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Disparities in Brain Death Certification Knowledge among Indian Physicians Involved in Organ Donation
Deepak Gupta1, Kanwaljeet Garg1, Sandeep Mishra1
1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Insights
Physician training in brain death certification (BDC) is insufficient in India, hindering organ donation. Addressing knowledge gaps and improving BDC practices are crucial for increasing organ procurement rates.
Area of Science:
- Medical Sciences
- Transplantation Medicine
- Public Health
Background:
- Brainstem death certification (BDC) is essential for organ donation in India.
- Current practices and knowledge gaps in BDC among physicians require investigation.
Purpose of the Study:
- To assess the current practices and knowledge gaps in brainstem death certification (BDC) among physicians involved in organ donation in India.
Main Methods:
- An online survey was conducted using Google Forms.
- The questionnaire link was distributed to physicians involved in organ donation across India via email and social media.
Main Results:
- 177 physicians responded (35.4% response rate), predominantly neurosurgeons. Less than half received BDC training, and few trained residents.
- Lack of public awareness and family refusal were major barriers. Over 80% followed observation periods, but drug screening and ancillary tests were inconsistently performed.
- Seniority correlated with higher BDC caseloads, and most physicians felt 2-3 doctors suffice for BDC.
Conclusions:
- Significant gaps exist in BDC knowledge and practices among Indian physicians.
- Targeted training and improved BDC protocols are necessary to enhance organ donation rates.
- Addressing barriers like public awareness and family refusal is vital for successful organ procurement.
Background:
Brainstem death certification (BDC) is a fundamental process in the organ donation workflow, serving as a prerequisite for the ethical and legal procurement of organs from deceased donors.
Aims/Objectives:
This survey studies the current practices and knowledge gaps in BDC among the physicians involved in organ donation in India.
Methods:
An online survey was performed using the application 'Google Forms'. The link to the questionnaire was distributed to physicians involved in organ donation in India via personal email and social media platforms.
Results:
We received 177 responses out of 500 (35.4%). The majority of respondents were neurosurgeons (63.8%), predominantly male (82.2%), aged 30-40 years (35.1%), and employed in teaching hospitals (74.5%). Less than half (41.8%) received BDC training during MBBS; only 10% of respondents frequently trained residents in BDC. Lack of public awareness (62.1%) and family refusal (62.1%) were major barriers to organ donation; 43.5% cited an absence of transplant facilities for low organ donation rates. Over 80% followed an observation period during brain death examination; 48% did not screen for drugs/toxins; 40% considered elevated body temperature a contraindication to BDC. 96% were aware of apnea tests, and 40.7% identified the need for ancillary tests; 18.1% routinely performed them. No correlation existed between specialty/gender and BDC cases; seniority influenced higher caseloads (over 20 annually). Most physicians (58.20%) believe 2-3 doctors are sufficient for BDC.
Conclusions:
It is crucial to address gaps in the knowledge and practices of BDC among physicians to enhance organ donation rates in India.
