42), and kidneys (3). Of the 155 charts, 130 (84%) made no mention of donation, and of 37 charts containing a donor request form, 34 (92%) were incorrectly filled out or left blank. Four charts (2.6%) mentioned donation in the narrative section, two (1.3%) documented discussion with family, and one patient was referred to our Organ Procurement Organization, with recovery of one kidney and heart valves. We conclude that physicians rarely document consideration of donation for patients dying in the ED; the number of potential donors far exceeds the number referred or recovered. Future efforts should focus on methods to increase recognition and referral of organ and tissue donors from the ED.