Where Are the Real Barriers in Post Mortem Organ Donation?
Dept. of General &
Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
Dept. of Health Psychology, Children's Memorial Health Institute, Warsaw, Poland
Dept. of Anesthesiology &
Intensive Care, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
Dept. of Surgery, University of Warmia &
Mazury, Olsztyn, Poland
Polish Union for Transplantation Medicine, Warsaw, Poland
Meeting: 2013 American Transplant Congress
Abstract number: 312
Low organ donation rate from deceased donors (DD) is believed to result from the societal misperception and non-acceptance of brain death.However, it has been shown that the attitude of health personnel toward organ recovery and transplantation is of utmost importance.
The mean DD donation rate in our country is 14.5 pmp. However, donation rate in various regions of the country differs greatly (from 5 to 26 pmp). We hypothesized there is a difference in attitude of physicians toward recognition (and acceptance) of brain death and a survey was conducted in regions with low and high donation rates in cooperation with a professional agency for public opinion surveys.
744 anesthesiologists, neurologists and neurosurgeons were interviewed. Physicians from the regions with low donation rates (LDR) were twice more reluctant than their colleagues from high donation rate regions (HDR) to start diagnostic procedure when clinical signs suggestive of brain death were present (14% vs. 7% would not diagnose death, respectively).
When clinical signs of brain death were present, formal determination was carried on in 43% of cases in LDR regions (in comparison to 26% in HDR regions) exclusively when there was a possibility of organ recovery. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 63% in HDR. Moreover, when there was no organ recovery planned, mechanical ventilation would not be terminated more often in LDR regions then in HDR regions (43% vs. 23%; p<0.05).
When asked what were the barriers in organ donation, LDR physicians more often claimed, that they were due to the poor relation with potential donor’s family, deficiency in communication skills and lack of experience in carrying out the procedure. Parallel survey in a general public on attitude towards organ donation showed no regional variance.
In conclusion, low donation activity seems to be mostly due to the medical staff attitude. Moreover, the tendency to diagnose brain death exclusively for purpose of organ recovery was observed.
To cite this abstract in AMA style:
Kosieradzki M, Jakubowska-Winecka A, Kusza K, Rowinski W. Where Are the Real Barriers in Post Mortem Organ Donation? [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/where-are-the-real-barriers-in-post-mortem-organ-donation/. Accessed June 6, 2025.« Back to 2013 American Transplant Congress