Social
and Behavioral Interventions to Increase Organ and Tissue Donation
In
response to the urgent need for donors, HHS Secretary Tommy
G. Thompson, during his first 100 days in office, launched a
national campaign to increase organ, tissue, marrow, and blood
donation. The Social and Behavioral Grant Program supports the
Secretary’s campaign through the implementation of public
and professional educational interventions. The program is focused
solely on increasing organ donation from deceased and/or living
donors.
Eligible
interventions could investigate factors relevant to consent
in cases of donation after cardiac death (DCD). Acceptable DCD
projects may focus on the effectiveness of hospital donor protocol
and policies or public and professional education, as they affect
family consent for donation. The scope of the FY 2003 program
also includes evaluation research projects focused on the effectiveness
of donor registries. Examples of relevant study issues include
strategies for maximizing a registry’s reach and utility,
expanding its use among varying and hard to reach populations,
facilitating informed consent, and comparing the effectiveness
of alternative avenues of sign-up. Rigorous evaluation protocols
to assess outcomes of the intervention must be included as a
key element of all proposed projects.
University of Arizona
Phoenix, Arizona
Principal Investigator: Alexander Dominick, M.B.A.
Hispanic Live Organ Donation: A Strength-Based Approach
This
2-year project intends to implement a dual-featured intervention.
The investigators will develop and implement a live organ donor
media/community campaign as well as replicate a deceased donor
campaign that was implemented in Tucson and Phoenix. The project
will appeal to the enhanced sense of family and community within
the Hispanic culture to increase the number of live and deceased
donors. Surveys and focus groups will evaluate the project’s
effectiveness.
University at Buffalo, University at Albany
Albany, New York
Principal Investigator: Carla Williams, MPA
A Multi-Campus Classroom Intervention to Increase Organ and
Tissue Donation
This
3-year project aims to increase the number of college students
in New York who communicate their intent to donate their organs
and tissues by enrolling in the State’s donor registry
and notifying their family of their enrollment decision. Students
will participate in a public communication course promoting
organ and tissue donation that requires them to devise and execute
campus-wide campaigns to increase declaration rates and family
discussion. The project will evaluate the impact of participation
in the course on knowledge and changes in registry enrollment.
Case Western Reserve University
Cleveland, OH
Principal Investigator: Laura A. Siminoff, Ph.D.
Testing the Early Referral and Request Approach (ERRA) Model
This
3-year project will test the ERRA Model to increase solid organ
donation from brain dead patients. The model consists of hospital-tailored
intervention modules plus communication modules based upon the
information needs of family decision-makers. The intervention
will target OPO requesters, family decision-makers, and health-care
providers. The investigators will evaluate hospital barriers
to time-sensitive referrals, a health care provider’s
ability to discuss organ donation with patients’ families,
and OPO requester’s ability to optimize their approach
to discussions of donation with families.
University of Miami
Coral Gables, Florida
Principal Investigator: Susan Ganz, M.D.
A Model Intervention for Increasing Intent of a New Immigrant
Population (Haitians in Miami-Dade County, Florida) to Donate
Organs and Tissues
This
2-year project will develop and evaluate a health campaign intervention
designed to increase intent to donate among Haitians living
in Miami-Dade County. The four-phased intervention will look
at the use and effectiveness of a theory-driven media and community
outreach campaign to enhance intent to donate in immigrant populations.
The campaign will use native language, focus groups, and trusted
community health providers to develop culturally-tailored messages.
The evaluation will help establish replicability in other immigrant
populations.
University of Michigan-Dearborn
Dearborn, Michigan
Principal Investigator: Thomas Beyersdorf
A
Culturally Sensitive Intervention to Increase Organ Donation
Registration Among Asian Pacific Americans
This project will study the Asian Pacific American community
from three perspectives: 1) behavior, attitude, willingness
and obstacles to organ donation; 2) receptivity to an organ
and tissue donation intervention, and 3) change in organ and
tissue donation registry sign-ups if culturally sensitive interventions
are administered. The project will implement culturally appropriate
interventions and will evaluate their effectiveness by changes
in awareness, attitude, intent to sign a donor card, and informing
family about their decision.
Mount
Sinai School of Medicine
New York, New York
Principal Investigator: Paul L.Herbert, Ph.D.
Improving Organ Donation in Chinese Communities in New York
City
This 3-year project will compare two types of interventions
aimed at increasing willingness to become an organ donor among
Chinese Americans. Grassroots campaigns and a paid-media advertising
campaigns will be implemented in three Chinese neighborhoods
in New York City. The investigators will design culturally sensitive
interventions that respect local institutions, persons, and
beliefs. The relative effectiveness and cost-effectiveness of
the interventions will be measured by the number of new registrants
on the organ donor registry and by survey.
Medical
University of South Carolina
Charleston, South Carolina
Principal Investigator: Prabhakar Baliga, M.D.
A Comprehensive Approach to Organ Donation by Incorporation
of Family Support Counselors as Members of the Hospital Critical
Care Team
This 3-year project will develop and evaluate an intervention
that will implement a hospital-based requestor model in which
counselors will provide emotional and bereavement support to
families of patients dying in the ICU. The intervention also
will provide education on brain death and the value of donation
to families. The effectiveness will be measured by the number
of families consenting to organ donation, counts of potential
donors, and changes in attitude and knowledge of organ donation
amongst health care providers.
