Beyond Consent: The Family Bereavement Trajectory Following Deceased Organ Donation

Background: Family members play a central role in decision-making for deceased organ donation and are directly affected by the donation process. Although qualitative studies h4ave explored these experiences, a comprehensive synthesis of family perspectives on post-donation experiences and attitudes remains limited.
Objective:  To systematically synthesize qualitative evidence on family perspectives regarding deceased organ donation, focusing on decision-making processes, post-donation experiences, and associated attitudes.
Methods: Five databases (PubMed, Web of Science, Embase, CINAHL, ProQuest) were searched from inception to Oct 13, 2025. Methodological quality was appraised using the JBI checklist. Data were synthesized using a meta-aggregative approach. 
Results: 9 studies involving 364 family members from 7 countries were included. Four synthesized findings were identified: (1) Decision-Making Under Emotional and Situational Complexity; (2) Meaning-Making and Moral Framing in the Consent Process; (3) Complex and Dual Emotional Outcomes Following Donation; and (4) Unmet Support Needs and System-Level Gaps.
Conclusions: Family experiences of deceased organ donation are shaped by the interaction of emotional, relational, and systemic factors. While donation may support meaning-making, its benefits depend on the quality of communication and continuity of care. Strengthening family-centered communication and establishing structured post-donation support systems are essential to improving family outcomes.