Transplant Trial Watch

Public opinion and legislations related to brain death, circulatory death and organ donation.

Othman, M. H., et al.

Journal of the Neurological Sciences 2020; 413: 116800.

This study aimed to evaluate public attitudes and legislations regarding brain death versus circulatory death and organ donation.

The study consisted of two parts. Part I included an online survey examining public opinion on brain death versus circulatory death in the setting of organ donation, where participants were randomly assigned to either a case report of organ donation after circulatory death or to one following brain death. Part II of the study included a systematic review. A literature search was conducted on MEDLINE and EMBASE. Data extraction was performed by two authors.

Part I: 1072 participants from 30 countries (mean age± SD: 32.86 ± 11.14 years). Part II: 57 studies on brain death and 36 studies on circulatory death were included in the review.

Study outcomes (part I): Public perception of brain death and circulatory death. Study outcomes (part II): Legislations on brain death and circulatory death before organ donation.


CET Conclusions
The study assessed public opinion on organ donation following brain death versus circulatory death (DCD) by conducting an online survey among adult and English-speaking laypeople recruited through a crowdsourcing platform. The sample size calculation showed that 1054 participants were needed and participants were randomised to one of two fictive cases of donors, i.e. a case of a brain death and a case of circulatory death. There were 1072 participants recruited from mostly Europe and the USA. Attitudes towards organ were similar with donation after brain death and circulatory death. The views of this selective sample of respondents suggest that implementation of DCD is unlikely to have a negative impact on donation rate. The authors also reviewed articles and other documents regarding brain death (n=57) and circulatory death (n=35). They found wide variety in legislation, guidelines on determination of death and practical procedures across 24 countries.

Trial registration

Funding source
Non-industry funded