South
Dakota State University
Sioux Falls, South Dakota
Principal Investigator: Nancy Fahrenwald, Ph.D., RN
A Culturally-competent Intervention to Increase Organ, Eye,
and Tissue Donation on South Dakota’s Indian Reservations:
A Collaborative Project by the SD Lion’s Eye Bank and
SD State University, College of Nursing
The
3-year project will pilot-test a cultural intervention that
includes printed materials, videos, and social marketing methods
that will be implemented within reservation schools, organizations,
and activities. The intervention will be developed within the
context of Sioux Indian cultural beliefs and values. The investigators
will help ensure culturally sensitive methods by using Sioux
Indian personnel. The project’s effectiveness will be
measured by changes in donor card completion, driver’s
license designation, and family notification.
Clinical
Interventions To Increase Organ Procurement
In
support of Secretary Thompson’s Gift of Life Donation
Initiative, HRSA launched a new grant program in FY 2002 to
support the evaluation of clinical interventions to increase
the number of heart beating and non-heart beating organ donors.
The program is intended to promote research that will assist
in implementing, evaluating, and disseminating model interventions
with the greatest potential for yielding a verifiable and demonstrable
impact on donation.
Eligible
interventions could focus on new and/or improved methods to
optimize hemodynamic stability in brain dead patients, improve
donor evaluation practices, and investigate time-efficient technologies
to match donor organs with compatible recipients. Additionally,
projects leading to more accurate identification of appropriate
non-heart beating donation candidates, improved methods of donor
stabilization and organ recovery are encouraged. Applicants
must be qualified organ procurement organizations (OPOs) or
other nonprofit, private organizations, which collaborate with
OPOs. Listed below are the awardees for FY 2003.
University
of Pittsburgh
Pittsburgh, Pennsylvania
Principal Investigator: Michael DeVita, MD
Donors After Cardiac Death Validating Identification Criteria
This
project will validate identification criteria that will accurately
recognize potential donors after cardiac death (DCD). It will
also look at post transplant data from DCD donors and validate
the current criteria being used in regard to DCD donors. Study
personnel will identify patients who are undergoing withdrawal
of life sustaining treatments (LST) and obtain demographic characteristics,
physiological data, and note the type of LST being delivered
and withdrawn, as well as the palliative medication delivered.
Funding
Amounts:
Year 1: $226,760
Year 2: $184,807
Year 3: $167,344
Total: $578,911
University
of Miami
Miami, Florida
Principal Investigator: Camillo Ricordi, MD
The Use of Perfluorinated Hydrocarbons During Pancreas Procurement
to Improve Utilization of Cadaveric Marginal and Non-Heart Beating
Donor Organs for Clinical Islet Transplantation
This
project will test whether marginal pancreata from non-heart
beating deceased donors with long ischemic times and who are
greater than 50 years of age can be utilized for clinical islet
transplantation. The proposed project includes the training
of OPO collaborators in this methodology for the preservation
and transport of perfluorocarbon (PFC) cultured pancreata utilizing
sufficient organs to establish significance. The field-testing
of this intervention at collaborating OPO centers will establish
replicability of the procedure on a larger scale.
Funding
Amounts:
Year 1: $472,342.00
Year 2: $638,101.00
Year 3: $933,712.00
Total: $2,044,155.00
University of Pittsburgh
Pittsburgh, Pennsylvania
Principal Investigator: John Kellum, MD
Hemoadsorption to Improve Organ Donor Recovery
The
purpose of this grant is to determine whether short-term attenuation
of the inflammatory response using CytoSorb can reduce pre-explanation
organ dysfunction, and thereby, improve organ recovery in brain-dead
organ donors. The goals of the project are to reduce circulating
cytokine levels in potential organ donors, improve organ function
in those donors, and to increase organ recovery per donor.
Funding
Amounts:
Year 1: $278,614.00
Year 2: $322,903.00
Year 3: $346,408.00
Total: $947,925.00
Trustees of Columbia University
New York, New York
Principal Investigator: Milan Kinkhabwala, MD
Hypothermic Machine Preservation of Liver Grafts for Transplantation
The
aim of this project is to establish the efficacy of continuous
hypothermic machine preservation (HMP) in liver transplantation.
The hypothesis is that HMP will increase the utilization of
existing cadaver livers by improving pretransplant assessment
of the graft, increasing the quality of preservation, and permitting
ex situ pharmacologic manipulation.
Funding
Amounts:
Year 1: $284,244.00
Year 2: $262,267.00
Year 3: $ 82,132.00
Total: $628,643.00
The
Children’s Hospital
Denver, Colorado
Principal Investigator: Mark Boucek, MD
Infant Heart Transplantation from Non-Heart Beating Donors:
A Strategy to Reduce Waiting Mortality
This
project intends to increase infant cardiac donors as a way to
reduce waiting time and waiting mortality by implementing a
non-heart beating donor protocol for cardiac donation in infants
and children. Data from the population of patients receiving
a donor organ from a non-heart beating donor and from a traditional
heart beating donor will be collected. Outcome measures of waiting
mortality and waiting time will be compared to local data contained
within the program transplant database and compared with national
data contained within the Scientific Registry of Transplant
Recipients database.
Funding
Amounts:
Year 1: $ 231,768.00
Year 2: $ 197,003.00
Year 3: $ 162,238.00
Total: $ 591,009.00
