Consenting to cornea donation:: influencing factors

Background: The purpose of the study was to determine factors influencing the decision of the next relative being asked for consent to cornea donation in a prospective, non-comparative case series. Methods: Interviews with the relatives of 264 potential cornea donors to the eye bank of the Ludwig-Maximilians-Universitat, Munich, were documented following a standardized protocol. The influence of sociological factors on the frequency of obtained consents was investigated by uni- and multivariate analysis. Results: During a 9-month period, 214 relatives of 264 possible donors were interviewed for consent to cornea donation. In total, 144 consents (67%) and 70 refusals (33%) were obtained; 50 relatives could not be reached. Analysis showed a higher consent rate for donors with a university degree (72%) versus those without (68%). Consent was more often obtained from relatives of donors that were divorced (71%) than from unmarried ones (63%). Husband and wife (71%) consented more frequently to cornea donation than children of age (62%) or parents (58%). Examination of residential area postal codes indicated more frequent refusals from donors of rural (56% consent rate) than urban Munich populations (67% consent rate). The situation was the opposite concerning the residential area of the consenting relative. Postal codes of both the donor and the relative were statistically significant factors in a multiple logistic regression model. There was relatively high willingness to donate in suicides (70%), but not significantly different from other causes like natural deaths (70%) and traffic accidents (66%). Conclusions: Some socioeconomic factors such as - in particular - the permanent address of the potential donors and their relatives reflecting a different background and status play an important role in the willingness to donate. A better understanding of this decision making can help the physician to ask more empathically for consent and inform the public more specifically about the donation process.