Korean J Transplant.  2023 Nov;37(Suppl 1):S42. 10.4285/ATW2023.F-6081.

Determination of factors influencing family decision upon organ or tissue donation request in potential deceased organ donors in Malaysia: a 22-years national audit

• Ismail AJ
• Ekram AZ

• KMID: 2551629
• DOI: http://doi.org/10.4285/ATW2023.F-6081

Abstract

Background
Organ transplantation remains the only definitive modality of treatment for patients suffering with end-stage or-gan failure. However, without organ donation, transplantation would be impossible. For 20 years, Malaysia remains among the lowest ranking country in the world in terms of deceased organ donation per million population.
Methods
A retrospective cross-sectional study conducted using the big national database involving potential organ donors from 2001 until 2023. The objective was to explore factors associated with family agreement upon organ or tissue donation re-quest, in those potential organ donors of 18 years and above that was initially referred to national transplant team as potential organ donors with devastating brain injury and features suspected of brain death which had family approach for request for organ or tissue donation.
Results
Out of the 4,447 patients in the 22-year database, 1,425 potential organ donors were enrolled. Only 315 (22.1%) families agreed to either organ or tissue donation. Factors that had P-value of <0.25 from univariate analysis were entered into multi-variate analysis using binary logistic regression that shows Chinese race, eventually confirmed as brain death, family-initiated organ donation discussion, families that had prior discussion with the deceased about organ donation and the potential donor had pledged as organ donor were all significant factors associated with the outcome.
Conclusions
This study shown that awareness and knowledge of organ donation and transplantation of the potential donors’ families were the most important factors as three out of five significant factors were related to this. All suspected brain deaths need to undergo official clinical brain death testing as this was significantly associated with family agreement upon request. Further research is needed to explore the reason for Chinese family has a higher tendency to agree on organ donation upon request.