A face-to-face interview is often not possible for logistical reasons. 10. Report on activities during 1993–1997.] Experiences of the North Rhine Westphalia Lions Cornea Bank 1995 and 1996]. Registered users can save articles, searches, and manage email alerts. Compliance with the time between death and the recovery request (8 hr on average in our series) is a favorable factor, as some authors had stressed (8,11). to maintaining your privacy and will not share your personal information without may email you for journal alerts and information, but is committed If an answering machine was on, the coordinator left no message but repeated the call every hour. There were a certain number of families (24.1%) who could not be reached by telephone within our 18-hr deadline, either because they were away from home when the repeated calls were made, or because no number was listed in the administrative file. JAMA 1995; 273 (6): 504. The cornea is the clear dome-like window covering the front of the eye that allows the light to pass through to the retina, and enables us to see. The coordinator listed patients having died the previous day in the five departments of Saint-Etienne University Hospital having particularly high rates of mortality: casualty, internal medicine; pneumology; gastroenterology; dermatology. J Fr Ophtalmol 1997; 20 (1): 25. He left his fixed-line or cell phone number to be called back, where relevant. Obtaining consent was fully delegated to one coordinator (JLP), an experienced nursing manager who had received specific training in cornea recovery and grafting, dispensed by the ophthalmology department and the Etablissement Français des Greffes. Harvesting was performed in the 24 hr after the heart stopped. The coordinator first introduced himself as a “member of the hospital staff,” without specifying whether he was a physician, and said he wished to “meet the family of the deceased.” If this meeting was declined, he then carried out the procedure to obtain consent by telephone. In our institution, half of our grafted corneas are obtained using this method. Five families called by telephone said they were shocked (2.6%, 5/192) as did five families in the face-to-face interview (3.5%, 5/142). Telephone interview is an effective method for obtaining consent to cornea donation. In 1905, the cornea became the first solid tissue ever to be transplanted successfully (1). An eye bank are nonprofit organizations that obtain, medically evaluate, process, preserve and distribute eyes/corneas for use in corneal transplantation, research and education. In the case of multiorgan recoveries, consent was always obtained after a face-to-face interview with the family. 30 mins. It is one of the most frequently performed human transplant procedures. [Corneoscleral transplant excision in the cadaver. The white part - sclera - can be used for glaucoma treatment. A plan to increase public commitment to organ donation [see comments]. Get new journal Tables of Contents sent right to your email inbox, March 27th, 2002 - Volume 73 - Issue 6 - p 926-929, Obtaining cornea donation consent by telephone, Articles in Google Scholar by Philippe Gain, Other articles in this journal by Philippe Gain, Changing Indications in Penetrating Keratoplasty: A Systematic Review of 34 Years of Global Reporting, “Effective” Requesting: A Scoping Review of the Literature on Asking Families to Consent to Organ and Tissue Donation, The Role of Specifically Tailored Communication Training Among Factors Influencing Consent for Cornea Donation Requested Via Telephone, Risk Factors for Human Corneal Graft Failure Within the Australian Corneal Graft Registry, How Effective Is Penetrating Corneal Transplantation? The manner in which a person dies determines what organs and tissues can be donated. This keeps the exchange anonymous because the identities of donor families and recipients are kept strictly confidential. No person contacted by telephone terminated the interview. He finally mentioned the possibility that the removed corneas would not be grafted, if they failed a quality control. Cornea 2000; 19 (1): 12. Reasons for not contacting the family (n=332), Rate of success in obtaining consent to cornea removal, according to the method of interview, Rate of success in obtaining consent to cornea removal of different series in the literature. We compared the acceptance rates according to the method of obtaining consent. Saving Sight serves as an intermediary, accepting correspondence from transplant recipients and donor families and then forwarding these letters to the appropriate parties. The percentage of persons shocked by the telephone call was nevertheless very small (2.6%) and no higher than that recorded in the face-to-face interviews. There were 197 men (59%) and 137 women (41%). It should be stressed that in our series no logistical difficulty was caused by the unavailability of ophthalmology staff or rooms for harvesting. We would emphasize the need to make the request gradually, and to say at the outset that we wish to meet the family. Over the last century, corneal transplantation has evolved into an array of techniques focused on the selective replacement of diseased layers of the cornea, tailored specifically to the underlying pathologic condition causing the corneal dysfunction. (4), nor tape recorded. When conducted in a structured and diplomatic manner, it obtains acceptance in a high number of cases. We carried out a prospective study of the effectiveness of telephone contact in obtaining donation consent. Three people never called back the coordinator. The respondent was also offered the possibility of calling the coordinator 1 month later to discover the outcome of the recovery (graft or no graft), while maintaining the recipient’s anonymity. Aust NZ J Ophthalmol 1990; 18 (1): 77. 