title: Taking Care of Relationships in the Intensive Care Unit: Positive Impact on Family Consent for Organ Donation.
abstract: BACKGROUND
  Organ donation refusal from relatives of potential donors with brain death significantly reduces organ availability. The need for organ donation has increased over time, but the shortage of available donors is the major limiting factor in transplantation. We analyzed the impact of a new systematic communication approach between medical staff and patients' relatives on the rate of consent to organ donation.
  
  
  METHODS
  The study was conducted as a single-center, non-randomized, controlled, before-and-after study at an 18-bed intensive care unit (ICU) of a university hospital. We compared the rate of consent for organ donation before and after the introduction of the new communication approach.
  
  
  RESULTS
  A total of 291 brain-dead patients were studied. The consent rate increased from 71% in the pre-intervention period (2007-2012) to 78.4% in the post-intervention period (2013-2015), with an 82.75% increase in the 2014 to 2015 period. During these periods, no significant variation of consent to organ donation was recorded at the national and regional levels.
  
  
  CONCLUSIONS
  The introduction of a new communication approach between medical staff and relatives of brain-dead patients was associated with a significant increase in the rate of consent to donation. Our results highlight the importance of empathy with relatives in the ICU.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: mariagraziabocci@gmail.com.
authors.forename: M G
authors.initials: MG
authors.lastname: Bocci
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: D'Alò
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Barelli
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Inguscio
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Prestifilippo
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Di Paolo
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Lochi
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fanfarillo
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: D L
authors.initials: DL
authors.lastname: Grieco
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Maviglia
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Caricato
authors.affiliation: Department of Medical-Surgical and Transplant Physiopathology, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mistraletti
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pulitanò
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Antonelli
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Sandroni
mesh_terms: D001926:Brain Death; D003142:Communication; D005190:Family; D006785:Hospitals, University; D006801:Humans; D007258:Informed Consent; D007362:Intensive Care Units; D011368:Professional-Family Relations; D020458:Third-Party Consent; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement