History of deceased organ donation, transplantation, and organ procurement organizations.

The historical development of deceased organ donation, transplantation, and organ procurement organizations is reviewed. The concept of transplantation, taking parts from one animal or person and putting them into another animal or person, is ancient. The development of organ transplantation brought on the need for a source of organs.

CMS oversight, OPOs and transplant centers and the law of unintended consequences.

The Health Resources and Services Administration launched collaboratives with the goals of increasing donation rates, increasing the number of organs transplanted, eliminating deaths on the waiting list and improving outcomes. The Center for Medicare and Medicaid Services (CMS) recently published requirements for organ procurement organizations (OPOs) and transplant centers. Failure to meet CMS performance measures could result in OPOs losing their service area or transplant centers losing their CMS certification.

Family initiated discussions about organ donation at the time of death.

Some family members initiate organ donation discussions before being approached by donor coordinators or healthcare providers. We examined differences between families that did vs. did not initiate organ donation discussions and factors predicting donation consent among those families that self-initiated the discussion.

Relationship of exposure to organ donation information to attitudes, beliefs, and donation decisions of next of kin.

Context: Public education campaigns about organ donation are common, but their association to actual attitudes, beliefs, and decisions about organ donation among family members of donation-eligible individuals is unknown.

Objective: To examine the sources of organ donation information identified by donor and nondonor families who participated in a large-scale study to examine factors that influence organ donation decisions.

Design: Semistructured telephone survey conducted after a passive recruitment strategy.

Does family disagreement affect donation decisions by next of kin?

Context: Information about the relationship between family disagreement and donation decisions may facilitate development of strategies to help families resolve conflict and possibly increase donation consent rates.

Objective: To assess how family interactions influence next-of-kin decisions about organ donation.

Design: Semistructured survey.

Pediatric organ donation: what factors most influence parents' donation decisions?

Objective: To identify factors that influence parents' decisions when asked to donate a deceased child's organs.

Design: Cross-sectional design with data collection via structured telephone interviews.

Setting: One organ procurement organization in the Southeastern United States.

Patients' willingness to talk to others about living kidney donation.

Background: Living donor kidney transplantation has several advantages for patients with end-stage renal disease. However, many patients are reluctant to pursue this treatment option, preferring instead to wait for a deceased donor organ.

Objective: To examine predictors of patients' willingness to talk to others about living kidney donation.

When the donor says yes and the family says no.

Signed donor cards clearly demonstrate the donor's intention to donate organs after death. In many states, this donation cannot be rescinded by the next of kin, and organs can be recovered from the donor even if the family objects. The family usually does not object if the donor has signed an organ donor card, especially if the donor had discussed the issue with the family.

A randomized trial of a home-based educational approach to increase live donor kidney transplantation: effects in blacks and whites.

Background: Blacks are disproportionately affected by chronic kidney disease, but are far less likely to undergo live donor kidney transplantation (LDKT) than whites. We assessed the differential effectiveness in blacks and whites of a home-based (HB) LDKT educational approach.

Study Design: A planned secondary analysis of a previously published randomized trial.

Intention to register as organ donors: a survey of adolescents.

Background: Little is known about factors that influence the intention of adolescents to register as organ donors. The identification of such factors has important implications for the development and implementation of educational programs and subsequent donor registration rates.

Objective: To determine whether adolescents with an expressed commitment to becoming organ donor registrants differ significantly from nondonors on sociodemographic characteristics and factors influencing their decision.

Attitudes toward financial incentives, donor authorization, and presumed consent among next-of-kin who consented vs. refused organ donation.

Background: Financial incentives, donor authorization, and presumed consent are strategies designed to increase organ donation rates. Surveys designed to assess attitudes toward these initiatives have been conducted with the general public, transplant patients, and transplant professionals.

Methods: To assess attitudes toward financial incentives, donor authorization, and presumed consent and to identify multivariate predictors of such attitudes, we conducted telephone interviews with 561 family members who had recently been asked for consent to donate the organs of a deceased family member (348 donors, 213 nondonors).

A 10-year analysis of organ donation after cardiac death in the United States.

Background: The greatest challenge facing transplantation today is how to increase the number of organ donors. Patients with severe brain injury who are not brain-dead can donate organs after they are removed from a ventilator and allowed to die, termed donation after cardiac death (DCD).

Methods: We analyzed the database of all organs recovered from deceased donors in the United States from 1994 through 2003 to determine DCD trends in the United States.

Are organ donation attitudes and beliefs, empathy, and life orientation related to donor registration status?

Context: The severe organ donor shortage necessitates additional research on variables that may distinguish those who register to be organ donors and those who do not. Such research has important implications for the development of educational interventions.

Objective: To examine whether registered organ donors differ significantly from nondonors on measures of organ donation beliefs and attitudes, empathy, and life orientation.