title: Organ donation in Switzerland--an analysis of factors associated with consent rate.
abstract: OBJECTIVE
  Switzerland has a low post mortem organ donation rate. Here we examine variables that are associated with the consent of the deceased's next of kin (NOK) for organ donation, which is a prerequisite for donation in Switzerland.
  
  
  METHODS
  During one year, we registered information from NOK of all deceased patients in Swiss intensive care units, who were approached for consent to organ donation. We collected data on patient demographics, characteristics of NOK, factors related to the request process and to the clinical setting. We analyzed the association of collected predictors with consent rate using univariable logistic regression models; predictors with p-values <0.2 were selected for a multivariable logistic regression.
  
  
  RESULTS
  Of 266 NOK approached for consent, consent was given in 137 (51.5%) cases. In multivariable analysis, we found associations of consent rates with Swiss nationality (OR 3.09, 95% CI: 1.46-6.54) and German language area (OR 0.31, 95% CI: 0.14-0.73). Consent rates tended to be higher if a parent was present during the request (OR 1.76, 95% CI: 0.93-3.33) and if the request was done before brain death was formally declared (OR 1.87, 95% CI: 0.90-3.87).
  
  
  CONCLUSIONS
  Establishing an atmosphere of trust between the medical staff putting forward a request and the NOK, allowing sufficient time for the NOK to consider donation, and respecting personal values and cultural differences, could be of importance for increasing donation rates. Additional measures are needed to address the pronounced differences in consent rates between language regions.
authors.affiliation: Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
authors.forename: Julius
authors.initials: J
authors.lastname: Weiss
authors.affiliation: CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Coslovsky
authors.affiliation: Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Keel
authors.affiliation: Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
authors.forename: Franz F
authors.initials: FF
authors.lastname: Immer
authors.affiliation: CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
mesh_terms: D000368:Aged; D005190:Family; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013557:Switzerland; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*