How to improve organ donation: results of the ISHLT/FACT poll

Oz, Mehmet C; Kherani, Aftab R; Rowe, Amanda; Roels, Leo; Crandall, Chauncey; Tomatis, Luis; Young, James B

doi:10.1016/S1053-2498(03)00074-3

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 22, Issue 4 , Pages 389-410, April 2003

How to improve organ donation: results of the ISHLT/FACT poll☆

Mehmet C Oz, MD
- Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York, USA
- Reprint requests: Mehmet C. Oz, MD, College of Physicians and Surgeons of Columbia University, New York Presbyterian Hospital, 177 Fort Washington Avenue, MHG-7GN-435, New York, New York, USA 10032. Telephone: 212-305-4434. Fax: 212-305-2439.
Aftab R Kherani, MD
- Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York, USA
Amanda Rowe, BA
- International Society for Heart and Lung Transplantation, Dallas, Texas, USA
Leo Roels, CPTC
- Donor Action Foundation, Linden, Belgium
Chauncey Crandall, MD
- Palm Beach Cardiovascular, West Palm Beach, Florida, USA
Luis Tomatis, MD
- Medical Affairs, Richard M. DeVos Family, Grand Rapids, Michigan, USA
James B Young, MD
- Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Received 11 December 2002; received in revised form 31 January 2003; accepted 10 February 2003.

Abstract

Background:

Worldwide organ shortages remain a long-standing problem. Efforts to address this have ranged from attempts to improve public awareness to modified mandated choice systems; most have been unsuccessful. In the face of this intractable problem, increased consideration has been given to direct and indirect compensation, and in certain countries, black markets for organs have developed. To examine the attitudes of the transplant medical community regarding these issues, we surveyed members of the International Society for Heart and Lung Transplantation (ISHLT) in conjunction with the Foundation for the Advancement of Cardiac Therapies (FACT).

Methods/results:

We asked for opinions about how to improve organ donation. Of 739 respondents, 75% supported presumed consent, and 39% identified it as the single best way to increase donation; improved public education was a distant second (18%). Seventy percent supported indirect compensation (e.g., payment of funeral expenses, donation to a charity of the family’s choice), and 66% opposed direct compensation (e.g., tax credit, life insurance benefit). When asked whether next of kin should be consulted regarding organ donation, and 84.2% responded affirmatively. However, of these individuals, 77.2% did not think that consultation should be required if the potential donor already had signed a donor card.

Conclusion:

Our membership dramatically favors indirect over direct compensation as a way of increasing organ donation. The majority also favors the wishes of the individual over the family in determining donor status. However, presumed consent is the single best way to significantly improve organ donation, according to the majority of our respondents. More effort should be directed toward policy in these areas as opposed to improving public education, which has failed to yield satisfactory results.