Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; School of Economics, Faculty of Arts and Social Sciences, University of Sydney, Sydney, Australia.
J Crit Care. 2020 Jun;57:23-29. doi: 10.1016/j.jcrc.2020.01.025. Epub 2020 Jan 22.
Australia has unmet need for transplantation. We sought to assess the impact of cultural and linguistic diversity (CALD) on family consent and medical suitability for organ donation.
Cohort study of New South Wales donor referrals, 2010-2015. Logistic regression estimated effects of primary language other than English and birthplace outside Australia (odds ratios OR, with 95% confidence intervals, 95%CI). Outcomes were whether families were asked for consent to donation, provided consent for donation, and whether the referral was medically suitable for donation.
Of 2977 organ donor referrals, a similar proportion of families had consent for donation was sought between non-English speakers and English speakers (p = .07), and between overseas-born compared to Australian-born referrals (p = .3). However, consent was less likely to be given for both non-English speakers than English speakers (OR 0.44, 95%CI:0.29-0.67), and those overseas-born than Australian-born (OR 0.54, 95%CI:0.41-0.72). For referrals both overseas-born and non-English speaking, families were both less likely to be asked for consent (OR 0.67; 95%CI:0.49-0.91) or give consent (OR 0.24; 95%CI0.16-0.37). There was no difference in medical suitability between English speakers and non-English speakers (p = .6), or between Australian-born and overseas-born referrals (p = .6).
Intervention to improve consent rates from CALD families may increase donation.
澳大利亚存在器官移植未满足的需求。我们旨在评估文化和语言多样性（CALD）对家庭同意和器官捐献医学适宜性的影响。
这是一项对新南威尔士州供体推荐者的队列研究，时间范围为 2010 年至 2015 年。逻辑回归估计了主要语言非英语和出生地在澳大利亚境外（比值比 OR，95%置信区间 95%CI）的影响。结局指标为是否向家庭征求捐献同意、家庭是否提供捐献同意以及该推荐是否适合进行捐献。
在 2977 例器官捐献推荐者中，非英语使用者和英语使用者之间寻求捐献同意的比例相似（p=0.07），海外出生者和澳大利亚出生者之间也相似（p=0.3）。然而，非英语使用者的同意率明显低于英语使用者（OR 0.44，95%CI：0.29-0.67），海外出生者也明显低于澳大利亚出生者（OR 0.54，95%CI：0.41-0.72）。对于海外出生和非英语使用者的推荐者，家庭更不可能被征求同意（OR 0.67；95%CI：0.49-0.91）或同意（OR 0.24；95%CI0.16-0.37）。英语使用者和非英语使用者之间（p=0.6）以及澳大利亚出生者和海外出生者之间（p=0.6）在医学适宜性方面没有差异。
针对 CALD 家庭的干预措施以提高同意率可能会增加捐献。
