A Study of Concerns of Families of Potential Donation After Circulatory Death Donors and Recommendations for Raising Donation Rates.

CONTEXT

The request process for donation after circulatory death (DCD) and family concerns about DCD differ in significant ways from the process for, and family concerns about, donation after brain death (DBD). In addition, donation rates for DCDs are typically lower than for DBDs. Although there has been a great deal of research on how the concerns of DBD families impact donation, limited research exists on family concerns and decision-making in the DCD request process.

OBJECTIVE

To determine the concerns of families approached for DCD and explore how those might be addressed to increase DCD donation rates.

DESIGN, SETTING, AND PARTICIPANTS: Written request response forms were completed by organ procurement and family services coordinators from 4 organ procurement organizations in 4 different states. They were filled out as soon as possible after speaking with families about DCD.

MAIN OUTCOME MEASURES

Responses were marked on a 12-item instrument, and anecdotal observations and detailed comments about family concerns, donor registration status, and decisions made were noted.

RESULTS

Family concerns that block DCDs differ in many ways from those that block DBDs. These concerns arise from stresses peculiar to the DCD situation and must be addressed for these types of donations to increase.

PURPOSE OF THE STUDY

The purposes of the study are to identify family concerns about donating organs that are specific to DCD and that may differ from DBD and to distinguish how those concerns might be addressed in ways that increase the likelihood of donation.