Specific Family Refusal to Donate Bones for Transplantation

Introduction:  Bone tissue is used in patients who need bone repair or reconstruction and in dental procedures.

Objectives:  To analyze the factors associated with and the trend of specific refusal of bone donation by an organ procurement organization in the state of São Paulo, Brazil.

Methods:  A cross-sectional study was conducted using data from 1,713 organ and tissue donation authorization forms from 2001 to 2020, provided by an organ procurement organization in the city of São Paulo. The study variables were year, age group, sex, cause of death, type of hospital, and donated and refused bones. The analysis was conducted using both descriptive and inferential statistics, employing chi-square tests, trend analysis, linear regression, and multiple logistic regression.

Results:  Bone donation was refused in 896 (52.30%) of effective donors, the majority of whom were male (513; 57.2%; p = 0.009) and aged 41 to 59 years (372; 41.5%; p = 0.018). From 2001 to 2009, there was a downward trend in bone donation refusals in the 0 to 11 and 12 to 19 age groups; however, there was an upward trend in refusals among those aged ≥ 60 years. In the period from 2010 to 2020, the trend of refusals remained decreasing in the age group from 0 to 11 years. From 2001 to 2020, the chance of people refusing bone donation was 24% lower in males (p = 0.001), 30% lower in the 20 to 40 age group (p = 0.017), 46% lower in the 41-59 age group (p < 0.001), and 51% lower in the ≥ 60 age group (p < 0.001).

Conclusion:  Over the last few years, there has been a decrease in the rate of refusal to donate bones. However, strategies targeting age groups involving young adults should be implemented, as they present higher refusal rates.

Descriptors
Tissue and Organ Procurement; Tissue Donors; Bone and Bones; Bone Banks; Nursing