title: Do trained specialists solicit familial authorization at equal frequency, regardless of deceased donor characteristics?
abstract: BACKGROUND
  The Organ Donor Breakthrough Collaborative recommended high-leverage changes including "master effective requesting.
  
  
  OBJECTIVE
  To measure who approaches decedent families to request organ donation and to determine whether trained specialists will solicit authorization at equal frequency regardless of donor characteristics.
  
  
  METHODS
  Retrospective analysis of data from 2006 to 2009 in an organ center's donor database. Decedents were stratified into 2 groups: those that met the Organ Procurement and Transplantation Network's eligible death criteria (ED donors) and those that did not (not eligible death [NED] donors).
  
  
  RESULTS
  Of decedents whose families were approached for authorization, 46% were ED donors and 54% were NED donors. Trained specialists solicited authorization from 76% of the total population but were more likely to solicit authorization from ED donors than NED donors (86% vs 68%, P<.001). Trained specialists were more likely to solicit authorization from donors whose cause of death was overrepresented in ED donors and donors less than 50 years old. Trained specialists were more likely than others to obtain authorization from families of all donors. Multivariable modeling demonstrated that having a trained specialist approach the decedent's family was associated with the highest odds of obtaining authorization.
  
  
  CONCLUSIONS
  Trained specialists approached most families of decedents for authorization, but disproportionately approached fewer families of NED donors. Having a trained specialist approach the decedent family has the strongest impact on obtaining donor authorization. These data suggest that fewer resources are allocated to NED donors, which may adversely affect the supply of deceased donor organs.
authors.affiliation: University of Alabama, Birmingham, AL, USA. ddubay@uabmc.edu
authors.forename: Derek A
authors.initials: DA
authors.lastname: Dubay
authors.forename: David T
authors.initials: DT
authors.lastname: Redden
authors.forename: Akhlaque
authors.initials: A
authors.lastname: Haque
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Gray
authors.forename: Mona
authors.initials: M
authors.lastname: Fouad
authors.forename: Connie
authors.initials: C
authors.lastname: Kohler
authors.forename: Garry
authors.initials: G
authors.lastname: Taylor
authors.forename: Devin E
authors.initials: DE
authors.lastname: Eckhoff
mesh_terms: D000328:Adult; D000407:Alabama; D002423:Cause of Death; D016009:Chi-Square Distribution; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D012189:Retrospective Studies; D013038:Specialization; D009927:Tissue and Organ Procurement