Attitudes of the American Public toward Organ Donation after Uncontrolled (Sudden) Cardiac Death

• Published in: American journal of transplantation Vol. 10; no. 3; pp. 675 - 680
• Main Authors: Volk, M. L., Warren, G. J. W., Anspach, R. R., Couper, M. P., Merion, R. M., Ubel, P. A.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.03.2010; Wiley
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Attitude to Death; Biological and medical sciences; Cardiac death donors; Clinical death. Palliative care. Organ gift and preservation; Cross-Sectional Studies; Death, Sudden, Cardiac; Decision Making; donation; Ethics; Female; Humans; Internet; Male; Medical sciences; Middle Aged; Public Opinion; public policy; Random Allocation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Tissue and Organ Procurement - ethics; Tissue and Organ Procurement - methods; transplant ethics; United States; United States; North America; America; Heart; Suboptimal donor; Human; Graft(material); American; Attitude; Political aspect; Sudden death; Mortality; Transplantation; Homotransplantation; public policy; Ethics; Organ donation; Treatment; Surgery; Donation; transplant ethics; Graft; Cardiac death donors; Circulatory system; Public health
• ISSN: 1600-6135; 1600-6143; 1600-6143
• DOI: 10.1111/j.1600-6143.2009.02971.x

Concerns about public support for organ donation after cardiac death have hindered expansion of this practice, particularly rapid organ recovery in the context of uncontrolled (sudden) cardiac death (uDCD). A nationally representative Internet‐based panel was provided scenarios describing donation in the context of brain death, controlled cardiac death and uncontrolled cardiac death. Participants were randomized to receive questions about trust in the medical system before or after the rapid organ recovery scenario. Among 1631 panelists, 1049 (64%) completed the survey. Participants expressed slightly more willingness to donate in the context of controlled and uncontrolled cardiac death than after brain death (70% and 69% vs. 66%, respectively, p < 0.01). Eighty percent of subjects (95% CI 77–84%) would support having a rapid organ recovery program in their community, though 83% would require family consent or a signed donor card prior to invasive procedures for organ preservation. The idea of uDCD slightly decreased trust in the medical system from 59% expressing trust to 51% (p = 0.02), but did not increase belief that a signed donor card would interfere with medical care (28% vs. 32%, p = 0.37). These findings provide support for the careful expansion of uDCD, albeit with formal consent prior to organ preservation. This nationwide survey of the general public found Americans to be slightly more willing to donate after cardiac death than brain death, and generally supportive of programs for donation after sudden cardiac death.