Acceptance of Organs From Deceased Donors: Results of a Global Survey.

Background: With <10% of transplantation needs being met, one contributing factor may be the potential subjectivity in transplant specialists' acceptance of organs. Such decisions, if influenced by knowledge and/or comfort gaps, warrant intervention. We assessed knowledge and comfort gaps regarding deceased donation (DD) among critical care specialists and organ acceptance among transplant specialists. Methods: The Transplantation Society working group surveyed specialists on end-of-life management and organ acceptance. Participants, stratified by country DD rates, ranked their current and desired levels of knowledge or comfort (on a 0-100 scale) for survey questions. The differences between current and desired knowledge and comfort were reported as gaps. Results: Among 438 responses, the largest global knowledge gaps were for positive serology for Chagas (gap 30), multidrug-resistant bacterial infection (gap 23.5), HIV (gap 20), cancer history <5 y (gap 20), primary brain malignancies (gap 17.5), and high-risk behavior (gap 16). The largest global comfort gaps were for positive serology for Chagas (gap 29.5), multidrug-resistant bacterial infection (gap 21), excessive alcohol use (gap 20), primary brain malignancies (gap 20), and high-risk behavior (gap 16). Relevant knowledge and comfort gaps, both ranging from 10 to 50, were observed in the acceptance of organs from donors after circulatory determination of death. In general, countries with higher DD rates demonstrated smaller knowledge and comfort gaps than countries with lower DD rates. Conclusions: This survey reveals important knowledge and comfort gaps in DD organ acceptance. Targeted education could increase organ utilization and help address transplantation shortages.