L. Washburn1, R. Ackah2, P. Moolchandani1, D. O’Conor1, T. Galván1, A. Rana1, J. A. Goss1 1Baylor College Of Medicine,Division Of Abdominal Transplantation, Michael E. DeBakey Department Of Surgery,Houston, TX, USA 2Ohio State University,Department Of Surgery,Columbus, OH, USA
Introduction:
Imminent death donation (IDD) is a new term in the field of transplant surgery to describe recovery of a living donor organ immediately prior to an impending and planned withdrawal of ventilatory support expected to result in the patient’s death. Supporters of IDD theorize the policy could increase the quantity and quality of procured organs. Implementation of IDD has the potential to increase the quantity and quality of procured organs. The UNOS Ethics Committee recently determined that IDD may be ethically appropriate and justifiable. Further work was not pursued due to potential risks, challenges to implementation, and lack of community support. The impact IDD will have on the public trust has not been fully addressed. This study aims to initiate the process of exploring the feelings, attitudes, and values the public has towards IDD.
Methods:
Participants will include families of donation after cardiac death (DCD) donors who donated more than one year ago. Families will be contacted via Lifegift, the organ procurement organization (OPO) which services Texas in the North, Southeast, and West. An electronic invitation will be sent to 500 participants and those who complete an informed consent will complete an anonymous survey. The survey, reviewed by two ethicists, includes a vignette with associated questions, a comprehension check, the Organ Donation Attitude Scale (ODAS), and demographic information. After survey collection, a statistical analysis of the data will be performed.
Results:
Results will consist of survey responses from families of DCD donors. Comprehension check questions will distinguish participants who understand the clinical vignette and the definition of IDD. The ODAS will assess support for organ donation and the clinical vignette will assess views towards IDD. Reasons for or against IDD will evaluated.
Conclusion:
Despite an agreement amongst multiple ethics committees, including the UNOS Ethics Committee, that IDD is a viable and ethical option for organ procurement, the Dead Donor Rule (DDR) remains a bedrock in the public and transplant psyche, that is, organ donation cannot lead to the death of the donor. This study serves to directly address the notion that IDD violates the public trust. Our preliminary study will have selection bias of participants that are already familiar with the organ donation process. Additionally, we will only represent community opinions within a single OPO. We plan to extend our work to OPOs across the United States to build upon the public opinion regarding implementation of IDD.