Harms of unsuccessful donation after circulatory death: An exploratory study
While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face‐to‐face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in...
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Veröffentlicht in: | American journal of transplantation 2018-02, Vol.18 (2), p.402-409 |
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creator | Taylor, Lauren J. Buffington, Anne Scalea, Joseph R. Fost, Norman Croes, Kenneth D. Mezrich, Joshua D. Schwarze, Margaret L. |
description | While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face‐to‐face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life‐giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies.
The authors use qualitative analysis of interviews with family members of potential donors and focus groups of professional stakeholders to characterize a spectrum of harms resultant from unsuccessful donation after circulatory death. |
doi_str_mv | 10.1111/ajt.14464 |
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The authors use qualitative analysis of interviews with family members of potential donors and focus groups of professional stakeholders to characterize a spectrum of harms resultant from unsuccessful donation after circulatory death.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.14464</identifier><identifier>PMID: 28805291</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adaptation, Psychological ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood & organ donations ; Cardiovascular System ; Death ; Decision Making ; donors and donation ; donors and donation: donation after circulatory death (DCD) ; ethics and public policy ; Family - psychology ; Family Conflict ; Female ; Focus groups ; Follow-Up Studies ; health services and outcomes research ; Humans ; Male ; Medical ethics ; Middle Aged ; organ allocation ; organ procurement ; organ procurement and allocation ; Organ Transplantation - methods ; organ transplantation in general ; Prognosis ; Qualitative research ; Tissue and Organ Procurement - methods ; Tissue and Organ Procurement - standards ; Young Adult</subject><ispartof>American journal of transplantation, 2018-02, Vol.18 (2), p.402-409</ispartof><rights>2017 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>2017 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><rights>2018 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4434-3e3d32cf4eebf9c7c0220729138acf64c5d257e1c3bd71c3f0e6fa4f8369bfeb3</citedby><cites>FETCH-LOGICAL-c4434-3e3d32cf4eebf9c7c0220729138acf64c5d257e1c3bd71c3f0e6fa4f8369bfeb3</cites><orcidid>0000-0002-7719-9025</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.14464$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.14464$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28805291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taylor, Lauren J.</creatorcontrib><creatorcontrib>Buffington, Anne</creatorcontrib><creatorcontrib>Scalea, Joseph R.</creatorcontrib><creatorcontrib>Fost, Norman</creatorcontrib><creatorcontrib>Croes, Kenneth D.</creatorcontrib><creatorcontrib>Mezrich, Joshua D.</creatorcontrib><creatorcontrib>Schwarze, Margaret L.</creatorcontrib><title>Harms of unsuccessful donation after circulatory death: An exploratory study</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face‐to‐face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life‐giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies.
The authors use qualitative analysis of interviews with family members of potential donors and focus groups of professional stakeholders to characterize a spectrum of harms resultant from unsuccessful donation after circulatory death.</description><subject>Adaptation, Psychological</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood & organ donations</subject><subject>Cardiovascular System</subject><subject>Death</subject><subject>Decision Making</subject><subject>donors and donation</subject><subject>donors and donation: donation after circulatory death (DCD)</subject><subject>ethics and public policy</subject><subject>Family - psychology</subject><subject>Family Conflict</subject><subject>Female</subject><subject>Focus groups</subject><subject>Follow-Up Studies</subject><subject>health services and outcomes research</subject><subject>Humans</subject><subject>Male</subject><subject>Medical ethics</subject><subject>Middle Aged</subject><subject>organ allocation</subject><subject>organ procurement</subject><subject>organ procurement and allocation</subject><subject>Organ Transplantation - methods</subject><subject>organ transplantation in general</subject><subject>Prognosis</subject><subject>Qualitative research</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Tissue and Organ Procurement - standards</subject><subject>Young Adult</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtLxDAYRYMovhf-ASm40UU1r75cCMPgkwE3ug5p-kU7tM2YNGr_vdGOgwpmkXwkh8MNF6EDgk9JWGdy3p8SzlO-hrZJinGcEs7WVzNLttCOc3OMSUZzuom2aJ7jhBZkG81upG1dZHTkO-eVAue0b6LKdLKvTRdJ3YONVG2Vb2Rv7BBVIPvn82jSRfC-aIwdb13vq2EPbWjZONhfnrvo8eryYXoTz-6vb6eTWaw4ZzxmwCpGleYApS5UpjClOAtxWC6VTrlKKppkQBQrqyzsGkOqJdc5S4tSQ8l20cXoXfiyhUpB11vZiIWtW2kHYWQtfr909bN4Mq8iyQqcFCwIjpcCa148uF60tVPQNLID450gBc2zPEkpDujRH3RuvO3C9wJVUIbThNFAnYyUssY5C3oVhmDx2ZEIHYmvjgJ7-DP9ivwuJQBnI_BWNzD8bxKTu4dR-QFRR5zs</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Taylor, Lauren J.