Transplant candidates’ perceptions of informed consent for accepting deceased donor organs subjected to intervention research and for participating in posttransplant research

Elisa J. Gordon*, Elizabeth Knopf, Caitlin Phillips, Adam Mussell, Jungwha Lee, Robert M. Veatch, Peter Abt, Sue Dunn, Peter P. Reese

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Deceased donor organ intervention research holds promise for increasing the quantity and quality of organs for transplantation by minimizing organ injury and optimizing function. Such research will not progress until ethical, regulatory, and legal issues are resolved regarding whether and how to obtain informed consent from transplant candidates offered intervention organs given time constraints intrinsic to distribution. This multi-center, mixed-methods study involved semi-structured interviews using open- and closed-ended questions to assess waitlisted candidates’ preferences for informed consent processes if offered an organ after undergoing intervention. Data were analyzed thematically. Sixty-one candidates participated (47% participation rate). Most were male (57%), white (61%), with a mean age of 56 years. Most candidates (79%) desired being informed that the organ offered was an intervention organ before accepting it, and were likely to accept an intervention organ if organ quality was good (defined as donor age 30) (81%), but fewer candidates would accept an intervention organ if quality was moderate (ie, donor age 50) (26%). Most perceived informed consent important for decision-making, while others considered it unnecessary given medical necessity to accept an organ and trust in their physician. Our findings suggest that most candidates desire an informed consent process before accepting an intervention organ and posttransplant data collection.

Original languageEnglish (US)
Pages (from-to)474-492
Number of pages19
JournalAmerican Journal of Transplantation
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2020

Funding

We thank The Greenwall Foundation for support of this study (PI: Gordon). Dr Reese's efforts were also supported by the Greenwall Foundation. Earlier drafts of this paper were presented at the American Society for Bioethics and Humanities in Anaheim, CA on October 21, 2018 and at the MacLean Center Conference in Chicago, IL on November 10, 2018. We thank Aleja Rodas for her research assistance. Research Electronic Data Capture (REDCap), a secure, online data capture application, is supported at the Feinberg School of Medicine by the Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. We thank The Greenwall Foundation for support of this study (PI: Gordon). Dr Reese's efforts were also supported by the Greenwall Foundation. Earlier drafts of this paper were presented at the American Society for Bioethics and Humanities in Anaheim, CA on October 21, 2018 and at the MacLean Center Conference in Chicago, IL on November 10, 2018. We thank Aleja Rodas for her research assistance. Research Electronic Data Capture (REDCap), a secure, online data capture application, is supported at the Feinberg School of Medicine by the Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422.

Keywords

  • deceased
  • donors and donation
  • education
  • ethics
  • ethics and public policy
  • health services and outcomes research
  • law/legislation
  • organ perfusion and preservation
  • organ procurement and allocation
  • qualitative research
  • social sciences

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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