Effect of organ donor race on health team procurement efforts

M S Hartwig, G Hall, D Hathaway, A O Gaber
Archives of Surgery 1993, 128 (12): 1331-5; discussion 1335

OBJECTIVE: To determine whether referral of potential organ donors is affected by race of the patient.

DESIGN: Retrospective chart audit.

SETTING: Regional trauma center serving a 50% African-American population.

PATIENTS: Records of patients meeting organ procurement organization criteria were reviewed for evidence that (1) they had been identified as a potential organ donor, (2) the family had been approached about organ donation, and (3) the family had agreed to or refused organ donation.

RESULTS: There were 620 deaths, 152 (24%) met all donor criteria, 114 (75%) were identified as potential donors, 90 (59%) were approached for donation, and 35 (23%) were organ donors. Of the white patients, 84% (71/85) vs 64% of the African-Americans (43/67) were identified as donors (P < .01); 69% (59) of the whites vs 46% (31) of the African-Americans were approached for donation (P < .01); and 28% (24) of the whites vs 16% (11) of the African-Americans were organ donors (P < .086).

CONCLUSIONS: Before and after controlling for cause of death, the risk that African-American donors would not be identified was more than 2.4 times greater than for whites (P < .01). No significant racial differences were noted in requests for suicide and homicide victims; for accident victims, significantly fewer requests were made of African-Americans. Efforts must be made to determine the dynamics of interaction between staff and donor families and to enhance health-care team members' abilities to identify donors and request donations from both races in stress-provoking situations.

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