Identification of Variables That Influence Brain-Dead Donors' Family Groups Regarding Refusal

• Published in: Transplantation proceedings 2009-10, Vol.41 (8), p.3466-3470
• Main Authors: Sotillo, E, Montoya, E, Martínez, V, Paz, G, Armas, Á, Liscano, C, Hernández, G, Pérez, M, Andrade, A, Villasmil, N, Mollegas, L, Hernández, E, Milanes, C.L, Rivas, P
• Format: Article
• Language: English
• Subjects: Attitude to Death; Biological and medical sciences; Brain Death; Cause of Death; Family; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Informed Consent; Interviews as Topic; Medical sciences; Professional-Family Relations; Refusal to Participate; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue and Organ Procurement - organization & administration; Tissue Donors - statistics & numerical data; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.09.014

Abstract Objective To identify the variables that influenced brain-dead donor family groups to refuse donation. Methods The Tissue and Organ Procurement System in Venezuela designed a tool to register some phases of a family interview performed by transplant coordinators. This tool analyzed three phases. The first phase of the interview allowed the coordinator to evaluate the communication quality with the family group during a brain-death notification. The second phase assessed how families understood this notification, and the third phase identified the family grief sequence. Among the 186 interviews during 2007 to procure tissues and organs for transplantation, 37.63% ( n = 70) concluded as family refusals. A retrospective study sought to analyze these results. Results The average time between notification of brain death and the first approach to the family was 8.78 hours. Setting a place for interviews was done in 91.10% of cases. Previous knowledge about donation was seen in only 53.33% of cases. The main phase of family grief identified was denial (80%). The five reasons for family denial were: absolute denial, family disagreement, uncertainty about the destination of the donated organs and tissues, fear about deformation of the donor's body, and lack of acceptance of brain death. Conclusions Brain-death notification produced a deep sadness among family groups. There was a lack of knowledge regarding donation of tissues and organs. It was impossible to quantify the time needed by families to understand and accept brain death and to identify the grief sequence in order to avoid family refusals.