Sadegh Beigee Farahnaz, Mohsenzadeh Mojtaba, Shahryari Shagin, Mojtabaee Meysam, Mazaheri Masoud
From the Organ Procurement Unit (OPU), Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences (SBMU), Darabad, Niavaran, Tehran 19569-44413, Iran.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):110-112. doi: 10.6002/ect.MESOT2018.O50.
The method of obtaining family consent for organ donation after occurrence of brain death in Iran is an opt-in process. Because of complicated cultural, legal, religious, and familial structures in Iran, it is not simple to take consent for organ donation in brain death situations. The process needs the professional staff to be experienced and have an appropriate personality to obtain consent.
We previous used a limited number of experienced coordinators to take consent. We revised our decision 2 years ago because of lack of trained personnel. From the beginning of 2017, we have started training courses regarding approaching families for donations for all interested coordinators. After participants finished the theoretical and practical training, we allowed them to interview themselves to practice a first evaluation for a suitable potential donor. We have continued this strategy and have gathered feedback from participating coordinators.
At the beginning of 2017, 9 coordinators who were previously qualified for handling other steps of organ donation were put into a compact training program to train for family interviews. In 2016, the experienced interviewers had a 88% success rate compared with a success rate of 83% in 2017 for inexperienced interviewers (P = .1). No significant differences were shown. Despite younger ages of donors obtained in 2017, median donated organs per donor decreased from 2.81 to 2.66. The average time interval between first contact with families and establishment of family consent was not significantly different between experienced and inexperienced coordinators (9.2 vs 8.7 h).
Although with the new strategy we experiensed a decrease in the consent rate, we believe this strategy will have long-term beneficial effects for our organization and the decreased rate will be a temporary decline. Interviews showed that this strategy made our coordinators more motivated and responsible for their job. As a result, both volume and quality of organ procurement activities will be increased.
在伊朗，脑死亡后获取器官捐赠家庭同意的方法是一种选择加入的程序。由于伊朗复杂的文化、法律、宗教和家庭结构，在脑死亡情况下获取器官捐赠同意并非易事。该过程需要专业人员具备经验且有合适的性格来获取同意。
我们之前使用有限数量的经验丰富的协调员来获取同意。由于缺乏训练有素的人员，我们在两年前修改了决定。从2017年初开始，我们为所有感兴趣的协调员开设了关于与家庭沟通捐赠事宜的培训课程。参与者完成理论和实践培训后，我们让他们自行进行面试，以对合适的潜在捐赠者进行首次评估。我们一直沿用这一策略，并收集了参与协调员的反馈。
2017年初，9名之前有资格处理器官捐赠其他步骤的协调员参加了紧凑的培训项目，以进行家庭访谈培训。2016年，经验丰富的访谈者成功率为88%，而2017年无经验的访谈者成功率为83%（P = 0.1）。未显示出显著差异。尽管2017年获取的捐赠者年龄较小，但每位捐赠者捐赠器官的中位数从2.81降至2.66。经验丰富和无经验的协调员在首次与家庭接触到获得家庭同意之间的平均时间间隔无显著差异（9.2小时对8.7小时）。
尽管采用新策略后我们的同意率有所下降，但我们相信该策略将对我们的组织产生长期有益影响，且下降率将是暂时的。访谈表明，该策略使我们的协调员对工作更有动力和责任感。因此，器官获取活动的数量和质量都将得到提高。
