Facilitators and Barriers to Donor Detection Based on Hospital Staff Opinions in Different Hospitals


Detection facilitator
Donor detection


How to Cite

Abdolmohammadi, Y. ., Tabibi, S. J., & Riahi, L. (2022). Facilitators and Barriers to Donor Detection Based on Hospital Staff Opinions in Different Hospitals. Iranian Red Crescent Medical Journal, 24(12). https://doi.org/10.32592/ircmj.2021.24.12.2235


Background: Donor detection is the first step of organ procurement for transplantation, and about 50% of all potential donors are not detected.

Objectives: The present study aimed to evaluate the facilitators and barriers to donor detection based on hospital characteristics and staff opinions.

Methods: In this cross-sectional study, a 16-item questionnaire was prepared to clarify medical staff opinions about facilitators (10 items) and barriers (6 items) to potential donor detection. The questionnaire was distributed on social networks, and all medical staff members were invited to participate in the study.

Results: A total of 230 medical staff participated in this study. From their point of view, the main facilitator was active detection via regular daily phone calls (150, 65.2%), which had the most advocators among medical staff of public (64.1%) and private hospitals (74.5%). Detection by donor coordinators or inspectors tanked the second (103, 44.8%). Moreover, private hospitals highly agreed with detection by donor coordinators and inspectors in 66.7% and 60.8% of cases, respectively. Donor detection by an in-hospital-coordinator was recommended by 42.6% of all 230 participants, with most advocators among those affiliated with an organization (65.4%). Staff opinions about donor selection and care to donor families were important barriers according to 53.5% and 46.1% of subjects, respectively.

Conclusion: To identify all potential donors, different strategies are necessary according to hospital characteristics. In public hospitals, daily calls; in private ones, active visits; and in an-organization-related hospitals, in-hospital coordinators could be effective.



Pillai AA, Levitsky J. Overview of immunosuppression in liver transplantation. World J Gastroenterol. 2009;15(34):4225. doi: 10.3748/wjg.15.4225. [PubMed: 19750565].

Lewis A, Koukoura A, Tsianos GI, Gargavanis AA, Nielsen AA, Vassiliadis E. Organ donation in the US and Europe: The supply vs demand imbalance. Transplant Rev. 2021;35(2):100585. doi: 10.1016/j.trre.2020.100585. [PubMed: 33071161].

Najafizadeh K, Ghorbani F, Rostami A, Fard-Mousavi A, Lorgard-Dezfuli-Nejad M, Marashian M, et al. Depression while on the lung transplantation waiting list. Ann Transpl. 2009;14(2):34–7. [PubMed: 19487792].

Michael A. History of brain death as death: 1968 to the present. J Crit Care. 2014;29(4):673–8. doi: 10.1016/j.jcrc.2014.04.015. [PubMed: 24930367].

Trilikauskienė A, Maraulaitė I, Damanskytė D, Lukminaitė D, Balčiūnienė N, Tamošuitis T. Implementing of active brain-dead donor detection strategy in a single donor center: one year experience. Medicine. 2020;56(8):1-9. doi: 10.3390/medicina56080366. [PubMed: 32707964].

Lopez-Soler RI, Garcia-Roca R, Lee DD. Disparities in living donation. Curr Opin Organ Transplant. 2021;26(5):542–6. doi: 10.1097/MOT.0000000000000912. [PubMed: 34375319].

Maynes EJ, O'Malley TJ, Austin MA, Deb AK, Choi JH, Weber MP, et al. Domino heart transplant following heart-lung transplantation: a systematic review and meta-analysis. Ann Cardiothorac Surg. 2020;9(1):20-8. doi: 10.21037/acs.2019.12.02. [PubMed: 32175236].

Najafizadeh K, Abbasi A, Ghorbani F, Radpei B, Kashani BS, Ahmadi ZH, et al. Organ retrieval from brain-dead patients by a single organ procurement center in Iran. In: Transplantation proceedings. Elsevier; 2009.

Akbarzadeh A, Khorramirouz R, Ghorbani F, Beigi RSH, Hashemi J, Kajbafzadeh A-M. Preparation and characterization of human size whole heart for organ engineering: scaffold microangiographic imaging. Regen Med. 2019;14(10):939–54. doi: 10.2217/rme-2018-0111.

Abdolmohammadi Y, Nabi M, Mostafavi K, Dezful MM, Nejatollahi SMR, Ghorbani F. Hospital Characteristics and Nursing Attitude toward Organ Donation. Iran Red Crescent Med J. 2022;24(3):e1530

Takahashi K, Wakasugi M, Okudera H, Seto C, Furuki I, Hasegawa T, et al. Importance of continuing education for medical staff to improve the confirmation rate of intent for organ donation. In: Transplantation proceedings. Elsevier; 2019.

Ju MK, Sim MK, Son SY. A Study on Nursing Students' Knowledge, Attitude, and educational needs for brain-death organ transplantation and donation and intent to donate organs. Transplant Proc. 2018;50(4):1187–91. doi: 10.1016/j.transproceed.2018.02.036. [PubMed: 29731091].

Lomero M del M, Jiménez-Herrera MF, Rasero MJ, Sandiumenge A. Nurses' attitudes and knowledge regarding organ and tissue donation and transplantation in a provincial hospital: A descriptive and multivariate analysis. Nurs Heal Sci. 2017;19(3):322–30. doi: 10.1111/nhs.12348. [PubMed: 28631279].

Oczkowski SJW, Durepos P, Centofanti J, Arsenau E, Dhanani S, Cook DJ, et al. A Multidisciplinary survey to assess facilitators and barriers to successful organ donation in the intensive care unit. Prog Transplant. 2019;29(2):179–84. doi: 10.1177/1526924819835826. [PubMed: 30895847].

Beige FS, Mohsenzadeh M, Shahryari S, Mojtabaee M. Role of more active identification of brain-dead cases in increasing organ donation. Exp Clin Transpl. 2017;15(1):60–2. doi: 10.6002/ect.mesot2016.O42. [PubMed: 28260435].

Zier JL, Spaulding AB, Finch M, Verschaetse T, Tarrago R. Improved time to notification of impending brain death and increased organ donation using an electronic clinical decision support system. Am J Transplant. 2017;17(8):2186–91. doi: 10.1111/ajt.14312. [PubMed: 28397363].

Bleakley G. Implementing minimum notification criteria for organ donation in an acute hospital's critical care units. Nurs Crit Care. 2010;15(4):185–91. doi: 10.1111/j.1478-5153.2009.00385.x. [PubMed: 20626795].

Bustos JL, Surt K, Soratti C. Glasgow coma scale 7 or less surveillance program for brain death identification in Argentina: Epidemiology and outcome. In: Transplantation proceedings. Elsevier; 2006.

Maraulait I. Implementing of Active Brain-Dead Donor detection Strategy in a Single Donor Center : :1–9.

Witjes M, Jansen NE, van der Hoeven JG, Abdo WF. Interventions aimed at healthcare professionals to increase the number of organ donors : a systematic review. Crit Care. 2019;23(1):1-19. doi: 10.1186/s13054-019-2509-3. [PubMed: 31221214].