Association Between Exclusive Intrahospital Organ Donation Committees and Donation Effectiveness in Rio de Janeiro, Brazil: A 5-Year Retrospective Study.

INTRODUCTION

Organ donation in Brazil faces persistent challenges related to early identification of potential donors, adequate clinical maintenance, and reduction of avoidable losses. Intrahospital Organ and Tissue Donation Committees for Transplants (CIHDOTT) were established as an internal organizational strategy, but gaps remain regarding the real impact of exclusively dedicated teams.

METHODS

Retrospective quantitative study analyzing secondary data from the Rio de Janeiro State Transplant Center (2020-2024). Institutions were classified as exclusive CIHDOTT, nonexclusive CIHDOTT, or no CIHDOTT. One-way ANOVA, Tukey HSD, linear regression, Holt-Winters forecasting, and binary logistic regression (forced entry; reference: No CIHDOTT) were performed using Python 3.10 in Google Colab.

RESULTS

Hospitals with exclusive CIHDOTT achieved a mean effectiveness rate of 37.50% vs 25.60% for nonexclusive CIHDOTT and 25.70% for hospitals without CIHDOTT. ANOVA confirmed statistically significant group differences (F = 19.32; P < .001). Notifications from exclusive CIHDOTT hospitals had 1.69 times greater odds of resulting in effective donations compared with no-CIHDOTT hospitals (odds ratios = 1.69; 95% CI: 1.47-1.95; P < .001). Nonexclusive CIHDOTT showed no significant difference from no-CIHDOTT (odds ratios = 0.98; P = .790). Linear regression confirmed a sustained positive trend in the exclusive group (β = 33.2; R² = 0.965).

DISCUSSION: These findings reinforce the structuring role of exclusive dedication in clinical surveillance, brain death protocol management, and family approach, converging with national and international evidence.

CONCLUSION

Exclusive CIHDOTT constitutes a relevant institutional factor for increasing donation effectiveness, with potential to guide state and national policies aligned with Pan American Health Organization guidelines and the 2030 Agenda.