[Factors associated with organ and tissue donation refusal. Prospective study in the West of France].

Objective: The refusal to permit organ sampling is of around 30% and is one of the principle causes for the lack of sampling. This study was aimed at establishing the frequency of decisions taken with regard to donations and the factors associated with refusal.

Method: A prospective study was conducted between April 2, 2000 and March 31, 2001 in hospitals authorised to perform organ sampling in the Western area of France. For each potential donor identified, a questionnaire was filled in after each interview. A logistical model was used in order to identify the independent and statistical factors associated with the refusal to allow sampling of an organ or tissue.

Results: Among the potentials donors, 265 brain dead donors, and 868 donors with ceased heart beats for tissue sampling, were included. The refusal rate was of respectively 32.8 and 45 %. Only 2.4% of potential donors carried cards identifying them as such. While living, the rate of refusal expressed by the two types of potential donors was similar (9%). The brain dead potential donors had more frequently expressed their consent for donation (20.7 vs. 9%). In the organ donors, the interviews were conducted by two persons in only 37.9% of cases, and in 2.4% of cases of potential tissue donors. In the potential organ donors, only those with a card identifying them as such and the hesitations of the family at the start of the interview were significantly associated with a lesser frequency of refusal. In potential tissue donors, the hesitations of the family reduced the refusal rate but age, religious beliefs, death etiology and the person conducting the interview increased it.

Conclusion: The encouraging efforts made for the awareness of donation during a person's lifetime must continue and the use of a donor card extended. The development of co-ordination posters in the hospitals would enhance the development of binomial interviews with the families.