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Family Refusal of Heart Valve Donation
Ana Paula de Oliveira Pires1, Melissa Santomero Damim1, Isabelle Cristina Nogueira da Silva1
1Nursing School of University of São Paulo (EEUSP), São Paulo, SP, Brazil.
Insights
Family refusal for heart valve donation was analyzed. Refusal rates varied by donor age, cause of death (stroke), and hospital type (private vs. public).
Area of Science:
- Cardiology
- Transplantation Medicine
- Public Health
Background:
- Heart valve impairment necessitates transplantation due to disease-related deterioration.
- Understanding family refusal is crucial for improving organ and tissue donation rates.
- This study focuses on heart valve donation refusal between 2001 and 2020.
Purpose of the Study:
- To analyze the factors influencing family refusal for heart valve donation.
- To identify trends in heart valve donation refusal over a 20-year period.
- To provide insights for enhancing organ procurement strategies.
Main Methods:
- Cross-sectional study design.
- Data collected from patients declared brain dead by an Organ Procurement Organization in São Paulo.
- Analysis of variables including sex, age, cause of death, and hospital type.
Main Results:
- 236 families (9.65%) refused heart valve donation.
- Refusal was most common in the 41-59 age group, with stroke as a frequent cause of death.
- Trends showed decreasing refusal in males and younger age groups (0-11) from 2001-2009, with increases in older groups and the general population; a downward trend was observed in the 41-59 age group and general population from 2010-2020.
Conclusions:
- Specific refusal for heart valve donation is linked to patient age.
- Cause of death, particularly stroke, influences donation refusal.
- The type of healthcare institution (public or private) is also associated with refusal rates.
Background:
Impairment of the heart valves can occur due to many diseases that cause deterioration of the contractile function and harm the body, making it necessary for the heart valves to be transplanted. This study's objective was to analyze families' refusal to donate heart valves between 2001 and 2020.
Methods:
This was a cross-sectional study conducted in accordance with the Terms of Family Authorization for Donation of Organs and Tissues from patients diagnosed with brain death by an Organ Procurement Organization in the state of São Paulo. The variables analyzed were sex, age, cause of death, hospital type (private or public), and refusal to donate heart valves. Data analysis was performed using Stata software version 15.0 (StataCorp, LLC, College Station, Tex, United States) in a descriptive and inferential way.
Results:
A total of 236 people (9.65%) refused to specifically donate heart valves of their relatives, the majority of whom were between 41 and 59 years old. Most potential donors had suffered a stroke and had been in a private hospital. From 2001 to 2009, there was a decreasing trend in males and the age group from 0 to 11 years old, whereas there was an increasing trend in those aged 60 years or older and in the general population. Between 2010 and 2020, there was a downward trend in the 41- to 59-year-old age group and the general population.
Conclusions:
The specific refusal to donate heart valves was associated with age, diagnosis, and whether the institution was public or private.
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