Department of Surgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
S Afr Med J. 2020 Feb 26;110(3):204-209. doi: 10.7196/SAMJ.2020.v110i3.14227.
South Africa (SA) has very low and unchanging organ donation rates. A key point in the pathway of organ donation is obtaining informed consent from the family, which is necessary before organ donation can proceed. There is no published SA research on the consent rate and factors that influence this.
To describe the number of requests for consent and factors influencing this process in the SA context.
A prospective descriptive study was performed of all requests to families for organ donation in Western Cape Province, SA, by Groote Schuur Hospital (state sector), Red Cross War Memorial Children's Hospital (state sector) and Netcare (private sector) transplant co-ordinators from 1 May 2017 to 1 May 2018 to describe factors influencing consent rates.
The 6 co-ordinators (3 state sector and 3 private sector) recorded data of 83 consecutive families approached in 16 hospitals over the 1-year period. Consent to organ donation was granted for 23 family requests (n=18 (state sector); n=5 (private sector)). The number of families approached was greater in the state sector (n=74) than in the private sector (n=9). The overall consent rate was 27.7% (24.3% (state sector); 55.5% (private sector)). The majority of referrals came from trauma and emergency units (n=55; 66.3%) and very few from intensive care units (n=25; 30.1%). Immediate fluid resuscitation was required in 56 (67.5%) potential donors. The majority of families (n=74; 89.2%) were receptive to the organ donation request, independent of their ultimate decision regarding donation. The main reason given for refusing to consent was that it was against their religion (n=21) or culture (n=18).
This study showed that the number of families approached for consent to organ donation were low in the Western Cape (lower in the private sector), with a low consent rate (lower in the state sector). Donor management by clinical teams needs to be ongoing and active during the consent process. Consent discussions (and public awareness initiatives) need to be sensitive to and deal with religious and cultural reservations about organ donation.
南非（SA）的器官捐献率非常低且保持不变。器官捐献途径中的一个关键点是从家属那里获得知情同意，这是进行器官捐献的必要前提。目前，关于 SA 中同意率及其影响因素的研究尚未发表。
描述在南非背景下，器官捐献请求的数量及其影响因素。
对 2017 年 5 月 1 日至 2018 年 5 月 1 日期间，格罗特舒尔医院（州立部门）、红十字会战争纪念儿童医院（州立部门）和 Netcare（私立部门）的器官移植协调员向西开普省 83 个家庭提出的器官捐献请求，进行前瞻性描述性研究，以描述影响同意率的因素。
6 名协调员（3 名州立部门和 3 名私立部门）记录了 16 家医院 1 年内 83 个连续家庭的数据。23 个家庭请求同意捐献器官（n=18（州立部门）；n=5（私立部门））。州立部门提出的家庭数量多于私立部门（n=74 对 n=9）。总体同意率为 27.7%（州立部门 24.3%；私立部门 55.5%）。大多数转介来自创伤和急诊部门（n=55；66.3%），而很少来自重症监护病房（n=25；30.1%）。56 名潜在供体需要立即进行液体复苏（67.5%）。大多数家庭（n=74；89.2%）对器官捐献请求持接受态度，无论他们最终是否决定捐献。拒绝同意的主要原因是宗教（n=21）或文化（n=18）原因。
本研究表明，西开普省（私立部门较低）提出器官捐献同意请求的家庭数量较少，同意率较低（州立部门较低）。临床团队需要在同意过程中持续积极地管理供体。同意讨论（和公众意识倡议）需要对关于器官捐献的宗教和文化保留意见保持敏感并加以处理。