</creator><creator>Buffington, Anne</creator><creator>Scalea, Joseph R.</creator><creator>Fost, Norman</creator><creator>Croes, Kenneth D.</creator><creator>Mezrich, Joshua D.</creator><creator>Schwarze, Margaret L.</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7719-9025</orcidid></search><sort><creationdate>201802</creationdate><title>Harms of unsuccessful donation after circulatory death: An exploratory study</title><author>Taylor, Lauren J. ; Buffington, Anne ; Scalea, Joseph R. ; Fost, Norman ; Croes, Kenneth D. ; Mezrich, Joshua D. ; Schwarze, Margaret L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4434-3e3d32cf4eebf9c7c0220729138acf64c5d257e1c3bd71c3f0e6fa4f8369bfeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adaptation, Psychological</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood & organ donations</topic><topic>Cardiovascular System</topic><topic>Death</topic><topic>Decision Making</topic><topic>donors and donation</topic><topic>donors and donation: donation after circulatory death (DCD)</topic><topic>ethics and public policy</topic><topic>Family - psychology</topic><topic>Family Conflict</topic><topic>Female</topic><topic>Focus groups</topic><topic>Follow-Up Studies</topic><topic>health services and outcomes research</topic><topic>Humans</topic><topic>Male</topic><topic>Medical ethics</topic><topic>Middle Aged</topic><topic>organ allocation</topic><topic>organ procurement</topic><topic>organ procurement and allocation</topic><topic>Organ Transplantation - methods</topic><topic>organ transplantation in general</topic><topic>Prognosis</topic><topic>Qualitative research</topic><topic>Tissue and Organ Procurement - methods</topic><topic>Tissue and Organ Procurement - standards</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taylor, Lauren J.</creatorcontrib><creatorcontrib>Buffington, Anne</creatorcontrib><creatorcontrib>Scalea, Joseph R.</creatorcontrib><creatorcontrib>Fost, Norman</creatorcontrib><creatorcontrib>Croes, Kenneth D.</creatorcontrib><creatorcontrib>Mezrich, Joshua D.</creatorcontrib><creatorcontrib>Schwarze, Margaret L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taylor, Lauren J.</au><au>Buffington, Anne</au><au>Scalea, Joseph R.</au><au>Fost, Norman</au><au>Croes, Kenneth D.</au><au>Mezrich, Joshua D.</au><au>Schwarze, Margaret L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Harms of unsuccessful donation after circulatory death: An exploratory study</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2018-02</date><risdate>2018</risdate><volume>18</volume><issue>2</issue><spage>402</spage><epage>409</epage><pages>402-409</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face‐to‐face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life‐giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies.
The authors use qualitative analysis of interviews with family members of potential donors and focus groups of professional stakeholders to characterize a spectrum of harms resultant from unsuccessful donation after circulatory death.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>28805291</pmid><doi>10.1111/ajt.14464</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7719-9025</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adaptation, Psychological Adolescent Adult Aged Aged, 80 and over Blood & organ donations Cardiovascular System Death Decision Making donors and donation donors and donation: donation after circulatory death (DCD) ethics and public policy Family - psychology Family Conflict Female Focus groups Follow-Up Studies health services and outcomes research Humans Male Medical ethics Middle Aged organ allocation organ procurement organ procurement and allocation Organ Transplantation - methods organ transplantation in general Prognosis Qualitative research Tissue and Organ Procurement - methods Tissue and Organ Procurement - standards Young Adult |
title | Harms of unsuccessful donation after circulatory death: An exploratory study |
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