Community preferences for the allocation of deceased donor organs for transplantation

a focus group study

Michelle Irving, Allison Tong, Stephen Jan, Germaine Wong, Alan Cass, Richard Allen, J Craig, Steve Chadban, John Rose, Kirsten Howard

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices.

    Methods:
     Participants were recruited from the community in four states in Australia. In focus groups, they identified and discussed attributes that they believed were important for allocating organs to potential recipients. Transcripts were analysed thematically.

    Results:
     Thirteen focus groups with 114 participants were conducted. Four major themes emerged: (i) saving and improving the lives; (ii) lowering the risk of lost opportunities; (iii) fairness and (iv) accountability. While happy to discuss general principles, many were not comfortable making organ allocation decisions and were happy to defer to health professionals; this reticence tended to disappear when discussing the use of their own organs.

    Conclusions:
     Participants wanted to save as many lives as possible as well as lower the risk of lost opportunities for those on the waiting list by maximizing the chances of success of every donation. A rational utilitarian ethical model of organ allocation, therefore, appeared to be the dominant framework adopted by the community. Key considerations were compatibility, high chance of peri-operative survival and favouring those with positive lifestyle and self-management choices. Communication between the transplant community and general community about organ allocation could be undertaken to create trust and shared understanding, which may ultimately increase organ donation rates in the future.
    Original languageEnglish
    Pages (from-to)2187-2193
    Number of pages7
    JournalNephrology Dialysis Transplantation
    Volume28
    Issue number8
    DOIs
    Publication statusPublished - 5 Jun 2013

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    Organ Transplantation
    Focus Groups
    Tissue and Organ Procurement
    Waiting Lists
    Social Responsibility
    Self Care
    Life Style
    Communication
    Transplants
    Health

    Cite this

    Irving, Michelle ; Tong, Allison ; Jan, Stephen ; Wong, Germaine ; Cass, Alan ; Allen, Richard ; Craig, J ; Chadban, Steve ; Rose, John ; Howard, Kirsten. / Community preferences for the allocation of deceased donor organs for transplantation : a focus group study. In: Nephrology Dialysis Transplantation. 2013 ; Vol. 28, No. 8. pp. 2187-2193.
    @article{44479dce49b4445690f8ff1e55e8c42b,
    title = "Community preferences for the allocation of deceased donor organs for transplantation: a focus group study",
    abstract = "Background: Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices.Methods: Participants were recruited from the community in four states in Australia. In focus groups, they identified and discussed attributes that they believed were important for allocating organs to potential recipients. Transcripts were analysed thematically.Results: Thirteen focus groups with 114 participants were conducted. Four major themes emerged: (i) saving and improving the lives; (ii) lowering the risk of lost opportunities; (iii) fairness and (iv) accountability. While happy to discuss general principles, many were not comfortable making organ allocation decisions and were happy to defer to health professionals; this reticence tended to disappear when discussing the use of their own organs.Conclusions: Participants wanted to save as many lives as possible as well as lower the risk of lost opportunities for those on the waiting list by maximizing the chances of success of every donation. A rational utilitarian ethical model of organ allocation, therefore, appeared to be the dominant framework adopted by the community. Key considerations were compatibility, high chance of peri-operative survival and favouring those with positive lifestyle and self-management choices. Communication between the transplant community and general community about organ allocation could be undertaken to create trust and shared understanding, which may ultimately increase organ donation rates in the future.",
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    author = "Michelle Irving and Allison Tong and Stephen Jan and Germaine Wong and Alan Cass and Richard Allen and J Craig and Steve Chadban and John Rose and Kirsten Howard",
    year = "2013",
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    doi = "10.1093/ndt/gft208",
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    Irving, M, Tong, A, Jan, S, Wong, G, Cass, A, Allen, R, Craig, J, Chadban, S, Rose, J & Howard, K 2013, 'Community preferences for the allocation of deceased donor organs for transplantation: a focus group study', Nephrology Dialysis Transplantation, vol. 28, no. 8, pp. 2187-2193. https://doi.org/10.1093/ndt/gft208

    Community preferences for the allocation of deceased donor organs for transplantation : a focus group study. / Irving, Michelle; Tong, Allison; Jan, Stephen; Wong, Germaine; Cass, Alan; Allen, Richard; Craig, J; Chadban, Steve; Rose, John; Howard, Kirsten.

    In: Nephrology Dialysis Transplantation, Vol. 28, No. 8, 05.06.2013, p. 2187-2193.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Community preferences for the allocation of deceased donor organs for transplantation

    T2 - a focus group study

    AU - Irving, Michelle

    AU - Tong, Allison

    AU - Jan, Stephen

    AU - Wong, Germaine

    AU - Cass, Alan

    AU - Allen, Richard

    AU - Craig, J

    AU - Chadban, Steve

    AU - Rose, John

    AU - Howard, Kirsten

    PY - 2013/6/5

    Y1 - 2013/6/5

    N2 - Background: Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices.Methods: Participants were recruited from the community in four states in Australia. In focus groups, they identified and discussed attributes that they believed were important for allocating organs to potential recipients. Transcripts were analysed thematically.Results: Thirteen focus groups with 114 participants were conducted. Four major themes emerged: (i) saving and improving the lives; (ii) lowering the risk of lost opportunities; (iii) fairness and (iv) accountability. While happy to discuss general principles, many were not comfortable making organ allocation decisions and were happy to defer to health professionals; this reticence tended to disappear when discussing the use of their own organs.Conclusions: Participants wanted to save as many lives as possible as well as lower the risk of lost opportunities for those on the waiting list by maximizing the chances of success of every donation. A rational utilitarian ethical model of organ allocation, therefore, appeared to be the dominant framework adopted by the community. Key considerations were compatibility, high chance of peri-operative survival and favouring those with positive lifestyle and self-management choices. Communication between the transplant community and general community about organ allocation could be undertaken to create trust and shared understanding, which may ultimately increase organ donation rates in the future.

    AB - Background: Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices.Methods: Participants were recruited from the community in four states in Australia. In focus groups, they identified and discussed attributes that they believed were important for allocating organs to potential recipients. Transcripts were analysed thematically.Results: Thirteen focus groups with 114 participants were conducted. Four major themes emerged: (i) saving and improving the lives; (ii) lowering the risk of lost opportunities; (iii) fairness and (iv) accountability. While happy to discuss general principles, many were not comfortable making organ allocation decisions and were happy to defer to health professionals; this reticence tended to disappear when discussing the use of their own organs.Conclusions: Participants wanted to save as many lives as possible as well as lower the risk of lost opportunities for those on the waiting list by maximizing the chances of success of every donation. A rational utilitarian ethical model of organ allocation, therefore, appeared to be the dominant framework adopted by the community. Key considerations were compatibility, high chance of peri-operative survival and favouring those with positive lifestyle and self-management choices. Communication between the transplant community and general community about organ allocation could be undertaken to create trust and shared understanding, which may ultimately increase organ donation rates in the future.

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    KW - graft recipient

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    KW - medication compliance

    KW - organ donor

    KW - organ transplantation

    KW - priority journal

    KW - self care

    KW - survival

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    KW - Adolescent

    KW - Adult

    KW - Aged

    KW - Aged, 80 and over

    KW - Community Health Services

    KW - Consumer Participation

    KW - Decision Making

    KW - Female

    KW - Focus Groups

    KW - Health Care Rationing

    KW - Humans

    KW - Male

    KW - Middle Aged

    KW - Organ Transplantation

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    KW - Prognosis

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    U2 - 10.1093/ndt/gft208

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    JO - Nephrology Dialysis Transplantation

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    SN - 0931-0509

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    ER -