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Investigating Physician Outlook Regarding Living Donation Prior to Planned Withdrawal of Care

S. Rath1, L. Washburn2, S. Creden1, M. Goss3, A. Rana1, J. Goss1, N. T. Galvan1

1Baylor College of Medicine, Houston, TX, 2University of Pittsburgh Medical Center, Pittsburgh, PA, 3McGovern Medical School, Houston, TX

Meeting: 2021 American Transplant Congress

Abstract number: 700

Keywords: Donation, Ethics, Public policy, Resource utilization

Topic: Clinical Science » Public Policy » Non-Organ Specific: Public Policy & Allocation

Session Information

Session Name: Non-Organ Specific: Public Policy & Allocation

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: The aim of this study is to assess the attitudes of physicians, physician assistants, and nurse practitioners in transplant and critical care regarding Living Donation Prior to Planned Withdrawal of Care (LD-PPW), which is the recovery of a living donor organ prior to withdrawal of life sustaining measures in a patient who is not brain dead, but for whom medical care towards meaningful recovery has been deemed futile.

*Methods: A case scenario was administered via email through Medical Marketing Services to healthcare practitioners involved in transplant and critical care. This scenario included a survey about a potential LD-PPW donor (“Jason”), and participants rated their agreement with hypothetical statements on a 5-point Likert scale as it pertains to his eligibility to donate (Figure 1). 17519 surveys were distributed, 3611 were viewed, and 148 completed responses were received.

*Results: Compared to previously published data surveying public perception of LD-PPW, this pilot data suggests that LD-PPW would be met with similar or even greater support from the professional community, with over 70% of responding practitioners indicating support for LD-PPW (Figure 2). 82% of respondents were confident in their ability to declare futility of care and 94% of respondents felt the care they provide would not vary with a patient’s organ donor status (Figure 2).

*Conclusions: This study was initiated because donation after cardiac declaration of death (DCDD) does not satisfy the current need for organ donation and transplantation, as nearly half of all DCDD does not proceed to organ donation. LD-PPW has been proposed as an alternative procedure targeted at increasing the quality and quantity of transplantable organs while respecting the donor’s right to donate. This pilot study revealed strong support for LD-PPW among healthcare practitioners, reaffirming previously published data of strong support within the public at large. Further research will assist execution of a formalized process for LD-PPW by allaying common concerns and identifying further barriers to implementation.

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To cite this abstract in AMA style:

Rath S, Washburn L, Creden S, Goss M, Rana A, Goss J, Galvan NT. Investigating Physician Outlook Regarding Living Donation Prior to Planned Withdrawal of Care [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/investigating-physician-outlook-regarding-living-donation-prior-to-planned-withdrawal-of-care/. Accessed May 12, 2025.

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