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Trends and Determinants of Familial Consent for Corneal Donation in Chinese
Allie Lee1, Michael Y Ni, Amanda C K Luk
1*Hong Kong Eye Hospital, Hong Kong SAR, China; †School of Public Health, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China; and ‡Hospital Authority Eye Bank, Hong Kong SAR, China.
Insights
Eye donation consent rates remain low, with cultural beliefs hindering procurement. Targeted health education is crucial to overcome barriers and increase corneal transplantation availability.
Area of Science:
- Ophthalmology
- Transplantation Medicine
- Public Health
Background:
- Corneal transplantation is vital for treating corneal diseases.
- A global shortage of donor corneas limits transplantation success.
- Low family consent rates significantly impede tissue procurement for eye donation.
Purpose of the Study:
- To analyze trends in family consent rates for eye donation.
- To identify key factors influencing consent and refusal for corneal donation.
- To evaluate the effectiveness of current procurement strategies.
Main Methods:
- Retrospective review of family consent for eye donation (2008-2014) in Hong Kong.
- Analysis of reasons for consent/refusal and sociodemographic data.
- Multivariable logistic regression to determine donation predictors.
Main Results:
- Overall consent rate was 36.8% with no significant change over 7 years.
- Primary consent reason: "wish to help others"; primary refusal reason: "traditional Chinese culture to keep body intact".
- Factors increasing consent included deceased being female and having a do-not-resuscitate order.
Conclusions:
- Eye donation consent rates have remained stagnant.
- Cultural barriers significantly impact organ donation rates.
- Health education campaigns must address cultural sensitivities to improve eye donation consent.
Purpose:
Corneal transplantation is the treatment of choice for many corneal diseases. At present, there is a global shortage of corneal transplant tissues, and failure to obtain consent from families of potential donors is a major limiting factor in tissue procurement.
Methods:
All family members of potential donors after cardiac death approached by the local eye bank staff members from January 2008 to December 2014 in Hong Kong were included. Reasons for consent or refusal and sociodemographic details of the deceased and the family members approached were reviewed. Trends in consent rates from 2008 to 2014 were examined. Multivariable logistic regression was performed to examine determinants of donation among cases from 2013 to 2014.
Results:
A total of 1740 cases were identified. The overall consent rate was 36.8%, and the consent rate did not change significantly over the 7-year study period (P = 0.24). The most common reason for consent by family members was "the wish to help others" (86.0%), and the most common reason for refusal was "traditional Chinese culture to keep the body intact after death" (42.7%). From the multivariable analysis in the subset of cases from 2013 to 2014 (n = 628), family members were more likely to consent when the deceased was female (adjusted odds ratio 1.45, P = 0.03), with a do-not-resuscitate order (adjusted odds ratio 2.27, P < 0.001).
Conclusions:
The consent rate for eye donation did not change significantly from 2008 to 2014. Our findings suggest that health education and promotion campaigns need to address cultural barriers to organ donation.
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