Compared to other European countires, Greece is lagging far behind in the field of organ donation after brain death, has not developed a DCD program and end-of-life practices  are not formally applied. The purpose of this study is to investigate the training level and the attitude of critical care professionals concerning the current national practices of deceased organ donation as long as the future perspectives of implementing end-of-life practices and donation after circulatory death (DCD).

Critical care professionals from 10 Intensive Care Units (ICU) in Greece were asked to answer voluntarily and anonymously an electronic questionnaire after participating in a dedicated lecture concerning present and future practices of deceased organ donation. The questionnaire was based on the hospital attitude survey (HAS) of the Donor Action (DA) program adjusted to the Greek situation.

Two hundred fifty critical care professionals (CCPs) answered the questionnaire (57% nurses and 43% doctors). The majority of the participants support organ donation (95%). However, only half of the participants have received formal education on organ donation processes and have participated in a discussion with families concerning brain death and organ donation or have knowledge of the Greek legal framework on deceased organ donation. Self-reported confidence levels regarding brain death testing and family discussion are reported as low in 35% of the participants and 92% of CCPs express the need for dedicated educational workshops in hospitals. Eighty percent of CCPs think it is acceptable to admit a patient with the sole purpose of organ donation. Although the majority of CCPs acknowledge the futility in continuation of life support treatment (LST) in certain ICU patients and feel comfortable about withdrawal of life support measures, they are reluctant in performing it due to lack of legal framework. However, twenty percent believe that withdrawal of LST is equal to euthanasia. Almost all CCPs report the need for implementation of end-of-life practices in ICU. Seventy five percent of the participants agree with donation after controlled circulatory death and support that organ donation should be considered in end-of-life procedures.

This is the first study to investigate the knowledge and attitude of CCPs in Greece towards brain death and deceased organ donation practices. Despite the positive attitude towards organ donation, a low level of knowledge and confidence in participating in organ donation procedures is reported. In addition, the need of formation of legal framework and protocols concerning end-of-life practices are reported to be  necessary and important to perform withdrawal of LST in certain ICU patients. Although DCD is not applied in Greece, the majority of CCPs agree with its implementation and support that organ donation should be considered in end-of-life procedures. Finally, the need of educational workshops on brain death and organ donation is raised.