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A Study of Concerns of Families of Potential Donation After Circulatory Death Donors and Recommendations for Raising
Margaret Verble1, Judy Worth1, Loreen Gulli2
1Verble, Worth & Verble, Lexington, KY, USA.
Insights
Family concerns about organ donation after circulatory death (DCD) differ from donation after brain death (DBD). Addressing these unique DCD concerns is key to increasing donation rates.
Area of Science:
- Transplantation research
- Organ donation science
- Medical sociology
Background:
- Donation after circulatory death (DCD) processes and family concerns differ significantly from donation after brain death (DBD).
- DCD donation rates are typically lower than DBD rates.
- Limited research exists on family concerns and decision-making in DCD requests compared to DBD.
Purpose of the Study:
- Identify family concerns specific to DCD organ donation that may differ from DBD.
- Explore strategies to address these unique DCD family concerns.
- Increase DCD donation rates by understanding and mitigating family barriers.
Main Methods:
- Organ procurement and family services coordinators from 4 organizations in 4 states completed written request response forms.
- Forms were completed shortly after family discussions regarding DCD.
- A 12-item instrument was used, supplemented by anecdotal observations and detailed comments on family concerns, donor registration, and decisions.
Main Results:
- Family concerns that impede DCD organ donation are distinct from those seen in DBD.
- These concerns stem from unique stressors inherent in the DCD scenario.
- Addressing these specific DCD-related concerns is crucial for improving donation rates.
Conclusions:
- Unique family concerns significantly impact DCD donation rates.
- Targeted interventions addressing DCD-specific family stresses are necessary.
- Understanding and mitigating these concerns can enhance organ availability from DCD donors.
Context:
The request process for donation after circulatory death (DCD) and family concerns about DCD differ in significant ways from the process for, and family concerns about, donation after brain death (DBD). In addition, donation rates for DCDs are typically lower than for DBDs. Although there has been a great deal of research on how the concerns of DBD families impact donation, limited research exists on family concerns and decision-making in the DCD request process.
Objective:
To determine the concerns of families approached for DCD and explore how those might be addressed to increase DCD donation rates.
Design, Setting, And Participants:
Written request response forms were completed by organ procurement and family services coordinators from 4 organ procurement organizations in 4 different states. They were filled out as soon as possible after speaking with families about DCD.
Main Outcome Measures:
Responses were marked on a 12-item instrument, and anecdotal observations and detailed comments about family concerns, donor registration status, and decisions made were noted.
Results:
Family concerns that block DCDs differ in many ways from those that block DBDs. These concerns arise from stresses peculiar to the DCD situation and must be addressed for these types of donations to increase.
Purpose Of The Study:
The purposes of the study are to identify family concerns about donating organs that are specific to DCD and that may differ from DBD and to distinguish how those concerns might be addressed in ways that increase the likelihood of donation.
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