BACKGROUND: The availability of pediatric donors does not meet the demand for pediatric recipients who are listed and waiting transplantation. There is a need to identify factors that may impact the willingness of families to consent for organ donation.

METHODS: All potential donor (PD) referrals to the OPO from 2007-2012 were analyzed. All donors were <18 years of age. Demographics, geographic area of residence, median county income, county poverty levels, cause of death, decoupling, family member approached, understanding of hopelessness by family and hospital region were collected. An analysis for donation consent was performed.

RESULTS: 106 PD referrals were included. 65 Consented for donation (CD) and 41 did not consent. There were no differences in demographics between groups. On univariate analysis, PD had lower CD if: resided in counties with high poverty rates than US level (57 vs 87%, p=0.04), resided in Appalachia (50 vs 71%, p0.04), median county income <$35000 vs 35-45000 vs >45000 (41 vs 71 vs 70%, p=0.02), or approached by OPO vs local provider vs family mentioned donation (42 vs 68 vs 90%, p<0.001).

On multivariate analysis, only first approach for donation by the OPO was independently associated with significantly decreased rates of consent. If donation was first mentioned by the local provider, there was a 3 fold increase in CD (p=0.03), and if family mentioned donation, there was a 24 fold increase in CD (p<0.001) compared to the OPO.

CONCLUSIONS: While techniques for OPO approach for donation must be evaluated, our results clearly show the importance of community and local healthcare provider education regarding organ donation. While rates of county poverty, household income and residence in underserved area such as Appalachia are not modifiable, these factors can help identify PD's who are at risk for non-consent. Targeting at-risk groups for non-consent, such as those in underserved areas or those who are financially limited, with educational programs will help increase organ donation awareness. This is of critical importance to help improve donation rates in PD's with organs suitable for transplantation in children.

« Back to 2015 American Transplant Congress