Brain Death and Organ Donation in Romania: A Nationwide Survey of Intensivists’ Perceptions and Clinical Practices

Overview

This nationwide cross-sectional survey evaluated intensive care physicians' knowledge, attitudes, and clinical practices regarding brain death determination, family communication, and organ donation pathways in Romania. The investigation targeted intensivists as primary stakeholders in donor identification processes, examining their perceptions of system-level barriers and identifying modifiable factors relevant to transplant policy development within a transitional healthcare system characterized by persistent organ supply-demand mismatch.

Methods and approach

A prospective questionnaire-based survey was administered to intensive care physicians across Romania through the Romanian Society of Anesthesia and Intensive Care. The structured instrument assessed knowledge and attitudes regarding brain death diagnostic criteria, family communication competencies, involvement in donation processes, ethical considerations, and organizational aspects of the transplant system. Descriptive exploratory analyses were performed on survey responses from participating ICU physicians.

Key Findings

One hundred seventeen ICU physicians participated with mean age 41.0 years. Substantial agreement existed regarding brain death diagnostic criteria (84.6%) and protocol clarity (83%). However, respondents perceived managing approximately 8.25 brain-dead patients annually and identified marked deficiencies: 69.3% considered their communication competencies insufficient, and only 38.5% of ICUs prioritized organ procurement. Family consent was regarded as decisive in donation decisions by 77.8% of respondents. Support emerged for systemic interventions including national donor registry establishment (87%) and donor card implementation (77%).

Implications

The survey identifies multifactorial constraints limiting organ donation performance in the Romanian healthcare system. Educational deficits in communication competencies, inconsistent institutional prioritization of procurement activities, and variable implementation of structured training protocols constitute significant barriers to optimizing donor identification and family engagement.

Disclosure

Key points

• Research title: Brain Death and Organ Donation in Romania: A Nationwide Survey of Intensivists’ Perceptions and Clinical Practices
• Authors: Alberto Emanuel Bacușcă, Grigore Tinică, Alexandru Burlacu, Andrei Țăruș, Domnica Bacușcă, Mihail Enache, Agnes Bacușcă, Bianca Hanganu, Cristina Gavriluță, Mariana Cuceu
• Institutions: Alexandru Ioan Cuza University, Cardiovascular Institute of the South, Grigore T. Popa University of Medicine and Pharmacy, Institutul Regional de Oncologie
• Publication date: 2026-02-26
• DOI: https://doi.org/10.3390/jcm15051769
• OpenAlex record: View
• PDF: Download
• Image credit: Photo by Thirdman on Pexels (Source • License)
• Disclosure: This post was generated by Claude (Anthropic). The original authors did not write or review this post.