Correlation Between Potential Donor Age and Family Refusal Rates in the State of Rio de Janeiro, Brazil

Janaina Lenzi¹, Andreia Assis¹, Márcia Ponte¹, Priscila Paura², André Albuquerque², Rodrigo Sarlo³, Cláudia Araújo⁵, Eduardo Rocha^5,4

¹Family Services, State Organ Procurement Organization , Rio de Janeiro, Brazil, ²Education, State Organ Procurement Organization, Rio de Janeiro, Brazil, ³General Coordination, State Organ Procurement Organization, Rio de Janeiro, Brazil, ⁴Health Foundation, State Health Board, Rio de Janeiro, Brazil, ⁵COPPEAD, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Introduction: It is well known that potential donor (PD) age influences family decision on organ donation. Accepting the death of a child or young person often is very difficult and donation rates (DR) may vary according to cultural beliefs and general education on organ donation. Studies are contradictory to DR among the elderly. Our study aims to analyze the influence of age on family refusal, in order to help developing strategies to increase awareness on the subject and training of health professionals in charge of interviewing families of PD.

Methods: Data from the records of the Rio de Janeiro State Transplant Program (PET) from 2011 to 2012 were reviewed and expressed as percentual analysis (%). Family refusal (FR) rates for donation were organized according to PD’ age group as follows: children (<11), teenagers (12 -17), adults (18-64) and seniors (>65).

Results: Our data show that in the period studied, among refusals 53% were associated to children, 51% to teenagers, 46% to adults, and 55% to senior PD. The main reason for children and teenager FR were misunderstanding of brain death and fear of body mutilation. These become to have a smaller participation as the potential donor age increases. Otherwise, absence of consensus among family members and first person refusal were the main reasons for FR in elderly PD.

Conclusion: Our study shows that FR occurred in over 50% of cases when a child, teenager or an elderly PD was involved. This result reinforces previous research and indicates that young donor age is associated with a reduced probability of donation. Furthermore, this research goes further by showing that seniors also have a lower likelihood of having their organs donated in RJ, Brazil. This means that health care professionals who interview families of PD should be trained to deal with these family questions, using different strategies according to the age of the deceased.