*Purpose: With approximately 25 African Americans (AAs) dying weekly while awaiting a transplantable organ, this study compares the experiences of AA families who authorized donation with those who refused.

*Methods: As part of a parent study testing the impact of a communication intervention on rates of family authorization, large administrative datasets were obtained from 9 partnering Organ Procurement Organizations (OPO). Initial analyses used these organizational data to assess authorization among African American families (N=1,651). Subsequent analyses were performed using a subsample of data collected via semi-structured telephone interviews of African American family decision makers (N=276). Initial bivariate analyses tested differences in study variables by authorization status (donor/nondonor). Two separate multilevel logistic regressions examined associations between independent variables and family authorization.

*Results: Analyses of the administrative datasets found that refusal was more likely when the patient was older, female, a DCD case, and not referred in a timely manner; refusal was less likely when families initiated donation conversations. Interview data revealed that families who refused to authorize donation were less likely to respond favorably to initial donation requests and reported less satisfaction with the overall approach, amount of time with OPO staff, and how questions were handled. Refusing families were also more likely to feel pressured, had less comprehensive donation discussions, and rated the OPO requesters’ communication skills lower. No significant differences in organ donation attitudes were found between families who authorized donation and those refusing to donate.

*Conclusions: The study suggests that AA families’ donation decisions are sensitive to the communication environment and may be optimized with culturally-appropriate requests.

« Back to 2020 American Transplant Congress