Dutch deceased donor dearth: More interesting research out of the Netherlands
Here at TransplantInformers, we recently provided a translation of the Dutch press release on research which surveyed surviving family members of potential deceased donors and motivations behind next-of-kin deceased organ donation consent or refusal. The active research coming out on this topic in the Netherlands doesn’t stop there.
Nichon Jansen-Frazer, from the Dutch Transplant Foundation (Nederlandse Transplantatie Stichting or NTS) has just finished a thesis defense on the low numbers of post-mortem donors and ways to address this. As the thesis abstract reports,
The maximum number of potential organ donors appeared three times higher than the number of actual donors. The main reason for loss of potential donors was objection by relatives (~60% of all donor losses during the study period).
To identify ways of making up for this deficit, Jansen-Frazer’s research implemented a very effective intervention:
We trained a special team of former or part-time intensive care nurses according to the ‘Communication about Donation’ programme. We named them ‘trained donation practitioners’ (TDP), and their role was to guide the family throughout the time they were present in the intensive care unit up to the point that a decision had been reached regarding organ and/or tissue donation. The family consent rate was significantly higher in the intervention hospital compared to two control hospitals.
This is definitely in keeping with the other latest research on deceased donation in the Netherlands. This dedicated training that focuses on effective communication and family guidance are shown to be effective in the research. We are eager to learn more of the findings and specific aspects of this training program and how this can be applied to other contexts. But at the very least, it seems that professionals dedicated to solid communication and well developed counseling skills are more effective in obtaining consent for donation, and that this is likely the direction to go.
TransplantInformers first found out about this research via this press release. While again in Dutch only, we can give you some of the salient tidbits in translation:
Only one-third of potential pool proceed with donation
Jansen analyzed the medical status of 23, 508 patients from 2005-2008 in 64 Dutch hospitals that had died in the intensive care (IC) unit. About 7.7. percent, or 1818 people whose suitable organs could have been available, only 549 of them donated their organs.
97% (1772) of all available organ donors considered the possibility through IC doctors. From this group 12% immediately declined because of the family’s direct objection or other reasons; the Donor Register is not advised of these reasons . 17% had given consent themselves, 15% confirmed that they did not want to donate and 56% had not confirmed. Then it is up to the next-of-kin to decide about deceased organ donation.
Two thirds of survivors object
Jansen’s research showed that many potential organ donors are lost due to family member’s objections. When the deceased has not registered their choice, and the next-of-kin must decide, 66% objected to organ donation. Nichon Jansen: ‘It is of course an emotional event, and the family can feel overwhelmed by the question, certainly if they have never spoken about organ donation. Then they already quickly say no. That is why it is so important to talk with each other about organ donation, even if you are not sick. If relatives know how the deceased thought about donation before the choice stands in front of them, they know how the deceased thought about it and they can handle it in the same spirit. Knowing that their loved one’s organs saved the life of another can also provide comfort.’
While the NTS site is primarily in Dutch, you can find a list of some of their publications which may interest you, and many of them are written in English.
Gefeliciteerd Drs. Jansen-Frazer!