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Organ donation: family members NOT honoring patient wishes
Ashley Britton Christmas1, Gary W Burris, Tyson A Bogart
1F.H. "Sammy" Ross, Jr. Trauma Center, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA. ashley.christmas@carolinashealthcare.org
Background:
Each year, many organ donation opportunities are missed because of the lack of familial consent. Occasionally, patients' consents for organ donation through the Department of Motor Vehicles (DMV) are posthumously overruled by their families. We assessed the number of potential opportunities for organ donation that are missed because of lack of familial consent despite previously expressed wishes for donation as registered with the state DMV.
Methods:
The medical records of potential donors were reviewed to ascertain appropriateness for donation, familial consent or denial for donation, and number of organs transplanted from each eligible donor. These data were then compared with DMV data regarding prior patient designations either for or against organ donation.
Results:
One hundred four approaches for donation were made to families during a 3-month period. The DMV donor status was available for 84 patients; 25 were designated as organ donors. Five families refused consent for organ donation despite the patient's documented wishes to donate (80% organ recovery). Twenty-two consents were obtained from the remaining 59 patients not listed as donors by the DMV (37% organ recovery). An average of 3.4 organs were transplanted from eligible donors.
Conclusion:
DMV designation for organ donation increases the yield of consent for organ donation. However, despite prior DMV designations for donation, 20% of families ultimately denied consent for donation. This translated into 17 missed opportunities for potential transplant recipients during the 3-month study period.
Insights
Despite documented wishes, families sometimes deny organ donation, leading to missed opportunities. Registering intent with the Department of Motor Vehicles (DMV) improves consent rates for organ donation.
Area of Science:
- Transplantation Science
- Public Health Policy
- Medical Ethics
Background:
- Organ donation is crucial, yet many opportunities are lost due to insufficient family consent.
- Family refusal of organ donation can override a patient's prior consent, registered with the Department of Motor Vehicles (DMV).
- This study quantifies missed organ donation opportunities resulting from familial consent denial despite documented donor wishes.
Purpose of the Study:
- To assess the impact of familial consent on organ donation rates.
- To determine the frequency of missed organ donation opportunities when families deny consent contrary to the donor's registered wishes.
- To evaluate the effectiveness of Department of Motor Vehicles (DMV) donor designations.
Main Methods:
- Retrospective review of medical records for potential organ donors.
- Comparison of donor medical records with Department of Motor Vehicles (DMV) donor registry status.
- Analysis of familial consent rates and the number of organs transplanted per donor.
Main Results:
- Of 104 approaches, 84 had available DMV donor status; 25 were designated donors.
- Five families denied donation despite prior DMV designation, resulting in 80% organ recovery from these cases.
- Twenty-two consents were obtained from non-designated individuals (37% recovery), with an average of 3.4 organs transplanted per eligible donor.
Conclusions:
- Department of Motor Vehicles (DMV) designation for organ donation significantly increases consent yield.
- However, 20% of families denied consent even with prior DMV designation, causing 17 missed donation opportunities in 3 months.
- Strengthening the recognition of documented donor wishes is vital to maximize organ recovery and meet transplant needs.
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