Enhancing Organ Donation from Brain-Dead Patients: Efficacy of an Innovative Physician-Patient Communication Model.
Zhang, M., et al.Transplant Proc. 2025 Dec;57(10):1849-1855.
Aims
To identify factors associated with successful organ donation among brain-dead patients, and to test whether an “innovative physician–patient communication model” improves donation success versus routine communication.
Interventions
The study group had a structured communication strategy combining “1T+3S Principles” (Trust + Selection of suitable donors, optimal timing, and key decision-makers) with a “T-F-B Framework” (Thank, Facts, Blessing/legacy framing). Compared with standard consultations and donation inquiries.
Participants
153 DBD donors randomised.
Outcomes
Donation success (heart/liver/kidney) and organ utilisation.
Follow-up
Up to transplant or organ decline
CET Conclusions
This single-centre RCT in a chinse transplant setting suggests that a structured, staged communication framework can materially increase donor conversion and reported organ utilisation in brain-dead ICU patients compared with routine discussions, with very large absolute differences in organ donation success rates. The intervention group demonstrated markedly higher donation success across all organ types compared with controls. Heart donation success was 27.63% versus 3.90%, liver donation success was 26.32% versus 3.90%, and kidney donation success was 25.00% versus 3.90%, with all comparisons highly significant (all p < 0.001), the intervention group had OR 7.7. The key predictors for success were: lower income, higher education (Master’s degree or above), hospitalisation >7 days, fewer immediate family members, and no extended/collateral family intervention However, the evidence quality is limited by single-centre design and likely limited generalisability beyond the local cultural/legal context/ The lack of blinding, which though hard to avoid in this context, does increases performance/measurement bias risk. Their outcomes that are highly susceptible to clinician behaviour and system-level factors, and the reporting is unclear reporting of allocation concealment, protocol standardisation, and CONSORT flow/attrition. Clinically, the intervention is low-cost and operationally scalable (training ICU staff, standard scripts, prioritising key decision-makers, and timing discussions), so it’s plausible as a quality-improvement lever for donor conversion to improve donation. However, this is really limited to the setting in which it was conducted, it is useful as a broader learning piece across China to improve their relatively low deceased donation rate it is promising, but outside of this context it is limited.
Trial registration
N/A