Physiotherapy in deceased organ donation: A mixed methods study of current practice and perceptions amongst UK-based...

Potential organ donors are often identified in intensive care following brainstem or circulatory death. Clinical optimisation is fundamental for maintaining organ viability and physiotherapists are well positioned to support this through targeted interventions. Despite this, the physiotherapy role in deceased organ donation remains underexplored. This study aimed to describe current practice and explore the perceptions of physiotherapists in the United Kingdom involved in managing deceased organ donors.

An explanatory sequential mixed methods design was utilised. An online survey was used to describe the national picture of current physiotherapy practice. Online semi-structured interviews were undertaken to explore perceptions and attitudes of physiotherapists towards the physiotherapy management of deceased organ donors.

Fifty-six physiotherapists completed the survey, with 52% (n = 29) reporting involvement in donor management "always," or "most of the time." Treatment aims included secretion clearance (49%, n = 26) and lung optimisation (45%, n = 24). Suctioning was the most frequently performed intervention (95%, n = 53), followed by positioning (71%, n = 40) and manual techniques (71%, n = 40). Only 5% (n = 3) reported having local guidelines. Seven physiotherapists participated in interviews, identifying six key themes: experiences, barriers, role perceptions, physiotherapist learning needs, multidisciplinary team learning needs, and future needs.

The role of physiotherapy in organ donor management is under-recognised and lacks national consensus. Findings highlight disparities in practice, limited guidance and the need for further training to strengthen clinical reasoning. Guidance development that addresses the practical, ethical and emotional complexities of this work is urgently needed to support physiotherapists in this evolving area.