• S L Gortmaker, C L Beasley, E Sheehy, B A Lucas, L E Brigham, A Grenvik, R H Patterson, N Garrison, P McNamara, and M J Evanisko.
• Dept of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA. sgortmak@hsph.harvard.edu
• J Transpl Coord. 1998 Dec 1;8(4):210-7.

AbstractThe greatest impediment to organ donation is refusal of family consent. This study examined the impact of 3 modifiable elements of the donation request on family consent rates: (1) decoupling (i.e., the family understands and accepts brain death before discussion of organ donation is begun); (2) the procurement coordinator participates in the request for consent; and (3) donation is requested in a quiet, private place. Data on the request process were collected prospectively for 707 medically suitable potential donors who had been referred to 3 organ procurement organizations. The average rate of consent for donation was 62.2%. Higher consent rates were independently associated with the 3 characteristics studied. These components were summarized in the Request Process Scale. Multivariate regression analyses indicated that consent rates can be as high as 74% when all 3 process elements are present. Hospitals and organ procurement organizations should incorporate these elements into their standard of practice when requesting organ donation.

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