Doctors should not be taking it on themselves to ask bereaved families for consent to use their loved one's organs for transplants, a study suggests.
Instead, the John Radcliffe Hospital research said consent was more likely to be given if a doctor was accompanied by a specialist transplant coordinator.
The study also said discussing donation at a separate time to informing the relative about death was important.
Transplant officials said the findings should inform hospital practice.
The refusing of consent by families, even when a person is on the donor register, is a major problem for the NHS.
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