Modifiable factors influencing relatives' decision to offer organ donation: systematic review

doi:10.1136/bmj.b991

Published 21 April 2009, doi:10.1136/bmj.b991
Cite this as: BMJ 2009;338:b991

Research

Modifiable factors influencing relatives’ decision to offer organ donation: systematic review

Arabella L Simpkin, research fellow, Laura C Robertson, research fellow, Vicki S Barber, team leader, J Duncan Young, clinician researcher

¹ Intensive Care Society Clinical Trials Group, Kadoorie Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU

Correspondence to: J D Young duncan.young{at}nda.ox.ac.uk

Objective To identify modifiable factors that influence relatives’decision to allow organ donation.

Design Systematic review.

Data sources Medline, Embase, and CINAHL, without language restriction,searched to April 2008.

Review methods Three authors independently assessed the eligibilityof the identified studies. We excluded studies that examinedonly factors affecting consent that could not be altered, suchas donor ethnicity. We extracted quantitative results to anelectronic database. For data synthesis, we summarised the resultsof studies comparing similar themes.

Results We included 20 observational studies and audits. Therewere no randomised controlled trials. The main factors associatedwith reduced rates of refusal were the provision of adequateinformation on the process of organ donation and its benefits;high quality of care of potential organ donors; ensuring relativeshad a clear understanding of brain stem death; separating therequest for organ donation from notification that the patienthad died; making the request in a private setting; and usingtrained and experienced individuals to make the request.

Conclusions Limited evidence suggests that there are modifiablefactors in the process of requests for organ donation, in particularthe skills of the individual making the request and the timingof this conversation, that might have a significant impact onrates of consent. Targeting these factors might have a greaterand more immediate effect on the number of organs for donationthan legislative or other long term strategies.

© Simpkin et al 2009
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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