Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study

ABSTRACT BACKGROUND The mismatch between the supply and demand for organs and tissues for transplantation is one of the reasons for the high rates of donation refusal. A more recent contributing factor has been the COVID-19 pandemic. OBJECTIVES To analyze, through the Terms of Donation of Organs a...

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Main Authors: Barbara Rossana Gimenez Hidalgo, Rafael Rodrigo da Silva Pimentel, Marcelo José dos Santos, Edvaldo Leal de Moraes
Format: Article
Language:English
Published: Associação Paulista de Medicina 2025-06-01
Series:São Paulo Medical Journal
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802025000300208&lng=en&tlng=en
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author Barbara Rossana Gimenez Hidalgo
Rafael Rodrigo da Silva Pimentel
Marcelo José dos Santos
Edvaldo Leal de Moraes
author_facet Barbara Rossana Gimenez Hidalgo
Rafael Rodrigo da Silva Pimentel
Marcelo José dos Santos
Edvaldo Leal de Moraes
author_sort Barbara Rossana Gimenez Hidalgo
collection DOAJ
description ABSTRACT BACKGROUND The mismatch between the supply and demand for organs and tissues for transplantation is one of the reasons for the high rates of donation refusal. A more recent contributing factor has been the COVID-19 pandemic. OBJECTIVES To analyze, through the Terms of Donation of Organs and Tissues, the rates and trends of specific refusals for each organ and tissue from brain-dead donors between 2001 and 2020 in an Organ Procurement Organization. DESIGN AND SETTING This was a cross-sectional, exploratory, and retrospective quantitative study on specific donation refusals conducted in one of the ten Organ Procurement Organizations in São Paulo, Brazil. METHODS The variables collected included year, age, gender, cause of death, type of hospital, and organs and tissues donated and refused. The data were transferred to Stata software for descriptive and inferential analysis, using generalized linear regression to examine time trends. A significance level of P lt; 0.05 was adopted. RESULTS Bones and skin had the highest rates of tissue donation refusal, at 56.40% and 55.37%, respectively. Among solid organs, the pancreas (4.05%) and lungs (5.23%) had the highest refusal rates. In the first decade analyzed, there were increasing time trends in refusals of valves, heart, pancreas, and lungs. In contrast, during the second decade, refusals of valves, kidneys, and pancreas showed decreasing trends. In 2020, the number of refusals for all tissues declined. CONCLUSION To reduce tissue-specific refusals, it is important to address and mitigate family beliefs, myths, and negative attitudes toward organ and tissue donation.
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spelling doaj-art-862f06ddb9ca4280906d65622753e33c2025-08-20T03:19:23ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602025-06-01143310.1590/1516-3180.2024.0175.r1.29112024Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional studyBarbara Rossana Gimenez Hidalgohttps://orcid.org/0000-0002-1711-9054Rafael Rodrigo da Silva Pimentelhttps://orcid.org/0000-0002-9461-1472Marcelo José dos Santoshttps://orcid.org/0000-0001-5123-8797Edvaldo Leal de Moraeshttps://orcid.org/0009-0005-1515-3426ABSTRACT BACKGROUND The mismatch between the supply and demand for organs and tissues for transplantation is one of the reasons for the high rates of donation refusal. A more recent contributing factor has been the COVID-19 pandemic. OBJECTIVES To analyze, through the Terms of Donation of Organs and Tissues, the rates and trends of specific refusals for each organ and tissue from brain-dead donors between 2001 and 2020 in an Organ Procurement Organization. DESIGN AND SETTING This was a cross-sectional, exploratory, and retrospective quantitative study on specific donation refusals conducted in one of the ten Organ Procurement Organizations in São Paulo, Brazil. METHODS The variables collected included year, age, gender, cause of death, type of hospital, and organs and tissues donated and refused. The data were transferred to Stata software for descriptive and inferential analysis, using generalized linear regression to examine time trends. A significance level of P lt; 0.05 was adopted. RESULTS Bones and skin had the highest rates of tissue donation refusal, at 56.40% and 55.37%, respectively. Among solid organs, the pancreas (4.05%) and lungs (5.23%) had the highest refusal rates. In the first decade analyzed, there were increasing time trends in refusals of valves, heart, pancreas, and lungs. In contrast, during the second decade, refusals of valves, kidneys, and pancreas showed decreasing trends. In 2020, the number of refusals for all tissues declined. CONCLUSION To reduce tissue-specific refusals, it is important to address and mitigate family beliefs, myths, and negative attitudes toward organ and tissue donation.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802025000300208&lng=en&tlng=enTissue and organ procurementNursingOrgan transplantationTransplantsBrain deathDeceased donorsOrgan donationTissue donationFamily interviewFamily consentFamily refusal
spellingShingle Barbara Rossana Gimenez Hidalgo
Rafael Rodrigo da Silva Pimentel
Marcelo José dos Santos
Edvaldo Leal de Moraes
Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
São Paulo Medical Journal
Tissue and organ procurement
Nursing
Organ transplantation
Transplants
Brain death
Deceased donors
Organ donation
Tissue donation
Family interview
Family consent
Family refusal
title Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
title_full Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
title_fullStr Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
title_full_unstemmed Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
title_short Trends in organ- and tissue-specific donation refusals in São Paulo, Brazil, a quantitative cross-sectional study
title_sort trends in organ and tissue specific donation refusals in sao paulo brazil a quantitative cross sectional study
topic Tissue and organ procurement
Nursing
Organ transplantation
Transplants
Brain death
Deceased donors
Organ donation
Tissue donation
Family interview
Family consent
Family refusal
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802025000300208&lng=en&tlng=en
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