Disparities in Brain Death Certification Knowledge among Indian Physicians Involved in Organ Donation

Abstract

Background: Brainstem death certification (BDC) is a fundamental process in the organ donation workflow, serving as a prerequisite for the ethical and legal procurement of organs from deceased donors. Aims/Objectives: This survey studies the current practices and knowledge gaps in BDC among the physicians involved in organ donation in India. Methods: An online survey was performed using the application 'Google Forms'. The link to the questionnaire was distributed to physicians involved in organ donation in India via personal email and social media platforms. Results: We received 177 responses out of 500 (35.4%). The majority of respondents were neurosurgeons (63.8%), predominantly male (82.2%), aged 30-40 years (35.1%), and employed in teaching hospitals (74.5%). Less than half (41.8%) received BDC training during MBBS; only 10% of respondents frequently trained residents in BDC. Lack of public awareness (62.1%) and family refusal (62.1%) were major barriers to organ donation; 43.5% cited an absence of transplant facilities for low organ donation rates. Over 80% followed an observation period during brain death examination; 48% did not screen for drugs/toxins; 40% considered elevated body temperature a contraindication to BDC. 96% were aware of apnea tests, and 40.7% identified the need for ancillary tests; 18.1% routinely performed them. No correlation existed between specialty/gender and BDC cases; seniority influenced higher caseloads (over 20 annually). Most physicians (58.20%) believe 2-3 doctors are sufficient for BDC. Conclusions: It is crucial to address gaps in the knowledge and practices of BDC among physicians to enhance organ donation rates in India.