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Hospital barriers to the procurement of cadaveric kidneys for transplantation Gabel, Gwenda Bonita

Abstract

Several studies have shown that hospital-based procurement programs fail to secure sufficient donor kidneys in-house. This study examines the institutional and knowledge barriers to the procurement of donor kidneys for a typical urban teaching hospital and the reasons for the failure. A combination of documentary examination, survey and interview methodologies were used to achieve study objectives. Hospital personnel, mostly those in contact with the donation process, constituted the study population, in particular, nursing personnel, physicians and hospital administrators. It was found that (1) gaps exist in the procurement process, i.e. not all the donor kidneys were accessed under existing policies and guidelines; (2) major institutional and knowledge barriers exist which inhibit the procurement process. For example, institutional policies and procedures lacked clarity, definition or were non-formalized. Also relevant hospital personnel were unable to identify all suitable donors. This study adds to our knowledge of impediments to the donor kidney procurement process. It highlights the need to formalize, clarify and define institutional policies and to provide adequate knowledge to relevant staff of the institution. The study also indicates a need for coordination of the donation process in order to secure adequate numbers of donor kidneys.

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