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Results for “Tissue and Organ Procurement”

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At least 19 recordsLinked to original sources
PubMed1995

Public policy governing organ and tissue procurement in the United States. Results from the National Organ and Tissue Procurement Study.

OBJECTIVE: To determine why Required Request policies, which mandate that hospitals request donation from donor-eligible families, have not resulted in increased organ procurement. SETTING: Stratified sample of 23 acute-care general hospitals in two metropolitan areas. DESIGN: Chart review identified all eligible donors in study hospitals during a 20-month period. Health care professionals who spoke with the families of eligible donors after death were interviewed to determine families' and health care providers' behaviors after patients' deaths with reference to the donation process. PARTICIPANTS: All patient deaths (n = 10,681) were reviewed, and 841 donor-eligible cases were chosen for in-depth study; 1809 health care professionals who provided care to these patients were interviewed. MEASUREMENTS: The ability of health care providers to identify donor-eligible patients, approach families about donation, and obtain families' consent to donation. RESULTS: 83% of health care professionals correctly identified donor-eligible patients. The families of donor-eligible patients were approached about donation in 73.0% of the cases. Families were more likely to be approached about organ (86.6%) donation than either tissue (69.5%) or cornea (67.3%) donation (P < 0.001). The families of organ-eligible patients were less likely to be approached if the patient was female, was on a general medical or surgical floor, or was being cared for by internists. Only 46.5% of families of eligible donors agreed to donate organs, 34.5% agreed to donate tissues, and 23.5% agreed to donate corneas. CONCLUSIONS: Although health care professionals do request that families donate, families consent to donation less frequently than was previously assumed. Empirically based education campaigns are needed so that health care professionals can improve their communication skills and so that discussion about this important issue can be stimulated among family members.

Adolescent↗
PubMed2003

Organ and tissue procurement system: a novel intervention to increase organ donation rates in Venezuela.

The limited number of organs and tissues available for transplantation in Venezuela and the need to improve outcomes for patients with life-threatening end-stage organ failure or inadequate quality of life resulted in the development and implementation of an organ and tissue procurement system by the Venezuelan National Transplant Organization. This procurement system, a 24-hour, nationwide, free phone service for detection of potential organ donors, connects callers with transplant coordinators. The on-call coordinator supervises family approach as well as maintenance, transport, and allocation of the organs and tissues. During a period of 21 months, the phone service received 1191 calls (713 requesting information to become a voluntary donor, 207 requesting information about donation and transplantation, and 271 reporting potential donors). Of the potential donors, 74% were men and 67% were aged between 11 and 40 years, and most came from hospital intensive care units, emergency departments, and trauma shock units. The main causes of death were trauma and stroke. Reasons why donation was not accomplished included early cardiorespiratory arrest and denied consent. In conclusion, establishing the procurement system resulted in an increase in the detection, referral, and maintenance of potential donors; doubling of the number of donors per million population; and an increase in the number of cadaveric transplants.

Adolescent↗
PubMed1994

The role of the medical examiner/coroner in organ and tissue procurement for transplantation.

Facts and principles concerning the role of the medical examiner or coroner in the procurement of organs or tissue for transplantation are presented. Topics discussed are the legalities and the importance of control of the dead body, the medical examiner's or coroner's role in the determination of death, recognition of and working around procurement artifacts and resultant loss of evidence, the medical examiner's or coroner's part in determining suitability of organs for transplantation, the medical examiner or coroner's request for donation by the family, granting of permission for donation of organs or tissue by the medical examiner or coroner, and examination of the mortally injured by the medicolegal officer.

Brain Death↗
PubMed1990

Organ and tissue procurement in the acute care setting: principles and practice--Part 1.

The specialty of organ transplantation has grown tremendously during the past decade. With the advent of cyclosporine, artificial organs, and organ-assist devices, the possibility of suitable patients with end-stage organ disease becoming successful transplant recipients has increased dramatically. Consequently, the need for donor organs has risen. The greatest source of potential organ-tissue donors exists in the acute care setting (ie, emergency departments and intensive care units). To meet the need for this increasing demand, emergency physicians must become familiar with the techniques of procurement. Part 1 defines the problem of procurement and presents financial, historic, organizational, legal, and psychosocial aspects of organ-tissue procurement. A synopsis of brain death concludes the discussion. Part 2 (February 1990) presents aspects of the evaluation, selection, maintenance, and management of the organ-tissue donor. Disease transmission and controversial issues in organ-tissue procurement also are discussed.

Brain Death↗
PubMed1990

Organ and tissue procurement in the acute care setting: principles and practice--Part 2.

In this two-part series on organ and tissue procurement in the acute care setting, the procurement problem, cost-benefit analysis, organizational development and framework, approach to surviving relatives, public attitudes, and brain death certification were discussed in part 1 (January 1990). Part 2 examines evaluation, selection, maintenance, and management of the organ-tissue donor. It concludes with a discussion of disease transmission, controversial issues, and financial considerations relevant to the procurement process in the acute care setting.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Tissue and organ procurement in the emergency department setting.

