Donation Physician Specialists and Missed Organ Donation Opportunities
Authors' conclusion
In this cohort study of consecutive eligible potential organ donors, implementation of a novel DP program was associated with a sustained reduction in missed organ donation opportunities, increased referrals, and a higher deceased donation rate.
Study context
- Population
- Consecutive deceased critically ill patients with brain injury, mechanically ventilated in the last 12 hours of life, ICUs and EDs in a Canadian province
- Participants
- 1,072 eligible potential donors
- Exposure
- DP program period vs baseline period
- DP programn = 942
- Baselinen = 123reference
- Outcome
- Missed organ donation opportunities (families of eligible potential donors not given the option of donation)
Methodological detailsinterrupted time series analysis, province-wide
- Interrupted time series analysis
- Province-wide
Main finding
As reported in the abstract
Missed organ donation opportunities
P < 0.001
- Immediate decrease in monthly proportion of missed cases after program start: 10.9% (95% CI, −22.0% to 0.3%)
- P = 0.06
- Subsequent monthly decline in missed cases: −0.7% per month (95% CI, −0.9% to −0.5%)
- P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Appropriate notification of the provincial organ donation organization
- Increased 0.9% per month (95% CI, 0.6% to 1.3%)
- P < 0.001
Annual donation rate (donors per million)
- Increased from 14.0 to 23.7 donors per million
Organs transplanted per donor
- Median (IQR) did not change: 4 [3-5]
- P = 0.69
Missed opportunities by most responsible physician (subgroup)
- Missed in 3% when most responsible physician was a DP vs 17% when not
- P < 0.001
Original publication
Donation Physician Specialists and Missed Organ Donation Opportunities. JAMA Netw Open. Published 1 August 2025. doi:10.
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