ArticleCritical care (London, England)2025
Relatives' experiences of end-of-life care and organ donation after controlled circulatory death: a national prospective multicenter study.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05041023 (Experience of Relatives and Caregivers of Death in ICU After the Withdrawal of Life-sustaining Therapies, Associated With an Organ Procurement Procedure), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Experience of Relatives and Caregivers of Death in ICU After the Withdrawal of Life-sustaining Therapies, Associated With an Organ Procurement Procedure (Controlled Donation After Circulatory Death).
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe development of controlled donation after circulatory determination (cDCDD) - a promising strategy to improve access to transplantation - raises unique ethical, relational and communication challenges. We aimed to evaluate the psychological outcomes and lived experiences of relatives of potential cDCDD donors.
methodsWe conducted a prospective multicenter study in 32 French ICUs. Relatives of patients identified as potential cDCDD donors following a decision to withdraw life-sustaining measures (WLSM) were recruited. One relative per patient, preferentially the most involved in decision-making, was followed up by structured phone interviews at 3 and 6 months. Outcomes included PTSD symptoms (IES-R, primary endpoint), anxiety and depression (HADS), experience of dying and death (CAESAR), prolonged grief (PG-13), and a study-specific questionnaire on perceptions of end-of-life and organ donation (OD) processes. Two subgroups were defined: OD+, when WLSM was initiated while OD was still considered possible, and OD-, when OD was no longer considered at the time of WLSM.
resultsA total of 159 relatives were included (119 OD+, 40 OD-). Follow-up was completed in 118 relatives at 3 months and 109 at 6 months. At 3 months, one third reported PTSD symptoms, half reported anxiety, and one third depression, with persistence at 6 months for a substantial proportion. Around 10% described a distressing experience of dying and death, and fewer than 10% met criteria for prolonged grief disorder. Psychological outcomes did not differ between OD + and OD - groups. Most relatives felt involved in WLSM and OD discussions, though 80% perceived being asked to authorize donation. Emotional responses were ambivalent, combining reassurance and distress.
conclusionRelatives of potential cDCDD donors experience high levels of psychological distress, but OD discussions did not exacerbate burden. These findings support that cDCDD can be implemented without additional risk for families, while underscoring the need for improved shared decision-making, communication, and emotional support in the ICU.
trial registrationClinicalTrials.gov ID NCT05041023 (First registration date: 2021-09-02).
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