The Effect of the Earthquake in Türkiye on Organ Donation and Transplantation

Introduction: Organ shortage is a global issue. A disaster like an earthquake not only increases the number of people in need of organs but also negatively affects the treatment processes of patients who have already undergone transplants. Aim: The aim of this study is to examine the impact of the earthquake that occurred on February 6, 2023, in Türkiye on organ donation and transplantation. Methods: The study was conducted using open-access statistical data of 2022-2023 years available on the official website of the Tissue, Organ Transplantation, and Dialysis Services of the Ministry of Health in Türkiye. Results: It was found that the earthquake did not affect the number of organ transplants, organ donations, brain death diagnoses, and family consent in Türkiye, but in the provinces affected by the earthquake, it decreased the number of organ donations, brain death diagnoses, and living donors and increased the number of family consent. Conclusion: Healthcare professionals in disaster-affected regions should receive specialized training to maintain critical organ donation protocols, supported by decentralized coordination systems that ensure the continuity of these processes even when central networks are disrupted.

Transforming organ donation and transplantation: Strategies for increasing donor participation and system efficiency

Organ transplantation is a critical medical procedure that saves and improves lives, yet the system faces significant challenges that result in many missed opportunities. This comprehensive review examines the factors contributing to these missed opportunities and the concerns of potential donors. The shortage of donors remains a major issue, exacerbated by low registration rates, family consent refusals, and strict medical and health criteria. Inefficiencies within the organ procurement and transplantation process, including logistical delays and suboptimal matching systems, further hinder the availability of organs. Public misconceptions and cultural and religious beliefs also negatively impact donor willingness. Moreover, potential donors and their families face ethical, psychological, and procedural concerns. Ethical dilemmas revolve around issues of autonomy and informed consent, while psychological concerns include fear and anxiety about the donation process and its impact on families. Procedural issues, such as transparency, legal hurdles, and post-donation follow-up, add to the complexities of organ donation. This review explores potential solutions to address these challenges, such as enhancing public education campaigns to dispel myths, and providing incentives for proactive registration. It also recommends improving the performance of organ procurement organizations, optimizing logistics for organ transport, and developing advanced matching algorithms to ensure equitable organ allocation. Addressing donor concerns through robust ethical standards, comprehensive psychological support, and clear communication strategies is essential. By adopting these multifaceted strategies, the organ transplantation system can be made more efficient and supportive, increasing the availability of organs and ultimately saving more lives. This review underscores the need for integrated and targeted approaches to overcome the existing barriers in organ transplantation.

Bereaved family members' perspectives of their organ donation decision at 3 months post death of the donor-eligible patient in critical care: A dual-method study

BACKGROUND

Offering organ donation is part of routine end-of-life care in critical care. Families describe feeling emotionally overwhelmed, which reduces their ability to understand complex medical information necessary to make informed decisions about organ donation. Late decisional regret is more common among families who decline donation. Thus, it is vital to investigate whether the organ donation decision choices that families make in hospital endure unchanged and what factors affect their perspectives.

OBJECTIVES

The objective of this study was to explore family members' perspectives of their final organ donation decision in hospital, either to consent or to decline donation, at around 90 d later.

METHODS

This dual-method study comprised semistructured interviews of family members of donor-eligible patients who experienced care in seven metropolitan teaching hospitals, a tertiary paediatric hospital, and a major regional hospital in New South Wales, Australia. Interviews were audio recorded and transcribed verbatim. Descriptive quantitative analysis and thematic analysis were used.

FINDINGS

Participants overwhelmingly agreed that their organ donation decision remained unchanged at 3 months after the death of their relative (n = 127, 97%). The remainder (n = 3, 2%) were unsure or stated "possibly not" (n = 1, 1%); in these cases, the eligible donor was certified dead via circulatory criteria. Five themes were synthesised in relation to the organ donation decision: Knowledge of the donor-eligible patient's prior wishes, Family members' prior decision to donate their own organs, Solace in the decision, Altruism, and Reality of the process.

CONCLUSIONS

The organ donation decision choice remained unchanged for the large majority. Further research is required to ascertain how people can be assisted to understand the organ donation process, particularly in the setting of certification of death by circulatory criteria, and how best to positively influence consent rates.

CLINICAL TRIAL REGISTRY NUMBER

Australian and New Zealand Clinical Trial Registration ACTRN12613000815763.

Communication strategies to enhance organ donation requests across cultures: a review of the literature

BACKGROUND

Requesting consent for deceased organ donation is a uniquely challenging communication that has profound consequences at the individual and population level. Communication between requesters and family decision-makers who come from different cultures must be better understood. This review aims to identify communication variables that influence consent for organ donation in cross-cultural requests, with a goal of enhancing end-of - life experiences for families and increasing access to life-saving transplants.

METHODS

We conducted a MEDLINE search of English language studies from 1996-September 2022. Inclusion criteria required that studies examine in-person requests for deceased organ donation and include both cross-cultural and interpersonal factors in the study analysis. 427 titles and abstracts were assessed by author-pairs, followed by 46 full text reviews.

RESULTS

Nine studies met inclusion criteria. Study locations included the United States (5), Israel (2), and Australia (2). Communication variables were grouped into three domains: pre-request, family approach, and request. The main outcome was likelihood of family authorization. Foreign birth and language and high religiosity were associated with lower likelihood of family approach and consent. Interpreter use was negatively associated with authorization, as was lower family satisfaction of interactions with medical staff. Perceptions of family willingness to donate and communication practices of requesters differed by family race. Family ratings of requester communication skills were less favorable in racially discordant requests.

CONCLUSIONS

A small number of international quantitative studies assess the effect of cross-cultural communication on organ donation requests. Findings indicate a significant impact on the experience of family decision-makers and suggest an overall negative association with consent. Strategies to alleviate barriers to communication in cross-cultural requests are suggested along with areas for future research.

A mixed-methods study of emotional support for families of organ donors in Hunan Province, China

Background

Family consent is a prerequisite for the organ donation of the deceased in China. However, a large number of donors are individuals who died due to accidental injuries or unanticipated diseases, which means that most of the families of such donors have just experienced the sudden death of their loved one and have to make a donation decision in a short time. This decision may cause psychological stress and some psychological damage to the minds of relatives of the donors. In addition, cultural sensitivity also has largely caused the relatives of donors inner conflicts and contradictions. And sometimes organ donation may still be stigmatized. However, have they received any emotional support and what is their emotional support needs are some questions that need to be answered. Therefore, this study aims to investigate the emotional support, influencing factors, and needs of the family members of organ donors in Hunan Province, China.

Materials and methods

This is mixed-methods research that combines quantitative and qualitative research methods. A cross-sectional survey was conducted among 102 donor families using a questionnaire to investigate their emotional support status. To further understand their emotional support needs, 12 donor families participated in the semi-structured interview.

Results

The results confirmed that: (1) A total of 67.7% of the 102 respondents received emotional support or psychological comfort. Thus, only a small number of respondents (31.4%) felt respected by the public. (2) Emotional support came mainly from immediate family members (73.91%), and official organizations such as the Red Cross (43.48%). (3) Marital status, health status, occupation, and coping style can affect the emotional support of the donor families (p < 0.05). (4) Interview showed that the families of donors need emotional support and psychological aid from psychological professionals mostly. And they also wish to receive the understanding and respect of the public.

Conclusion

Most families of organ donors received emotional support from family, Red Cross, and friends, but only a minority of families of donors reported receiving respect from the public after the donation. And families of donor showed a strong need for emotional support and professional psychological aid from institutions.