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In recent years, organ donation and transplantation have entered a stage of steady development in China. Nevertheless, the shortage of transplant organs and the contradiction between supply and demand of organs are still the bottlenecks to achieve the strategy of "self-sufficiency in organ transplantation" advocated by the World Health Organization (WHO). The key reasons for donor loss described in the "critical pathway of organ donation" defined by the WHO include the identification and referral of potential donors and the maintenance and repair of organs. Smooth development, high efficiency and high-quality development of organ donation cannot be achieved without the support of intensive care medicine, which are highly associated with the cognition, recognition and participation of intensive care unit(ICU) staff. In this article, research progress in ICU staff’s cognition, attitude and willingness for organ donation were reviewed and relevant influencing factors were discussed, aiming to offer targeted suggestions on how to resolve these difficulties.
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Objective To refine and summarize the research status and development trend of organ donation discipline in China. Methods Relevant Chinese and English literatures related to organ donation were searched from China National Knowledge Infrastructure (CNKI) and Web of Science core collection database from January 1, 2018 to December 31, 2022. Visual analysis was performed by the CiteSpace software from the number of published articles, keywords, journal source distribution, cooperation network of core authors, main research institutions, and citation of key literatures, etc. Results A total of 792 articles were published from 2018 to 2022, with an average annual number of 158 articles, which showed a rapidly upward trend. Among them, 182 articles were published in the form of postgraduate dissertation, accounting for 23%. Common keywords included organ transplantation, brain death, cardiac death, willingness/cognition/attitude, legal system, influencing factor/risk factor, infection/complication, Organ Procurement Organization, prognosis/quality, education for college students/medical students, extracorporeal membrane oxygenation, children, ischemia-reperfusion injury, donor-derived infection, ethics, expended criteria donor, nursing and coordinator, etc. Keyword clustering hotspots focused on the theme of “organ donation” and branched into multiple disciplines. The publications of research results were characterized with pluralism and diversity, and the research contents were centered on medicine and spanned a wide range of disciplines. A large proportion of researches were published by the teams from large-scale organ transplantation institutions, and relatively close cooperative relationship was formed within the institutions. However, the intensity of cooperation among different institutions was relatively low, and the cooperative relationship among authors was insufficient, which failed to form an intimate academic network. The top five countries worldwide regarding the number of published articles were the U.S. (n=940), U.K. (n=377), Spain (n=263), Canada (n=241) and China (n=181), indicating that the achievements of Chinese researchers have been gradually recognized in the international academic community. Conclusions From the quantity and content of published articles in recent years, “organ donation” has laid certain research foundation in China. It is one of the topics concerned and widely studied by multiple academic communities in China. Relevant research issues have multidisciplinary, plural and diverse characteristics.
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Public trust is the foundation for supporting the sustainable development of various social donation systems. However, the construction of trust system is continuous, long-term, and easily lost and difficult to defend. This study explored the multi-object and multi-dimensional trust demands of the public, donors and their families in interpersonal, system, social and supervision aspects. It was proposed that participating institutions and practitioners should take the multidimensional claims as an action-oriented, break the crisis of trust by building two major support systems centered on the public and donors’ families, and jointly safeguard the sustainable and high-quality development of organ donation.
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Organ shortage is a common problem in the field of transplantation worldwide. It is urgent to expand the donor pool via different effective and safe approaches. Recently, "the statement from international collaborative on expanding controlled donation after the circulatory determination of death (cDCDD)" has attracted widespread attention from scholars. The statement aims to promote cDCDD in order to increase organ donation rates, with the ultimate goal of achieving self-sufficiency in transplantation. In this article, the key contents mentioned in the statement were summarized, the terminology update and relevant discussion of donation after the circulatory determination of death (DCDD), the development trend of DCDD, the basic part of the clinical pathway of cDCDD and the key factors affecting the implementation of cDCDD were illustrated, and the inspiration drew from this statement to the sustainable development of organ donation program in China was reflected.
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Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.
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Communication with the family members of donors is an integral part of the organ donation and transplantation, and the core of it lies in building trust through interpersonal communication. Every word and deed from the communicator will directly affect the overall impression of family members of potential donors towards organ donation. Regardless of whether or not granted the donation ultimately, family members may share their personal experiences and feelings with friends and relatives around them, which develops a secondary dissemination. Therefore, "the choice of best candidate for communication with family members of organ donation" has been an issue that organ donation practitioners have been working on in clinical practice. Taking into consideration of the experiences from different countries or regions, various advices and practices on this issue have been proposed due to differences in social systems, cultural background, organizational structure, clinical practice, etc. In this paper, we had a discussion on this topic, summarize the difficulties currently encountered in communication with family members and propose corresponding strategies.
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Organ transplantation has brought hope for healing of patients with end-stage organ failure. However, the shortage of human organs has become one of the important factors that severely restrict the development of human organ transplantation. Donation after cardiac death (DCD) is a safe way to expand the source of donors. While trying to make extensive effort to increase the quantity of donation after brain death (DBD), countries attempt to grasp the opportunity of DCD when conditions permit. In this article, the historical background and global development trend of DCD, fundamental conditions for the implementation of controllable DCD, key issues and ethical review in the practice of controllable DCD were discussed.
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Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.