Acceptance of Organs From Deceased Donors: Results of a Global Survey.
Abstract
Background: With <10% of transplantation needs being met, one contributing factor may be the potential subjectivity in transplant specialists' acceptance of organs. Such decisions, if influenced by knowledge and/or comfort gaps, warrant intervention. We assessed knowledge and comfort gaps regarding deceased donation (DD) among critical care specialists and organ acceptance among transplant specialists. Methods: The Transplantation Society working group surveyed specialists on end-of-life management and organ acceptance. Participants, stratified by country DD rates, ranked their current and desired levels of knowledge or comfort (on a 0-100 scale) for survey questions. The differences between current and desired knowledge and comfort were reported as gaps. Results: Among 438 responses, the largest global knowledge gaps were for positive serology for Chagas (gap 30), multidrug-resistant bacterial infection (gap 23.5), HIV (gap 20), cancer history <5 y (gap 20), primary brain malignancies (gap 17.5), and high-risk behavior (gap 16). The largest global comfort gaps were for positive serology for Chagas (gap 29.5), multidrug-resistant bacterial infection (gap 21), excessive alcohol use (gap 20), primary brain malignancies (gap 20), and high-risk behavior (gap 16). Relevant knowledge and comfort gaps, both ranging from 10 to 50, were observed in the acceptance of organs from donors after circulatory determination of death. In general, countries with higher DD rates demonstrated smaller knowledge and comfort gaps than countries with lower DD rates. Conclusions: This survey reveals important knowledge and comfort gaps in DD organ acceptance. Targeted education could increase organ utilization and help address transplantation shortages.
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Authors: Marcelo Cantarovich, Medhat Askar, Shaifali Sandal, Hari S Meshram, Stephen Beed, Karen M. Dwyer, Nithya Krishnan, Mohammad Ghnaimat, Vivek B. Kute, Carlos Diaz, Mário Abbud‐Filho, Curie Ahn, Ban Hock Tan, Paola Garcia-Padilla, Oscar Imventarza, 하종원, Hiroto Egawa, Gustavo F Ferreira, Elias John Elenjickal, H Pilmore, Mirela Bušić, Jeffrey Schiff, Marti Manyalich, Lara Danziger-Isakov, Marina Berenguer, Beatriz Dominguez-Gil Gonzalez, John Gill, Jean Tchervenkov, Hawthorne Wj, James Markmann, Stock Peter, Kumud Dhital, Andreas Zuckerman, Andrea Herrera-Gayol, Gabriel Eduardo Gondolesi
Institutions: University of Pennsylvania, Georgetown University, Dalhousie University, University of British Columbia, Tufts University, Cincinnati Children's Hospital Medical Center, McGill University Health Centre, University of California, San Francisco, University of Toronto, Singapore General Hospital, Seoul National University, Toronto General Hospital, Medical University of Vienna, MedStar Georgetown University Hospital, The Royal Melbourne Hospital, Westmead Hospital, Westmead Institute for Medical Research, Hospital de Base, St. Paul's Hospital, National Medical Center, Specialty Hospital, Jordan, Penn Center for AIDS Research, Instituto de Investigación Sanitaria La Fe, Hospital Universitari i Politècnic La Fe, Apollo Hospitals, Apollo Hospitals, Pontificia Universidad Javeriana, Instituto Cardiovascular de Buenos Aires, University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Tufts Medical Center, Auckland City Hospital, Westmead Institute, Organización Nacional de Trasplantes, Hospital Universitario San Ignacio, Hamamatsu Rosai Hospital, Institute of Transplantation Sciences, Universidad Hospital Italiano, Argerich Hospital, Centro Universitário Academia, Research Institute of the McGill University Health Centre, Conseil de L'Europe, Apollo Hospitals