title: When the living and the deceased cannot agree on organ donation: a survey of US organ procurement organizations (OPOs).
abstract: The legal concept of first person authorization (FPA) is based on the principle that a decision by a person with decision-making capacity should be respected even after he or she dies. Although the transplant community largely supports this concept, its implementation has not been universal. We conducted a web-based survey of all 58 Organ Procurement Organization (OPO)executive directors in the United States to assess OPOs' procurement policies and practices in the context of family objections. All 58 respondents(100%) responded to our survey. All OPOs except one have an online donor registration website. Most OPOs(89%) (51 of 57 respondents) estimated that the frequency of family objecting to organ donation in cases of registered donors was <10%. No OPOs reported the frequency to be higher than 25%. Only 50% (27 of 54) of the OPOs have a written policy on handling family objections. Approximately 80% of the OPOs reported honoring FPA. However, in the past 5 years, 20 OPOs (35%) have not yet participated in organ procurement from a registered deceased donor over family objection. Further research to identify the barriers and possible solutions to implementing FPA is warranted.
authors.forename: W J
authors.initials: WJ
authors.lastname: Chon
authors.forename: M A
authors.initials: MA
authors.lastname: Josephson
authors.forename: E J
authors.initials: EJ
authors.lastname: Gordon
authors.forename: Y T
authors.initials: YT
authors.lastname: Becker
authors.forename: P
authors.initials: P
authors.lastname: Witkowski
authors.forename: D J
authors.initials: DJ
authors.lastname: Arwindekar
authors.forename: A
authors.initials: A
authors.lastname: Naik
authors.forename: J R
authors.initials: JR
authors.lastname: Thistlethwaite
authors.forename: C
authors.initials: C
authors.lastname: Liao
authors.forename: L F
authors.initials: LF
authors.lastname: Ross
mesh_terms: D003625:Data Collection; D005190:Family; D006801:Humans; D014019:Tissue Donors / Q000331:legislation & jurisprudence*; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence*; D014481:United States