Rates of potential and actual cornea donation in a general hospital: impact of exhaustive death screening and surrogate phone consent.
BACKGROUND
In France at the end of 2002 the number of patients waiting for corneal grafts exceeded the number performed including the specimens imported from abroad. The major reason for the lack of grafts is that potential donors are not exhaustively identified and surrogate consent is difficult to obtain. This study reports the rates of potential cornea donation in a general French hospital when a transplant coordination team screened all deaths and made extended use of the phone to obtain familial consent.


METHODS
All deaths in our institution were registered from February 2002 to January 2003. During this period, the transplant coordination team recorded on a daily basis the circumstances of death, medical contraindications, logistical problems, the consent rate, and the way patients' families were approached, namely, face-to-face or by phone interview.


RESULTS
Among 1088 deaths, 687 (63.1%) were unsuitable for corneal donation. All of the remaining 401 (36.9%) patients were considered for donation. Three hundred fifty four surrogates were interviewed by the transplant coordinator. In only 47 cases (18%) was it impossible to inform relatives and obtain donation consent. Two hundred seventy four families (77.4%) were contacted by phone (acceptance rate 60%) and 80 (22.6%) during a face-to-face interview (acceptance rate 72%). The acceptance rate was 62.7%. Finally, 443 corneas were retrieved, which represented 20.4% of institutional deaths.


CONCLUSIONS
In a general hospital, systematic registration of deaths led to selection of 36.9% as potential corneal donors. The use of phone interviews allowed us to perform a procurement in 20.4%.
Geissler
A
A
Hospital Coordination Team, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Paoli
K
K
Maitrejean
C
C
Durand-Gasselin
J
J
D016039:Corneal Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D005190:Family; D005602:France; D006769:Hospitals, General; D006801:Humans; D007258:Informed Consent / Q000592:standards; D013689:Telephone; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000458:organization & administration / Q000706:statistics & numerical data