Morgan James, Hopkinson Cathy, Hudson Cara, Murphy Paul, Gardiner Dale, McGowan Olive, Miller Cathy
Department of Anaesthesia and Critical Care, Leeds Teaching Hospitals NHS Trust, UK.
NHS Blood and Transplant Directorate, Bristol, UK.
J Intensive Care Soc. 2018 May;19(2):101-106. doi: 10.1177/1751143717738194. Epub 2017 Nov 15.
Between 1 April 2012 and 31 March 2015, 263 of the 2244 families in the UK whose loved ones had registered to donate organs for transplantation after their death on the NHS Organ Donor Register chose to override this decision; an override rate of 11.7%. Multivariable logistic regression analysis was applied to data relating to various aspects of the family approach in order to identify factors associated with such overrides. The factors associated with family overrides were failure to involve the Specialist Nurse for Organ Donation in the family approach (odds ratio 3.0), donation after circulatory death (odds ratio 2.7) and Black, Asian or Minority Ethnicity (odds ratio 2.7). This highlights the need to further engage with these groups in exploring donation as an end of life choice, and suggests that there may be, from the perspective of the family, fundamental differences between donation after brainstem death and circulatory death. It further adds to the body of data linking involvement of the Specialist Nurse for Organ Donation in the family approach to improved UK consent rates.
在2012年4月1日至2015年3月31日期间，英国国家医疗服务体系器官捐赠登记册上登记其亲人死后愿意捐赠器官用于移植的2244个家庭中，有263个家庭选择推翻这一决定；推翻率为11.7%。对与家庭处理方式各方面相关的数据进行多变量逻辑回归分析，以确定与此类推翻决定相关的因素。与家庭推翻决定相关的因素包括：在家庭处理过程中未让器官捐赠专科护士参与（比值比3.0）、循环性死亡后捐赠（比值比2.7）以及黑人、亚洲人或少数族裔（比值比2.7）。这凸显了需要进一步与这些群体接触，探讨将捐赠作为一种临终选择，并且表明从家庭角度来看，脑干死亡后捐赠和循环性死亡后捐赠可能存在根本差异。这进一步补充了一系列数据，这些数据将器官捐赠专科护士参与家庭处理方式与英国更高的同意率联系起来。