3. Arch Intern Med 1996; 156 (21): 2419. The item(s) has been successfully added to ", This article has been saved into your User Account, in the Favorites area, under the new folder. Transplantation73(6):926-929, March 27th, 2002. Acceptance of donation was obtained from 66.5% of the families contacted (222/334). 4 Address correspondence to: Philippe Gain, MD, PhD, Service d’Ophtalmologie, CHU de Saint-Etienne, 42055 Saint-Etienne Cedex, France. (8) but only in the face-to-face interview with families, as it enabled some families to reconsider an initially negative response. A lower acceptance rate by telephone than in face-to-face interview is not surprising however, as relations are obviously established less well than in person. For more information, please refer to our Privacy Policy. In 2% of cases (4/192), family was geographically distant and was not coming to the hospital. Delbosc B, Boissier F. [French Directory of Eye Banks. Cornea donation process comes up against difficulties in obtaining families’ consent. For non-heart-beating donors only, if a face-to-face meeting could not be held during the first 12 hr (family geographically distant or having already returned home), the family was contacted by telephone. Conversely, the medical team sometimes guided the coordinator to families with whom it had enjoyed excellent relations. On the contrary, some authors consider suspicion of the medical profession as a factor in refusal (12). 6. After this consideration time, the acceptance rate rose to 68.1% of cases (92/135) (P <0.001). Minors and adults subject to legal protection were excluded, except in one case when corneas were recovered from a 16-year-old boy as requested by his family. Peters TG, Kittur DS, McGaw LJ, Roy MRS, Nelson EW. It is the main focusing element of the eye. Williams KA, White MA, Badenoch PR, et al. Please enable scripts and reload this page. The transplantation process depends upon the pricesless gift of corneal donation from one human being to another. After the telephone interview the respondent’s identity, relationship to the deceased, and the reason for his possible refusal, were recorded in the file. Donor cornea procurement: six-year review of the role of the eye bank in South Australia. The reasons for telephoning were in 85% of cases (163/192) the family’s absence during the coordinator’s working hours, or the family returning home at the moment the coordinator was informed of the death. We therefore believed it to be legitimate to telephone to make contact, and to study the effectiveness of this means of obtaining consent to cornea donation. The coordinator then directly requested the respondent’s consent, and offered time to consider, if necessary. Vision will be dramatically reduced if the cornea becomes cloudy from disease, injury or infection. Obtaining consent for eye donation. The procurement request was part of a wider request to recover other organs or tissues, which we believed was not desirable to conduct by telephone. The corneas were harvested by corneoscleral excision with 2 mm of sclera, in the authorized premises of our hospital, by one of the department’s four ophthalmology residents. French law requires that all means must be implemented to obtain consent to cornea donation, but does not demand face-to-face contact or written consent. How successful is corneal transplantation? Gain, Philippe1 4; Thuret, Gilles1; Loup Pugniet, Jean2; Rizzi, Patricia1; Acquart, Sophie3; Claude Le Petit, Jean4; Maugery, Jean1, Department of Ophthalmology and Hospital coordination team, Bellevue Hospital, Saint-Etienne, France; French Blood Center-Corneal Bank, Saint-Etienne, France. Although we had recourse to the telephone interview in more than half the cases (57.5%), our overall rate of cornea-donation acceptance (66.5%) remains high compared with some series in the literature (3–7). Comparisons of the acceptance rates according to the method of obtaining consent, and comparisons of our series’ results and those in the literature, were performed using a nonparametric test of χ2 with P <0.05 considered as significant. Of these logistical problems, the main obstacle is the inability to meet the family in person. To our knowledge, this is the first study to analyze the efficiency of the telephone in obtaining consent to recover corneas with a view to grafts. Indeed on the telephone, the coordinator offered to meet the family if they so wished. This proposal was always declined, as no family returned to the hospital. Over 90 perecent of all corneal transplants are successful and restore the recipient's vision. Mandated choice. In no case did we use this method of obtaining consent if it was possible to meet the family in person. The donor’s eyes are then prepared for the procedure to recover the cornea. The eye bank facilitates this important process. The telephone interview was conducted as follows. It is a disorder that results from the cornea becoming clouded, causing blindness. He explained that only the “simple translucent membrane at the front of the eye” would be removed, and would not “destroy the gaze,” that the removal would be completely invisible and performed by an ophthalmologist, without saying that it would be a resident. Explicitly addressing these points, coupled with the coordinator’s independence from the tissue-allocation procedure, were liable to increase the acceptance rate in our series by winning families’ trust. The ability to call back the coordinator directly in his office or on his cell phone, thus avoiding distressing holds at the hospital switchboard, is in our view extremely important. No one contacted by telephone wished to come or return to the hospital to meet the coordinator. Organ-culture at 31°C, securitization, quality control, and cornea traceability procedures were performed by staff of the cornea bank of the French Blood Center (Auvergne-Loire regional branch).

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