title: Factors influencing the family consent rate for organ donation in the UK.
abstract: The refusal rate for organ donation in the UK is 42%, among the highest in Europe. We extracted data on every family approach for donation in UK ICUs or Emergency Departments between 1st April 2012 and 30th September 2013, and performed multiple logistic regression to identify modifiable factors associated with consent. Complete data were available for 4703 of 4899 approaches during the study period. Consent for donation after brain death was 68.9%, and for donation after circulatory death 56.5% (p < 0.0001). Patient ethnicity, knowledge of a patient's wishes and involvement of a specialist nurse in organ donation in the approach were strongly associated with consent (p < 0.0001). The impact of the specialist nurse was stronger for donation after circulatory death than for donation after brain death, even after accounting for the impact of prior knowledge of patients' wishes. Involvement of the specialist nurse in the approach, encouraging family discussions about donation wishes and promotion of the organ donor register are key strategies to increase UK consent rates, and are supported by this study.
authors.affiliation: NHS Blood and Transplant, Bristol, UK.
authors.forename: W
authors.initials: W
authors.lastname: Hulme
authors.affiliation: NHS Blood and Transplant, Bristol, UK.
authors.forename: J
authors.initials: J
authors.lastname: Allen
authors.affiliation: Anaesthesia and Intensive Care Medicine, North Bristol NHS Trust Southmead Hospital, Bristol, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Manara
authors.affiliation: Neuro-anaesthesia and Critical Care, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: P G
authors.initials: PG
authors.lastname: Murphy
authors.affiliation: Intensive Care Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Gardiner
authors.affiliation: NHS Blood and Transplant, Bristol, UK.
authors.forename: E
authors.initials: E
authors.lastname: Poppitt
mesh_terms: D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology* / Q000706:statistics & numerical data*; D008297:Male; D000072184:Nurse Specialists; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D006113:United Kingdom
keywords: brain death; consent; organ donation; transplantation