Organ Donations Tied to Time of Request

When a relative dies from trauma or a sudden illness the family is stunned and and in a state of disbelief or denial. That is not a good time for a doctor to request the donation of organs to provide transplants. To most people it would add “insult to injury” and the request would probably be denied.

This was confirmed in a recent study in the U.K. that showed the request for donation of organs was denied more often when family members were asked for consent at the same time they were informed their relative has been declared brain dead or has died. Dr. Duncan Young, of John Radcliffe Hospital in Oxford, along with his research colleagues found that the decision to donate a dying relative's organs is directly tied to who makes the request and when.

The group reviewed 20 studies and found that a time gap between the delivery of bad news and a request for organ donations is important. The success rate of requests was also higher when it involved a transplant coordinator and the hospital staff. Other important factors in the donation decision were:

• amount of information given to survivors
• quality of care perceived to have been given to their loved one
• understanding of what brain death actually means
• location of the request, private locations being more successful
• approach, expertise and empathy of the person making the request
• amount of time the family has to decide on the request

The researchers said that the results might appear logical, but using the right procedures could increase the number of organ donations and save lives.

Teresa Shafer, of the LifeGift Organ Donation Center in Texas, wrote in an editorial which accompanied the study that requesting an organ donation is more than “popping the question.” It requires observation, collaboration, planning, and action based on the family and hospital dynamics. Shafer said that hospitals and organ procurement groups have to work together to increase the availability of transplant organs. She added that “the donation request is too important to delegate to those who are not expert, prepared and focused on a successful outcome.”

Dr. Young and colleagues said that the reasons for refusal were important because 41 percent of requests were denied in a recent British study.

Shafer said that organ requests should be presented to the family a second time, even if initially refused because families often alter their original position and consent to donate at a later time. There is a relatively short period of time for successful organ transplants and in order to be prepared and to secure more organ donors, hospitals and medical centers need to have trained transplant coordinators on staff to deal with survivors.

There are thousands of individuals on organ transplant waiting lists. Each death, no matter how unfortunate or traumatic could provide several life saving transplants. Individuals who have already made their choice and decided to become organ donors should make it clear to their relatives that this is their choice, and in the event their life is terminated they want their decision to be honored.