title: Patients on state organ donor registries receive similar levels of intensive care compared to those who are not: an opportunity to increase public intent to donate.
abstract: The intent to donate organs is affected by the public perception that patients on state registries receive less aggressive life-saving care in order to allow organ donation to proceed. However, the association between first person authorization to donate organs and the actual care received by eventual organ donors in hospitals is unknown. From August 2010 to April 2011, all eight organ procurement organizations in United Network for Organ Sharing Region 5 prospectively recorded demographic data and organ utilization rates on all donors after neurologic determination of death (DNDDs). Critical care and physiologic parameters were also recorded at referral for imminent neurologic death and prior to authorization for donation to reflect the aggressiveness of provided care. There were 586 DNDDs and 23% were on a state registry. Compared to non-registered DNDDs, those on state registries were older but were noted to have similar critical care parameters at both referral and authorization. Furthermore, there was no significant difference in organs procured per donor or organs transplanted per donor between registered and non-registered DNDDs. Thus, DNDDs who are on state donor registries receive similar levels of intensive care compared to non-registered donors. The association noted in this study may therefore help to dispel a common misperception that decreases the intent to donate.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Madhukar S
authors.initials: MS
authors.lastname: Patel
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Shariq S
authors.initials: SS
authors.lastname: Raza
authors.affiliation: Western University of Health Sciences, Pomona, CA, USA.
authors.forename: Akash
authors.initials: A
authors.lastname: Bhakta
authors.affiliation: Department of Anesthesiology, Stanford University, Stanford, CA, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Ewing
authors.affiliation: Department of Trauma and Critical Care, Broward General Medical Center, Fort Lauderdale, FL, USA.
authors.forename: Marko
authors.initials: M
authors.lastname: Bukur
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Parsia A
authors.initials: PA
authors.lastname: Vagefi
authors.affiliation: Division of Trauma, Burns, and Surgical Critical Care, Brigham & Women's Hospital, Boston, MA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.affiliation: Surgical Critical Care Section, Veterans Affairs Portland Health Care System, Portland, OR, USA.|Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Malinoski
mesh_terms: D000293:Adolescent; D000328:Adult; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D016377:Organ Transplantation; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*; D055815:Young Adult
keywords: critical care; donor registration; end-of-life decisions; first-person authorization; organ donation