Introduction: We sought to identify harms perceived by families of patients who underwent an unsuccessful attempt to donate organs after circulatory death.

Methods: We identified a regional sample of family members (n=15) who had direct experience with unsuccessful donation during attempted DCD. We recorded face-to-face interviews using questions developed to draw out their personal experience with organ donation and reaction to alternative donation strategies. We used qualitative content analysis to characterize harms of non-donation.

Results: Family members reported a broad spectrum of harms associated with failed DCD. One, families viewed unsuccessful donation as a “total waste” of time and healthcare resources. Two, donor families expressed empathy for potential recipients who lost a valuable life-extending resource, noting “there are two families involved in this” and “the other family[hellip]was hoping for those organs and they got let down [too].” Three, families perceived the inability to donate as a missed opportunity to reveal the donor's good qualities. Donation had “inherent nobility;” it signified a chance to validate their loved one as compassionate and generous, despite hardships encountered during life. Four, donor families lost a strategy to cope with grief. Families reported their commitment to donation inspired hope during a time of sorrow through the opportunity to honor the donor's last wishes and offer a life-saving gift. As such, the inability to donate correlated with powerlessness to generate meaning from heartbreak and “suddenly we lost that hope again.” Five, some families experienced self-doubt regarding their decision to withdraw life-supporting treatments when the time to circulatory death exceeded the window for donation, questioning, “did we take that life support off when it wasn't his time to go?” A few felt failed donation had no impact on their overwhelming sadness while others found value in the attempt to donate because “It's better than not trying.”

Conclusions: Families of patients who did not progress to circulatory death in time to donate organs felt the experience represented a wasted opportunity and revealed harms including inability to honor the donor's last wishes and find meaning in their grief. Understanding these consequences may help to inform alternative donation strategies.

CITATION INFORMATION: Taylor L, Buffington A, Joseph S, Fost N, Schwarze M. Donor Families' Perspectives of the Harms of Failed Donation After Circulatory Death: A Qualitative Analysis. Am J Transplant. 2017;17 (suppl 3).

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