James DuBois continues with his research on organ transplantation
At present, over 100,000 people are waiting for an organ transplantation. While many people sign their donor cards or join donor registries, most of these individuals will never be eligible to donate their organs. For example, people who die unexpectedly from cardiac arrest are currently not eligible to donate organs. This is because once circulation is lost most organs die quickly and are not transplantable. However, a recent report from the Institute of Medicine estimated that at least another 22,000 people each year would be eligible to donate organs if we developed protocols to rapidly cool organs following death from cardiac arrest. This is called rapid organ recovery or ROR. While it is widely practiced in Spain and the Netherlands, it is uncommon in the United States.
Dr. James DuBois, who served on the Institute of Medicine’s Committee on Increasing Rates of Organ Donation, recently received a $50,000 grant from the Greenwall Foundation to study what community members and professionals think about ROR. The research team conducted 7 focus groups with representatives of African-American, Latino, and Caucasian communities in St. Louis. Additionally, survey data was gathered from 110 community members and professionals in the St. Louis area. The study aimed to understand attitudes toward ROR and how ROR might best be promoted within communities.
“We found that most people believed they would be able to donate organs if they signed their donor cards. They did not know that they have to die in a very unusual manner in order to be eligible,” said DuBois.
He added that many people had misconceptions about organ donation. For example, they confused brain death—which satisfies legal criteria for death—with a persistent vegetative state in which patients are alive and may breathe spontaneously. “We found that most concerns about organ donation disappeared when accurate information was presented. This was true even of the newer ROR procedure,” he continued. Nevertheless, the research team found that the details of ROR policies matter a great deal to many people. For example, while most people supported the idea of preserving organs by cooling bodies following death, many strongly felt that this should only happen with donor or family permission—even when state laws permit routine organ cooling.
DuBois believes the team’s findings will be very helpful to policy makers as they consider whether or how to move forward with ROR.
“Just over two years ago, Illinois passed a law allowing organ preservation even without donor or family permission," he said. "I think our data show that the public strongly supports ROR and organ donation in general, but health care workers will regularly encounter resistance if they do not get permission for their interventions. If ROR is done right, it could save many lives and give new people the opportunity to donate organs. But if it is done poorly, it could easily increase mistrust and even hurt donation rates.”
The results from this study have been shared at conferences and will be published in 2009.