The Role of Specifically Tailored Communication Training Among Factors Influencing Consent for Cornea Donation Requested Via Telephone.

Obtaining consent for cornea donation can be a major stumbling block for tissue banks in the procurement process in many countries. In Germany, consent for organ and tissue donation is regulated by the German Transplantation Act (Transplantationsgesetz [TPG] of 1997, revised 2007). According to the TPG, consent for donation must be requested from the next of kin in the absence of a donor's written will, and even if such will exists, the next of kin must be informed about the planned organ or tissue procurement. Similar regulations are common throughout Europe. Consent for cornea donation from non–heart-beating donors is often requested by means of a telephone interview.1-9 In the Aachen cornea bank, this is almost exclusively the case. In our experience, the decisions whether to consent to cornea recovery seemed to be influenced by preexisting values and opinions as well as the momentary situation of the consulted family members in the bereavement process, but studies have reported that staff education and training may improve rates of solid organ donation consent10-13 among other modifiable factors related to the consent process.14 In particular, Siminoff et al13 reported increased solid organ donation rates from 46.3% to 55.5% after completion of a communication seminar by transplant coordinators. Members of our medical staff had participated in communication workshops offered by the European Donor Hospital Education Program (EDHEP), initiated by Eurotransplant in 1991,15 focused on obtaining consent for solid organ donation in face-to-face interviews. After that program was discontinued, we developed our own training seminar which is based on an assessment of the needs of our medical staff,16 and specifically addresses the context of telephone interviews requesting consent for cornea donation. Although some data were published regarding the impact of the EDHEP seminar on the perceptions and self-evaluation of participants,15,17-20 its efficacy in improving consent rates of organ donation has not been demonstrated. Also, we are not aware of a report in literature regarding the effectiveness of any training program on consent rates for cornea donation. We have therefore performed a retrospective analysis of consent interviews to verify whether specific communication training may have a significant impact on consent rates. Because of the multifaceted nature of consent decisions, we used a multifactorial approach to identify, and adjust for, other potential factors.