title: Lower rate of family refusal for organ donation in non-heart-beating versus brain-dead donors.
abstract: BACKGROUND
  Family refusal is an important factor that limits the number of organ donors. Cultural and religious factors as well as perception of brain death are the principal reasons for these refusals. We examined whether the type of potential donor, that is brain-dead or non-heart-beating, had an influence on family refusal. In July 2005, we initiated a program of non-heart-beating donors who had died in the street or at home.
  
  
  METHODS
  We compared family refusals among these potential donors with those among potential brain-dead donors from July 2005 to October 2008.
  
  
  RESULTS
  The mean time of stay in the hospital was significantly greater for brain-dead donors than those who were non-heart-beating: 4 +/- 2 versus 0.23 +/- 0.01 days (P < .01). The rate of family refusals was significantly greater among the families of potential brain-dead donors, that is 24% (24/99) than non-heart-beating donors, that is, 4% (2/47; P < .01). Donor age was similar in both groups.
  
  
  CONCLUSIONS
  The rate of family refusals among potential non-heart-beating donors was significantly lower than that among families of brain-dead individuals. Greater understanding of death because the heart is not beating, less time of uncertainty about death, and shorter hospital stay could explain this difference.
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain. aandres.hdoc@salud.madrid.org
authors.forename: A
authors.initials: A
authors.lastname: Andrés
authors.forename: E
authors.initials: E
authors.lastname: Morales
authors.forename: S
authors.initials: S
authors.lastname: Vázquez
authors.forename: M P
authors.initials: MP
authors.lastname: Cebrian
authors.forename: E
authors.initials: E
authors.lastname: Nuño
authors.forename: T
authors.initials: T
authors.lastname: Ortuño
authors.forename: J M
authors.initials: JM
authors.lastname: Morales
authors.forename: E
authors.initials: E
authors.lastname: Hernández
authors.forename: E
authors.initials: E
authors.lastname: González
authors.forename: M J
authors.initials: MJ
authors.lastname: Gutiérrez
authors.forename: A
authors.initials: A
authors.lastname: Hernández
authors.forename: N
authors.initials: N
authors.lastname: Polanco
authors.forename: E
authors.initials: E
authors.lastname: Gutiérrez
authors.forename: E
authors.initials: E
authors.lastname: Gutiérrez
authors.forename: M
authors.initials: M
authors.lastname: Praga
mesh_terms: D000328:Adult; D001293:Attitude to Death; D001294:Attitude to Health; D001926:Brain Death; D005190:Family; D005260:Female; D006339:Heart Rate; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D013030:Spain; D014019:Tissue Donors / Q000706:statistics & numerical data*; D020858:Tissue and Organ Harvesting / Q000706:statistics & numerical data*; D055815:Young Adult