Knowing patients' preferences about organ donation: does it make a difference?

BACKGROUND: The purpose of this study was to examine in detail the impact of knowledge of a donor-eligible patient's preferences on organ donation decisions.

METHODS: Nine trauma hospitals located in southwest Pennsylvania and northeast Ohio were selected. Data came from chart review of all dead patients and interviews with family members involved in the decision process (n = 360 patients 16 years of age or older).

RESULTS: Of the families interviewed, 52.5% had to guess the patient's preferences about donation. When making the decision, 81.9% of the families considered how the patient might have felt about donation. Not knowing the patient's wishes related to refusal to donate (54.5% vs. 45.5%, p < 0.001). After adjusting for other factors, important predictors of donation were considering patients' feelings (5.03 times more likely to donate) and knowing preferences (6.90 times more likely to donate if they knew wishes were to donate and 0.03 times less likely to donate if they knew wishes were to not donate compared with not knowing preferences).

CONCLUSION: Having knowledge of a patient's preference to donate increased the likelihood of donating by 6.90 times, and having enough information about the patient's wishes increased satisfaction with the decision by 3.32 times. Families only infrequently made decisions counter to patients' own wishes concerning organ donation.