There is an answer to the shortage of organ donors.

From a retrospective review of 32,562 deaths that occurred in 1988 in the service area of Kentucky Organ Donor Affiliates, an area with a population of 3.4 million, 173 potential solid organ donors were identified for a rate of 50.8 donors per million population base. There were only 38 actual solid organ donors from this potential pool. The physician failed to recognize the potential for donation in 29 instances and in 92, the family refused consent for donation. In the second phase of the study, we analyzed 155 consecutive medically suitable organ donor referrals for one year. A specific focus on the process and timing of the request for donation was made in this review. In 143 of these instances (92 per cent), a clear temporal separation of the explanation of death or the certainty of family acceptance of death before the request for donation yielded a donor success in 53 of 82 instances. In contrast, only 11 of 61 instances resulted in a consent when the discussion of death and donation were combined into one discussion with the family (p less than 0.05). From this study, there seemed to be adequate numbers of organs available to provide for the current pool of recipients within the state of Kentucky. Educational assistance and an ongoing individual patient review of each death improved the donor rate during the time frame of this study. It is essential to allow a temporal separation between the explanation of death and the request for organ donation to maximize actual organ donation.