論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Sequence and timing of organ donation discussions in brain-dead donors: a subanalysis of the J-RESPECT study.
掲載誌名	正式名：Journal of intensive care 略　 称：J Intensive Care ISSNコード：20520492/20520492
掲載区分	国外
巻・号・頁	14(1),pp.76
著者・共著者	Tetsuya Yumoto, Hiromichi Naito, Mineji Hayakawa, Shoji Yokobori, Kei Nishiyama, Takahiro Atsumi, Osamu Tasaki, Junya Tsurukiri, Mariko Hayamizu, Shimon Murahashi, Munehiro Hayashi, Takeshi Nishimura, Yukari Goto, Hiromichi Narumiya, Atsushi Mizutani, Mamoru Miyajima, Junya Shimazaki, Takeshi Miura, Nozomu Shima, Kazuki Deuchi, Hitomi Nakayasu, Hitoshi Kano, Takashi Yorifuji, Atsunori Nakao,
発行年月	2026/07
概要	BACKGROUND:The optimal timing of organ donation discussions in patients with catastrophic brain injury remains unclear. In Japan, national guidance recommends providing information after recognition of a state compatible with brain death; however, real-world practice has not been well characterized. This study aimed to evaluate the sequence of organ donation option presentation relative to clinical determination of a brain death-compatible state and to assess option presentation timing.METHODS:We conducted a multicenter retrospective cohort study using data from the J-RESPECT study, including adult brain-dead donors from 16 institutions in Japan between 2010 and 2023. Donors were classified as brain death-first (option presented after clinical determination of a brain death-compatible state) or option-first (option presented before such determination). Mixed-effects logistic and linear regression models with random intercepts for institution were used to examine factors associated with presentation sequence and timing.RESULTS:Among 190 donors, 76 (40%) were classified as brain death-first and 114 (60%) as option-first. In mixed-effects logistic regression, age was the only independent factor associated with presentation sequence (adjusted OR 1.03 per year, 95% CI 1.00-1.07), while substantial between-institution variability was observed (intraclass correlation coefficient = 0.32). Institutional timing policy was not significantly associated with presentation sequence. The median interval from admission to option presentation was 5 days in the brain death-first group and 2 days in the option-first group (p < 0.001).CONCLUSIONS:Substantial inter-institutional variability exists in the sequence and timing of organ donation discussions in Japan. Further studies are needed to determine optimal approaches to organ donation communication and timing in clinical practice.
DOI	10.1186/s40560-026-00905-3
文献番号	WOS:001857880300001
PMID	42642790