Literature Review

[The Netherlands] Family concerns in organ donor conversations: A qualitative embedded multiple-case studyCritical Care; Sanne P C van Oosterhout, Anneke G van der Niet, Wilson F Abdo, Marianne Boenink, Jelle L P van Gurp, Gert Olthuis; 12/24Listening and responding to family concerns in organ and tissue donation is generally considered important, but has never been researched in real time. [This study found that] concerns clustered around six topics: 1) Life-event of a relative's death, 2) Dying well, 3) Tensions and fears about donation, 4) Experiences of time, 5) Procedural clarity, and 6) Involving (non-)present family. When concerns were highly charged with emotion, the clinicians' responses were less frequently attuned to families' needs. The identified concerns and the distinction between clearly and less clearly articulated concerns may prove valuable for clinicians to improve family support. We advise clinicians to engage with a curious, probing attitude to enhance the dialogue around concerns, elaborate on less clearly articulated concerns and identify the informational needs of the family.

Donor time to death and kidney transplant outcomes in the setting of a 3-hour minimum wait policyJAMA Network Open; Samuel J. Tingle, MBBS; Nicholas D. H. Chung, MBBS; Abdullah K. Malik, MBBS; Georgios Kourounis, MBBS; Emily Thompson, PhD; Emily K. Glover, MBBS; Jennifer Mehew, PhD; Jennifer Philip, MD; Dale Gardiner, MBBS; Gavin J. Pettigrew, PhD; Chris Callaghan, PhD; Neil S. Sheerin, PhD; Colin H. Wilson, PhD; 11/24Due to concerns regarding organ viability, most organ donation organizations internationally wait no longer than 1 to 2 hours for potential donation after circulatory death (DCD), possibly underutilizing an important organ source; UK policy mandates a minimum 3-hour wait time. In this cohort study of 7,183 DCD kidney transplant recipients, donor time to death was not associated with short-term or long-term kidney transplant outcomes. This study suggests that organ donation organizations can safely extend the minimum wait time to 3 hours to significantly increase the number of kidneys available for transplant internationally.

From pigs to payouts, weighing solutions for the US kidney shortageHealthcare Brew; by Caroline Catherman; 9/18/24About one out of every 20 people waiting for a kidney transplant die each year, according to the United Network for Organ Sharing. Scientists, policymakers, and other experts are scrambling to find a solution. Kidneys are currently the most needed organ in the country, and an ongoing crisis has left tens of thousands in limbo. As of September, nearly 90,000 people in the US are waiting for kidneys, but only around 27,000 transplants were performed in 2024, according to data from the Organ Procurement and Transplantation Network (OPTN).Publisher's note: Hospice Analytics, a Hospice & Palliative Care Today sponsor, posted this blog and has given presentations on opportunities and challenges for hospices to honor patient wishes regarding organ and tissue donation.

Why doctors aren’t participating in organ donation after cardiac death Physician's Weekly; by Frank D. Brodkey, MD, FCCM; 6/13/24Organ donation after cardiac death (DCD) differs from the more traditional organ donation after brain death (DBD) insofar that DCD donors are alive and donate organs after discontinuation of life support so that a natural death with cessation of heartbeat and circulation may occur, followed by extraction of organs. This may increase the availability of transplantable organs, leading to improvement in the lives of other humans.  According to the Health Resources and Services Administration, 5896 donations, representing 36% of all donations in 2023, were DCD, representing an increase of 40.7% over the preceding three years. There, however, are significant ethical and scientific issues in the performance of DCD with concepts of end-of-life care, personal autonomy, and concepts of dignity of life and death. ...