Organ Donation in Switzerland - An Analysis of Factors Associated with Consent Rate

被引:20
作者
Weiss, Julius [1 ]
Coslovsky, Michael [2 ,3 ]
Keel, Isabelle [1 ]
Immer, Franz F. [1 ]
Jueni, Peter [2 ,3 ]
机构
[1] Swiss Natl Fdn Organ Donat & Transplantat, Swisstransplant, Bern, Switzerland
[2] Univ Bern, CTU Bern, Dept Clin Res, Bern, Switzerland
[3] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
来源
PLOS ONE | 2014年 / 9卷 / 09期
关键词
PRESUMED-CONSENT; CADAVERIC ORGAN; DONOR; WILLINGNESS; IMPROVEMENT; RELATIVES; FAMILIES; DECISION; TRANSPLANTATION; PROFESSIONALS;
D O I
10.1371/journal.pone.0106845
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background and Aim: Switzerland has a low post mortem organ donation rate. Here we examine variables that are associated with the consent of the deceased's next of kin (NOK) for organ donation, which is a prerequisite for donation in Switzerland. Methods and Analysis: During one year, we registered information from NOK of all deceased patients in Swiss intensive care units, who were approached for consent to organ donation. We collected data on patient demographics, characteristics of NOK, factors related to the request process and to the clinical setting. We analyzed the association of collected predictors with consent rate using univariable logistic regression models; predictors with p-values <0.2 were selected for a multivariable logistic regression. Results: Of 266 NOK approached for consent, consent was given in 137 (51.5%) cases. In multivariable analysis, we found associations of consent rates with Swiss nationality (OR 3.09, 95% CI: 1.46-6.54) and German language area (OR 0.31, 95% CI: 0.14-0.73). Consent rates tended to be higher if a parent was present during the request (OR 1.76, 95% CI: 0.93-3.33) and if the request was done before brain death was formally declared (OR 1.87, 95% CI: 0.90-3.87). Conclusion: Establishing an atmosphere of trust between the medical staff putting forward a request and the NOK, allowing sufficient time for the NOK to consider donation, and respecting personal values and cultural differences, could be of importance for increasing donation rates. Additional measures are needed to address the pronounced differences in consent rates between language regions.
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页数:7
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