Corman Dincer Pelin, Birtan Deniz, Arslantas Mustafa Kemal, Tore Altun Gulbin, Ayanoglu Hilmi Omer
From the Anaesthesiology and Reanimation Department, Marmara University School of Medicine, Istanbul, Turkey.
Exp Clin Transplant. 2018 Mar;16 Suppl 1(Suppl 1):51-54. doi: 10.6002/ect.TOND-TDTD2017.O21.
Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate.
We retrospectively evaluated the final decisions of families of 52 brain-dead donors treated at our institution between 2014 and 2017. Data underwent descriptive analyses. The standard interview content was generated after literature search results were reviewed by the authors. Previously, we examined the impact of standardized interviews done by intensive care unit physicians with relatives of potential brain-dead donors regarding decisions to donate or reasons for refusing organ donation. After termination of that study, interviews were done according to the intensivist's orientation, resulting in significantly decreased donation rates. Standardized interviews were then started again, resulting in increased donation rates.
Of 17 families who participated in standardized interviews, 5 families (29.4%) agreed to donate organs of their brain-dead relatives. In the other group of families, intensivists governed informing the families of donation without standardized interviews. In this group of 35 families, 5 families (14.3%) approved organ donation. The decision regarding whether to agree to organ donation was statistically different between the 2 family groups (P < .05).
Conducting a standard interview between relatives of brain-dead donors and the intensivists, facilitating visits between relatives and the brain-dead patients, and informing relatives about the donation process resulted in an increased rate of organ donation compared with routine protocols.
器官捐赠是器官移植最重要的阶段。研究表明，脑死亡患者家属对捐赠的态度在其决策中起着重要作用。我们假设，重症监护病房的医生必须通过标准化访谈和问卷，来增强家属对器官捐赠意义的认识，包括在失去亲人的同时拯救生命，并让他们了解脑死亡和捐赠过程，以提高捐赠率。
我们回顾性评估了2014年至2017年间在我院接受治疗的52例脑死亡捐赠者家属的最终决定。对数据进行描述性分析。作者在查阅文献检索结果后生成了标准访谈内容。此前，我们研究了重症监护病房医生对潜在脑死亡捐赠者亲属进行标准化访谈，对捐赠决定或拒绝器官捐赠原因的影响。在该研究结束后，访谈按照重症监护医生的指导进行，导致捐赠率显著下降。随后再次开始标准化访谈，捐赠率有所提高。
在参与标准化访谈的17个家庭中，有5个家庭（29.4%）同意捐赠其脑死亡亲属的器官。在另一组家庭中，重症监护医生在没有标准化访谈的情况下告知家属捐赠事宜。在这35个家庭的组中，有5个家庭（14.3%）批准了器官捐赠。两组家庭在是否同意器官捐赠的决定上存在统计学差异（P < 0.05）。
与常规方案相比，在脑死亡捐赠者亲属和重症监护医生之间进行标准访谈、促进亲属与脑死亡患者之间的探视，并告知亲属捐赠过程，可提高器官捐赠率。
