In-hospital systems for organ donation after brain death in Japan: A nation-wide survey-advancing brain-dead organ donation systems in Japan.

Objectives: Brain-dead organ donations in Japan remain significantly fewer than in other countries, highlighting inadequacies in the organ donation system. This study aimed to examine the state of organ donation systems in hospitals that have conducted brain-dead organ donations and to explore potential in-hospital improvements. Methods: Among 148 hospitals that carried out at least one brain-dead organ donation between 2018 and 2023, 84 participated in an anonymous, self-administered online survey, yielding a 57% response rate. Results: A total of 96% of responding hospitals reported having in-hospital donor coordinators (IHCos), with an average of 7.0±6.0. Their IHCo teams included nurses in 98%, physicians in 50%, and administrative staff in 27% of hospitals. A significant positive correlation was observed between the numbers of organ donation options presented and actual organ donations. Hospitals offering more options tended to have six or more IHCos and/or a system for identifying potential donors. Furthermore, hospitals with full-time IHCos had significantly more deceased organ donors. Conclusions: Appropriate allocation of IHCos and the establishment of a system to identify potential donors can enhance the assessment of patients' or their families' willingness to donate organs and support the successful completion of the donation process.