Process and barriers to organ donation and causes of brain death in northeast of Iran

Abstract

IntroductionOrgan transplantation is the treatment of choice for some diseases. However, the need for cadaveric organ donation has either plateaued or is on a decreasing trend in some countries, especially in developed ones. In this study, we aimed to identify the barriers to organ donation in brain dead patients, who were referred to the organ procurement organizations (OPO) in northeast Iran.MethodsIn this cross-sectional study during 2006 to 2013, data were collected from medical records of brain dead patients. Demographic information, cause of brain death, the process of obtaining informed consent, and the reasons for declining organ donation were obtained from the OPO records. The data were analyzed using chi-square test by SPSS 13 software.ResultsOf 1034 brain dead patients, 751 cases (72.6%) were eligible for organ donation, and, ultimately, 344 cases underwent organ donation. The rate of organ donation increased during the course of the study; medical and legal reasons as well as family refusal to authorize donation were the main barriers to the process.ConclusionBased on the pattern of mortality, the need for living donors in developing countries, such as Iran and other countries in the Mediterranean region, can be reduced by improving the quality of healthcare, efficient identification of brain death, and obtaining consent with appropriate strategies.

Uso terapêutico de tecidos e órgãos humanos para transplantes: eventos adversos e ações de biovigilância

“…A segurança do paciente na assistência à saúde é princípio básico da qualidade do cuidado (12,17,20) . Nesse contexto, a literatura aponta estratégias, para aumentar a segurança do paciente, no processo de doação e transplante, como a implementação ou revisão de protocolos (7,12) ; a realização de estudos sobre boas práticas e evidências no cuidado (12) ; o acompanhamento constante e a análise de fatores indicativos de alterações clínicas, cirúrgicas e de processos (17) ; a coleta, análise e acompanhamento de indicadores de qualidade (12) ; a análise e notificação da ocorrência de incidentes ou eventos adversos (9,15,20) ; e a contínua capacitação de profissionais (12,20) . Assim, a divulgação de eventos adversos ocorridos e de medidas de mitigação de danos, na comunidade científica, visa promover amplo conhecimento de situações que possam ocorrer e, dessa forma, criar estratégias para evitar sua ocorrência ou recorrência (20) .…”

“…A utilização de indicadores também pode auxiliar no acompanhamento e no controle do processo de transplantes, sendo a ferramenta que possibilita mensurar os processos (8) . Nesse contexto, ressalta-se que a doação de órgãos também depende da confiança no sistema e na segurança do processo e que falhas podem resultar em agravos ao paciente e repercussões danosas à sociedade e equipes de saúde (9) . Desenvolver os procedimentos com qualidade e segurança é um desafio para os sistemas de vigilância, para as instituições e para os profissionais de saúde.…”

Knowledge, Attitude, and Performance of ICU, CCU, and Emergency Wards Nurses in Kermanshah, Iran, regarding Organ Donation

“…Today, the demand for organ transplants is increasing worldwide with an increasing number of those in the waiting list for organ transplantation [ 3 , 6 , 7 ]. Iran is considered as one of 30 countries with high demand for organ donation [ 8 ]. Accordingly, every 10 minutes, one person is added to the waiting list for organ transplant, and, every two hours, one patient dies while waiting for organ transplantation.…”

The role of Altruism and Empathy in anticipating the Attitude toward Organ Donation among Nurses in Intensive Care Units of Qazvin: A Cross-Sectional Study

“…For organ donation, brain death should be confirmed by the brain death confirmation association, and the shorter the time interval between the admission of the patient and the confirmation of brain death, the more the number of organs, especially the lungs, which can be transplanted [20]. According to the mortality pattern, the need for living donors can be reduced in developing countries, such as Iran and other Mediterranean countries, by improving the quality of health care, identifying effectively brain death, and obtaining the consent using appropriate strategies [21].…”