Organ Donor Family Consent Request Protocols Compared

ACRE trial finds no advantage to organ donor collaborative requesting approach
By Jeff Muise
HealthDay Reporter

FRIDAY, Oct. 9 (HealthDay News) -- Organ donation using collaborative requesting instead of routine requesting by a patient's clinician may not provide increases in consent rates, according to an unblinded, multi-center, randomized controlled trial performed in the United Kingdom published Oct. 8 in BMJ.

The Assessment of Collaborative REquesting (ACRE) trial collaborators, representing 79 intensive care units, compared consent success rates for requests by the clinical team alone (routine approach) or by the clinical team plus the donor transplant coordinator (collaborative approach).

The researchers found that 62 out of 101 relatives in the routine group and 57 out of 100 in the collaborative group consented to organ donation. Analyzed by the number of approaches to relatives, 60.3 percent of routine and 67.2 of collaborative approaches were successful. Unexpectedly, the number of donors from whom solid organs were actually retrieved after consent was lower in the collaborative group (79 percent) than in the routine group (92 percent). This result was unexplained by the data, the investigators note, but may have resulted from withdrawn consent, unsuitable organs, or operational issues.

"We found no evidence for an increase in rates of consent for organ donation from relatives when collaborative requesting was used in place of routine requesting by the patient's clinician," the authors conclude. "There was weak evidence that the presence of a donor transplant coordinator at the interview was associated with a reduction in the number of organs retrieved from donors in whom consent for donation was available."

Several study authors are employed by or on the advisory group for the National Health Service Blood and Transplant, which funded the study.

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