A retrospective chart review of all emergency department (ED) deaths in patients younger than 65 years in seven area hospitals was performed for the calendar year of 1990. The number and percentage of families approached and consenting to tissue donation among the various EDs was compared and reasons for not approaching families were evaluated for their validity. Procurement rates between the years 1990 and 1991 were compared for two area hospitals, which made a specified (nonmedical) service responsible for tissue requests in 1991. There were 368 deaths, 255 of which were potential donors by acceptable criteria. Only 109 (43%) families were approached regarding tissue donation. The overall procurement rate was 12%. Suburban EDs had a higher approach and procurement rate than did urban EDs (49% vs 36%; P < .05 and 19% vs 5%; P < .01, respectively). Procurement rates for two hospitals that designated a specific procurement service in 1991 more than doubled (5% vs 11%; P = NS). Tissue procurement rates in EDs with procurement systems in place are low despite consent rates of those approached of 36%. The major contributing factor is the failure to request tissue from the families of eligible candidates even when there are no exclusion criteria met. Suburban EDs had a higher success rate than urban EDs.

Data Collection↗
PubMed1997

Tissue banking programmes in Europe.

In Europe, organ centres such as Bio Implant Services (BIS) in cooperation with Eurotransplant, play an intermediary role from donation of tissue and organs to allocation and transplantation. They take responsibility for donor medical/safety screening and organize procurement. Tissue banks are autonomous and are responsible for tissue processing and preservation. Allocation of scarce tissues is performed according to rules set by committees of renowned experts in the field. Most frequently donated types of tissues are corneas, heart valves, bone and soft tissue and skin. In this article, optimal serological screening of the donor, and the banking of these tissues in Europe is reviewed in relation to clinical need and volume of transplantable tissues available, number of banks and their organisational level, methods of explantation, processing and preservation, quality standards and new developments.

Bone Banks↗
PubMed1997

[Which graft for which patient? and when? III. Organization schema of organ procurement and graft coordination].

Organ and tissue procurement strongly increased during the past decades to become a common activity among accredited hospitals. Structuring efficient regional organ procurement organisations appear as an important goal in order to offer the relevant number and quality of transplants to the patients on the national waiting list maintained by the Etablissement français des Greffes. Two structures acting together coordinate organ and tissue procurement: (i)accredited hospitals allocate some medical and non medical personal interfacing; (ii) the Etablissement français des Greffes through one of its seven regional units or its national unit. These units are in charge with the operational responsibility of multiorgan and tissue retrieval co-ordination in their geographical area, with organ allocation and with an institutional role of local and regional organ procurement development and promotion.

France↗
PubMed1995

Health care professional attitudes toward donation: effect on practice and procurement.

Failure to procure organs, tissues, and corneas for transplantation can be attributed to a number of factors. The existing literature is largely speculative concerning why health care professionals (HCPs) fail to approach the families of medically suitable donors and why requests for donation are not successful. This study is based on the direct examination of 1,797 HCP attitudes and knowledge about donation in conjunction with how HCPs performed when faced with a donor-eligible patient. HCP attitudes, rather than knowledge, are more important to the successful procurement of organs. The HCPs with more positive attitudes about donation and their role in the procurement process were more likely to request donation. HCPs were more successful in obtaining consent to donation when they believed that the donation process would benefit the donor family and that their efforts to procure organs would be successful. These results indicate that educating HCPs about the donation process to make them more comfortable with it is crucial.

Attitude of Health Personnel↗
PubMed1998

Nursing and the procurement of organs and tissues in the acute care hospital setting.

Organ and tissue transplantations are now well established procedures; however, a scarcity of donors and the obstacles encountered during the procurement process have resulted in a growing shortage of organs and tissues. This paper reviews the issues surrounding the procurement process and the role that nurses play in that process. Two case studies are presented and discussed in order to identify important issues to address with the family (i. e., clarification about the meaning of brain death, the impact of donation on funeral arrangements, and the costs of donation) and to suggest practical strategies for approaching these issues.

Adaptation, Psychological↗
PubMed1994

Differences in the procurement of organs and tissues by health care professionals.

BACKGROUND: The act of donating organs is familiar to most health care professionals (HCPs). However, the process of tissue and cornea donation is not nearly as well known. Most studies of the donation process have neglected the issue of tissue and cornea donation. This study offers some preliminary data concerning the differences between organ and tissue and cornea donation processes. As well, this is one of the first studies to report an eligibility rate for tissues among hospital deaths. METHODS: During a 5-month period in 1989, the charts of all patients (n = 233) who died in the study hospital were reviewed on a weekly basis to establish eligibility to donate organs, tissues and corneas. A case series of 50 eligible patients cases was selected for in-depth interviews. Cases were defined as those patients who were eligible to donate tissues or organs. The patient's attending physician, house officer, and primary nurse were interviewed using an open-ended interview format. These audiotaped interviews focused on the events surrounding the patient's death, focusing on the issue of donation. We also collected information concerning HCP knowledge of the medical criteria for donation and their attitudes toward donation. Consent was obtained from all HCPs before beginning the interview process. RESULTS: Of the 233 deaths, 4.3% were eligible to donate organs, 11.2% were eligible to donate tissues, and 18.9% were eligible to donate corneas. On the basis of our interview data we found that all eligible organ donors were identified and their families asked by at least one member of the patient's health care team to consider donation. HCPs were less successful identifying tissue patients: 30 of the 41 tissue donors (73.2%) were identified and only 65.9% of donor families were asked to donate. Rates of consent to donation were lower than might be expected based on public opinion polls. 33.3% of families consented to organ donation while only 29.6% consented to donate tissue and cornea. CONCLUSION: HCPs performed less efficiently in terms of the procurement process for tissues and corneas as compared to organs. They were also less knowledgeable about the donation criteria for tissues and corneas than organs. They generally exhibited more positive attitudes about corneal donation. More education of HCPs is necessary before we can optimally procure tissues for transplantation.

Aged↗