Factors affecting family consent to corneal donation at a hospital-based eye bank in a tertiary Israeli medical center

Abstract

Purpose To identify clinical, demographic, and situational factors associated with family consent to corneal donation in a culturally diverse Israeli medical center operating under an opt-in system. Methods This retrospective observational study included 824 deceased individuals eligible for corneal donation at Hadassah Medical Center between 2019 and 2022. Data were collected on various variables, such as religion, Jewish religiosity, donor card registration, hospitalization details, method of family approach (face-to-face or telephone), next of kin identity and relation to consent for corneal donation. Univariate and multivariate analyses were performed to identify factors associated with family consent to corneal donation. Results Overall, 30.7% of families consented to corneal donation. In multivariable analyses, older age, religion, Jewish religiosity, donor card registration of the deceased, and donor card registration of a first-degree family member were independently associated with family consent. Jewish families were more likely to consent than non-Jewish families (OR=7.79), and within the Jewish population, secular and modern Orthodox families had the highest consent rates (57.3% and 53.6%, respectively). Donor card registration showed the strongest association with consent, with the highest consent rate observed when both the deceased and a first-degree family member were registered (83.3%, OR = 29.80). Consent rates did not differ significantly between telephone and face-to-face approaches. Conclusions Religion, Jewish religiosity, and donor card registration were independently associated with family consent to corneal donation. Comparable consent rates following telephone and face-to-face approaches suggest that telephone based requests may be an effective alternative when in-person discussions are not feasible. These findings support efforts to increase awareness of corneal donation, promote donor card registration, and tailor communication strategies to different cultural and religious communities.