OBJECTIVE To account for factors affecting family approach and consent for organ donation after brain death (BD). MATERIAL AND METHODS A prospective cohort study in a large, tertiary, urban hospital, where we reviewed the database of all brain-dead patients between January 2006 and December 2017 cross-matched with local organ procurement organization (OPO) records. RESULTS Two-hundred sixty-six brain-dead patients were included (55% African Americans (AAs)). Two-hundred twenty-two were approached for donation. The reason for not approaching families was medical exclusion due to cancer or multi-organ failure. Patient demographics or religion were not associated with approaching families. Lower creatinine level was the only independent factor associated with higher approach. Consent rate for organ donation was 72.5%. Consent was significantly higher in Caucasians (89% vs 62% for AAs), younger patients (46.7 vs 52.5 years old), in patients with lower creatinine at time of death (1.7 vs 2.4 mg/dL), patients for whom apnea testing was completed (92% vs 80%) and patients with diabetes insipidus (DI) (72% vs 54%). There was no significant relationship between consent and patient gender, admission diagnosis, number of examinations or completion of a confirmatory test. In a logistic regression model, only AA race independently predicted consent for donation (odds, 95% CI, 0.27, 0.12-0.57 p < .001). In a different model, apnea test completion was an additional independent predictor (3.66, 1.28-10.5 p = .015). CONCLUSIONS Approaching families for organ donation consent was associated with medical suitability only and not with demographic or religious characteristics. AAs were 3.7 times less likely to consent for organ donation than non-AAs. Completion of apnea testing was associated with higher consent rates, an observation that needs to be explored in future studies documenting the effect on bedside family presence during this test.

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脑死亡后器官捐献同意率的影响因素：12年的登记

目的 考虑影响脑死亡 (BD) 后器官捐赠的家庭方法和同意的因素。材料与方法 一项在大型三级城市医院进行的前瞻性队列研究，我们回顾了 2006 年 1 月至 2017 年 12 月期间所有脑死亡患者的数据库，并与当地器官采购组织 (OPO) 记录交叉匹配。结果 包括 266 名脑死亡患者（55% 非裔美国人 (AAs)）。有 222 人被要求捐赠。不走近家人的原因是癌症或多器官衰竭导致的医疗排斥。患者人口统计学或宗教信仰与接近家庭无关。较低的肌酐水平是与较高方法相关的唯一独立因素。器官捐献的同意率为72.5%。白种人（AA 为 89% 与 62%）、年轻患者（46.7 岁与 52.5 岁）、死亡时肌酐较低的患者（1.7 与 2.4 毫克/分升）的同意显着更高，呼吸暂停测试为完成（92% 对 80%）和尿崩症（DI）患者（72% 对 54%）。同意与患者性别、入院诊断、检查次数或完成确认试验之间没有显着关系。在逻辑回归模型中，只有 AA 种族独立预测捐赠同意（几率，95% CI，0.27、0.12-0.57 p < .001）。在不同的模型中，呼吸暂停测试完成是一个额外的独立预测因子 (3.66, 1.28-10.5 p = .015)。结论 与家人取得器官捐赠同意书仅与医疗适用性有关，与人口统计学或宗教特征无关。AA 同意器官捐赠的可能性是非 AA 的 3.7 倍。完成呼吸暂停测试与更高的同意率相关，需要在未来的研究中探索这一观察结果，以记录此测试期间对床边家庭存在的影响。