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Differences in the procurement of organs and tissues by health care professionals
L A Siminoff1, R Arnold, D S Miller
1University of Pittsburgh, Department of Psychiatry, PA 15213.
Insights
Health care professionals (HCPs) are less successful identifying eligible tissue and cornea donors compared to organ donors. Increased education is needed to improve tissue and cornea donation procurement rates.
Area of Science:
- Medical Science
- Transplantation Medicine
- Public Health
Background:
- Organ donation is widely understood by healthcare professionals (HCPs), but tissue and cornea donation processes are less familiar.
- Existing research has largely overlooked tissue and cornea donation, necessitating further investigation into these areas.
- This study provides initial data comparing organ donation with tissue and cornea donation processes and reports tissue eligibility rates among hospital deaths.
Purpose of the Study:
- To compare the processes and outcomes of organ donation versus tissue and cornea donation.
- To determine the eligibility rates for tissue donation among deceased patients in a hospital setting.
- To assess healthcare professionals' knowledge, attitudes, and performance regarding organ, tissue, and cornea donation.
Main Methods:
- A 5-month chart review of 233 deceased patients to identify eligibility for organ, tissue, and cornea donation.
- In-depth interviews with healthcare professionals (physicians, house officers, nurses) involved in 50 eligible donation cases.
- Data collection on donation events, HCP knowledge of medical criteria, and attitudes toward donation, with informed consent obtained from all interviewed HCPs.
Main Results:
- Eligibility rates: 4.3% for organs, 11.2% for tissues, and 18.9% for corneas among 233 deaths.
- Identification and consent rates were lower for tissue donors (73.2% identified, 65.9% asked) compared to organ donors.
- Family consent rates were 33.3% for organs and 29.6% for tissues/corneas, lower than anticipated based on public opinion.
Conclusions:
- Healthcare professionals demonstrated lower efficiency and knowledge regarding tissue and cornea procurement compared to organ donation.
- HCPs generally held more positive attitudes towards corneal donation than tissue donation.
- Enhanced education for HCPs is crucial for optimizing tissue procurement for transplantation.
Background:
The act of donating organs is familiar to most health care professionals (HCPs). However, the process of tissue and cornea donation is not nearly as well known. Most studies of the donation process have neglected the issue of tissue and cornea donation. This study offers some preliminary data concerning the differences between organ and tissue and cornea donation processes. As well, this is one of the first studies to report an eligibility rate for tissues among hospital deaths.
Methods:
During a 5-month period in 1989, the charts of all patients (n = 233) who died in the study hospital were reviewed on a weekly basis to establish eligibility to donate organs, tissues and corneas. A case series of 50 eligible patients cases was selected for in-depth interviews. Cases were defined as those patients who were eligible to donate tissues or organs. The patient's attending physician, house officer, and primary nurse were interviewed using an open-ended interview format. These audiotaped interviews focused on the events surrounding the patient's death, focusing on the issue of donation. We also collected information concerning HCP knowledge of the medical criteria for donation and their attitudes toward donation. Consent was obtained from all HCPs before beginning the interview process.
Results:
Of the 233 deaths, 4.3% were eligible to donate organs, 11.2% were eligible to donate tissues, and 18.9% were eligible to donate corneas. On the basis of our interview data we found that all eligible organ donors were identified and their families asked by at least one member of the patient's health care team to consider donation. HCPs were less successful identifying tissue patients: 30 of the 41 tissue donors (73.2%) were identified and only 65.9% of donor families were asked to donate. Rates of consent to donation were lower than might be expected based on public opinion polls. 33.3% of families consented to organ donation while only 29.6% consented to donate tissue and cornea.
Conclusion:
HCPs performed less efficiently in terms of the procurement process for tissues and corneas as compared to organs. They were also less knowledgeable about the donation criteria for tissues and corneas than organs. They generally exhibited more positive attitudes about corneal donation. More education of HCPs is necessary before we can optimally procure tissues for transplantation.