The Impact of Unplanned Mentions of Donation

As the designated requestor for all hospitals within our donor service area, it is key that Midwest Transplant Network is the one to speak with potential organ, eye and tissue donor families about donation. While there may be times when a physician establishes a plan with MTN staff to collaboratively approach a family about organ donation, any donation conversation initiated by a member of the hospital team without an established and agreed upon plan with MTN is considered an “unplanned mention of donation” or UMD. This includes any mention of Midwest Transplant Network, the organ or tissue donation team, etc.

Because the opportunity for organ, eye and tissue donation is a part of end-of-life considerations for patients, it is especially important to be sensitive about how and when this is presented to the family. Unplanned mentions of donation by members of the hospital staff, while well meaning, have the potential to leave doubts in the family’s mind that all lifesaving efforts for their loved one were exhausted. It may be difficult for a family to reconcile that the hospital team can be both interested in their loved one’s recovery while at the same time advocating for the opportunity for donation. MTN follows an effective request process and works with hospital nursing and medical staff to ensure the timing of donation conversations is handled with respect and compassion for potential donor families during an acute phase of grief. It is important that in the case of organ donation the patient has either been declared deceased by neurologic criteria/brain dead, or the family is accepting of their loved one’s terminal prognosis and they are ready for end-of-life conversations and may benefit from having the ability to fold donation into their plans.

For all organ, eye and tissue donations, it is important that the family is ready to discuss next steps and that MTN has deemed the patient is eligible to be a donor prior to the donation conversation. Even when received positively, unplanned mentions of donation by hospital staff may not be able to provide the family with the most accurate representation of their loved one’s eligibility to be a donor. Medical and scientific advancements in the field mean that patient eligibility can change frequently, and as the organ procurement organization for Kansas and the western two-thirds of Missouri, MTN is able to ensure families receive the most current and accurate information about their loved one’s opportunity to donate.

MTN Family Service Coordinators are trained in grief support and crisis intervention and are committed to ensuring that we partner with the hospital team to provide the very best care possible to families during this difficult time. Hospital staff can continue to support families by ensuring that they never initiate a donation conversation and always huddle with MTN staff to form a collaborative plan.