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Collaborative Requesting Does Not Increase Consent for Organ Donation
The technique is advocated by the UK's Organ Donation Task Force, but its effectiveness has never been rigorously tested.
One of the biggest barriers to increased donor rates is the refusal of consent by relatives. A recent audit of 341 deaths in intensive care units in the UK revealed that 41% of relatives of potential donors denied consent. In an interview study a third of relatives who had refused donation said that they would not refuse again, whereas only a few of people who had given consent regretted their decision.
There may therefore be factors in the way the request for donation is made that could affect the decision.
So a research team, led by Dr Duncan Young from John Radcliffe Hospital in Oxford, carried out the first randomised controlled trial to compare collaborative requesting with routing testing.
The study involved 201 relatives of patients meeting brain stem death criteria in 79 UK intensive care units. Relatives were randomly assigned to either collaborative requesting by the patient's clinician and a donor transplant coordinator or routine requesting by the patient's clinician alone.
Sixty one per cent of relatives in the routine requesting group consented to organ donation and 57% consented in the collaborative requesting group.
The conversion rate (donors with consent from whom any organs were retrieved) was 91.9% in the routine requesting group and 78.9% in the collaborative requesting group.
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