Posted July 17, 2020

Laura Siminoff, Ph.D., Temple University
Heather Gardiner, Ph.D., Temple University

Before a vascularized composite allotransplantation (VCA) procedure can be performed, there must be a graft available for donation. For donation of solid organs, such as a heart or kidney, Organ Procurement Organization (OPO) request staff approach the families of deceased organ donors to obtain donation authorization. This process is the same for VCA donation; however, unlike solid organs, there is a limited awareness of the need for and benefits of VCA among both OPO request staff and the general public, which makes securing family authorization for these donations challenging.

Drs. Heather Gardiner and Laura Siminoff at Temple University received a Fiscal Year 2017 Investigator-Initiated Research Award to address issues in the authorization of VCA donation and ultimately increase the number of VCA grafts available for transplantation. The team sought to understand the barriers to discussing VCA donation among OPO request staff and the issues impeding family authorization of VCA donation. Telephone surveys were conducted with 157 OPO requesters nationwide, and results indicated that nearly 65% of OPO requesters lack VCA-specific training, while 70% lack experience in requesting for VCA donation. When asked to assess their own knowledge of VCA on a 10-point scale (1 = not knowledgeable at all and 10 = very knowledgeable), OPO requesters had a mean score of 2.8. Focus groups with the general public (N=54) and donor families (N=11) revealed a greater hesitancy to donate VCA compared to solid organ donation.

The Communicating Effectively about Donation (CEaD) training programs were developed by the research team to train OPO request staff to learn effective communication tactics to increase the likelihood of family authorization for solid organ donation. This program has proven successful at increasing the requesters’ comfort with discussing donation and their ability to obtain family authorization for donation. In the next phase of their study, Drs. Gardiner and Siminoff will be adapting the CEaD program for requesting VCA donation. The revised CEaD, CEaD-VCA, will address and fill gaps in knowledge of VCA and its need to increase OPO request staff familiarity and comfort with discussing VCA donation with families. The CEaD-VCA will then be beta tested by OPO requesters who will complete a pre- and post-training survey to assess changes in knowledge of and attitudes toward VCA. Finally, beta-testers will complete live simulations of a VCA request to further gauge communication skills regarding VCA donation and authorization.

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