Sarti Aimee J, Sutherland Stephanie, Meade Maureen, Weiss Matthew J, Dhanani Sonny, Lotherington Ken M, Landriault Angele, Vanderspank-Wright Brandi, Valiani Sabira, Keenan Sean, Kramer Andreas H, Beed Stephen, Brennan Joanne, Cardinal Pierre, Chassé Michaël, Nickerson Peter, Shemie Sam D
Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Can J Anaesth. 2025 Jun;72(6):975-985. doi: 10.1007/s12630-025-02978-4. Epub 2025 Jun 26.
Donation after death determination by circulatory criteria (DCC) is an option currently available for imminently dying patients who do not meet neurologic criteria for death. When organ donation is not successful following withdrawal of life-sustaining measures (WLSM), family members may experience additional feelings of loss and bereavement. In this study, we sought to explore the lived experiences of family members who consented to donation after DCC, including families whose loved ones proceeded to donation and those for whom donation was not possible.
We conducted a qualitative study using semi-structured interviews with family members whose loved ones agreed to donation after DCC and underwent WLSM in Canadian intensive care units. We recruited participants from all Canadian provinces with an organ donation organization (n = 10) and analyzed themes using a modified grounded theory approach.
Interviews with 79 family members of 78 potential donors with DCC revealed nine main themes as important in the context of WLSM in DCC: 1) early and repetitive communication, 2) predicting time of death (after WLSM), 3) invitation to witness WLSM, 4) family agency in donation after DCC (e.g., wishing they had been able to take some action and/or exert more control), 5) environment, 6) support, 7) honouring donor/meaning making, 8) guilt, and 9) triple loss (i.e., death, unsuccessful donation, and loss for recipients).
In this qualitative study, we identified a range of experiences among family members in the context of WLSM in DCC. Among those, we found family involvement in the WLSM and the DCC process to be very important. Family member perspectives on organ donation are essential to guide practices that can support consistent, high-quality family-centred care in this context.
依据循环标准判定的死后器官捐献（DCC）是目前可供不符合脑死亡标准的濒死患者选择的一种方式。当维持生命措施撤除（WLSM）后器官捐献未成功时，家庭成员可能会经历更多的失落和丧亲之痛。在本研究中，我们试图探究同意DCC后进行器官捐献的家庭成员的生活经历，包括其亲人成功进行捐献的家庭以及那些捐献未成功的家庭。
我们开展了一项定性研究，对在加拿大重症监护病房中其亲人同意DCC后进行捐献并接受了WLSM的家庭成员进行半结构式访谈。我们从加拿大所有设有器官捐献组织的省份招募了参与者（n = 10），并采用改良的扎根理论方法分析主题。
对78名潜在DCC捐献者的79名家庭成员进行的访谈揭示了在DCC的WLSM背景下重要的九个主要主题：1）早期且反复的沟通，2）预测死亡时间（WLSM后），3）邀请见证WLSM，4）DCC后家庭在捐献中的作用（例如，希望他们能够采取一些行动和/或施加更多控制），5）环境，6）支持，7）尊重捐献者/赋予意义，8）内疚，以及9）三重损失（即死亡、捐献未成功和受赠者损失）。
在这项定性研究中，我们确定了DCC的WLSM背景下家庭成员的一系列经历。其中，我们发现家庭参与WLSM和DCC过程非常重要。家庭成员对器官捐献的看法对于指导在此背景下能够支持持续、高质量以家庭为中心的护理的实践至关重要。
