Prog Transplant
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To help alleviate the organ shortage, transplant centers are using organs from expanded-criteria donors, who were considered unsuitable just a few years ago, such as non-heart-beating donors. In 1998, we made a concerted effort to increase the number of non-heart-beating donors recovered by our organ procurement organization. ⋯ From these donors, 61 of 82 recovered kidneys were transplanted into 58 patients, and 18 of 20 recovered livers were transplanted. A non-heart-beating donor program can significantly add to the number of organ transplants and successful transplantations.
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Families' understanding of brain death may be a factor that contributes to decisions regarding organ donation. ⋯ Most families (96%) were told their family member was brain dead, but only 28.3% were able to provide a completely correct definition of brain death. No association between the definition of brain death and willingness to donate was found. Those who donated were less likely to agree with the statement that someone is dead only when the heart stops than those who did not donate. Respondents who accepted that their loved one was dead when informed the patient was brain dead were more likely to donate than those who did not consider the patient dead until mechanical support was turned off and the heart stopped.
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The high demand for organs for transplantation necessitates enhancement of organ procurement activity worldwide. ⋯ Considering that the characteristics of the study population had not changed, we believe that the Donor Action program was an important factor leading to the observed improvement in identification of brain death.
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A questionnaire was distributed in a group of randomly selected hospital staff to ascertain the level and factors associated with awareness regarding organ transplantation, brain death, and cadaveric organ donation. Between October and December 2000, a total of 166 paramedical (nurses, technologists, medical physicists) and 100 nonmedical (administrative, clerical, engineering, social scientists, and miscellaneous) staff of a tertiary referral academic hospital in northern India received this questionnaire. ⋯ A significant positive correlation (r = 0.147, P = .01) was observed between the awareness of transplantation, brain death, and organ donation. A significant association was also observed between the workplace (operating room and intensive care unit vs other areas) and awareness of transplantation (P = .048), and brain death and organ donation (P = .030).
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This article explores the role of ethics and regulation in human research conducted by organ procurement agencies; basic ethical principles for human research are outlined. Organ procurement agencies are not required to observe federal regulations; however, voluntary adherence will ensure that procurement research is conducted according to current standards of ethical practice. ⋯ Even if studies qualify for exempt status, there is a moral presumption that informed consent should be sought, unless certain narrow conditions for waiver of consent are satisfied. Finally, when future research utilizing organ procurement records is anticipated, procurement coordinators should provide sufficiently detailed information to families about such plans to permit their advance informed consent to research activities.