Loss, Julika and Drewitz, Karl P. and Schlitt, Hans J. and Loss, Martin (2013) Accept or refuse? Factors influencing the decision-making of transplant surgeons who are offered a pancreas: results of a qualitative study. BMC SURGERY, 13: 47. ISSN 1471-2482,
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Background: Most offered pancreases are not transplanted. This study investigates the factors that inform and influence the transplant surgeon's decision to select an offered pancreas. Methods: Semi-standardized interviews were conducted with 14 highly qualified transplant surgeons from all 14 German transplant centers performing > 5 pancreas transplantations per year. The interviews focused on medical and non-medical criteria on which the individual accept/refuse decision depends. Interviews were recorded, transcribed and underwent content analysis. Results: The interviewees agreed upon certain main selection criteria, e. g. donor age, lab results, ICU stay. However, there was no consistency in judging these parameters, and clear cut-offs did not exist. The pancreas macroscopy is a pivotal factor, as well as knowing (and trusting) the donor surgeon. 3/14 surgeons reported that they had occasionally refused a pancreas because of staff shortage. Some interviewees followed a restrictive acceptance policy, whereas others preferred to accept almost any pancreas and inspect it personally before deciding. Conclusion: The assessment of medical donor characteristics is highly inconsistent. Both very cautious as well as very permissive acceptance policies may render the allocation process less efficient. A more standardized policy should be discussed. Finally, better training for donor surgeons seems advisable, in order to increase trust and thus pancreas utilization.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | KIDNEY TRANSPLANTATION; HEALTH-CARE; MORTALITY; SURVIVAL; GRAFTS; ORGANS; IMPACT; Pancreas transplantation; Under-utilization; Allocation process; Refusal |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Institut für Epidemiologie und Präventivmedizin > Medical Sociology |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Mar 2020 09:00 |
| Last Modified: | 27 Mar 2020 09:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15832 |
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