In the initial period following the implementation of the Organ Transplant Act, the number of brain-dead donors fell to 36 in 2002. However, this number began to rise after the Brain Death Presumed Declaration System was introduced in 2011, reaching 368 cases that year, 573 cases in 2016, and maintaining an annual count of over 400 brain-dead organ donations over the last decade [1]. The role of organ transplant coordinators has evolved to become more specialized and demanding, encompassing not only direct care tasks such as assessing brain-dead patients and counseling families but also handling administrative responsibilities due to changes in laws and regulations [2]. These changes have led to an increased demand for highly specialized organ transplant coordinators.

Korea is divided into three regions: the central, southwest, and southeast. As of 2022, there are 36 hospital-based organ procurement organizations (HOPOs) that specialize in managing brain-dead patients, and 75 hospitals have contracts with the Korea Organ Donation Agency (KODA) to manage brain-dead patients and provide organ transplants [3]. The Enforcement Decree of the Organ Transplant Act mandates that each transplant facility employ at least one nurse and one social worker dedicated to consultations and communications related to organ procurement and transplantation [4]. However, while the law clearly outlines some responsibilities of organ procurement nurses, it does not provide a comprehensive legislative framework covering the full range of their duties, nor does it establish a standardized education system. Furthermore, despite the highly specialized nature of managing brain-dead donors and facilitating organ transplants, which requires professional expertise, organ transplant coordinators primarily rely on training from their respective facilities or hospitals. This training often lacks a systematic and standardized educational protocol. The management of brain-dead donors and organ transplants involves not just a single facility or hospital but also necessitates prompt and coordinated action among multiple facilities. Therefore, the establishment of clear operational guidelines and a structured, standardized training program could improve work efficiency and ensure the quality of healthcare services.

Kim et al. [2] and Byun et al. [5] conducted job analyses for organ transplant coordinators in Korea in 2003 and 2014, respectively. However, due to the significant increase in organ transplants over the past decade and the growing complexity and diversity of the tasks involved, there is a need to reanalyze the current job functions. Similarly, organ transplant coordinators, such as new graduate nurses who experience high turnover rates due to work adjustment difficulties (52.8% compared to the average of 15.8% among nurses in Korea) [6], face challenges in adapting to their roles. Despite these similarities, research on this topic remains sparse.

Against this backdrop, this study aimed to analyze the current workforce and tasks of organ transplant coordinators in Korea, focusing on those managing brain-dead donors and organ transplants and having the ultimate goal of enhancing coordinators’ competency through efficient work coordination and expertise development. The findings of this study will provide foundational data for creating a robust work system, establishing qualification standards, developing comprehensive manuals with appropriate compensation, and designing standardized educational curricula. These measures are intended to prevent burnout and improve the expertise of coordinators. The specific objectives are as follows: (1) to identify the general characteristics of organ transplant coordinators; (2) to assess the criticality, difficulty, and frequency of tasks performed by organ transplant coordinators; and (3) to compare the criticality, difficulty, and frequency of tasks according to the general characteristics of organ transplant coordinators.

The content and methodology of the study received approval from the Institutional Review Board (IRB) at Gangnam Severance Hospital (IRB No.3-2023-0146). All participants were asked to read the research purpose and methods provided at the beginning of the survey, and only those who agreed to participate in the study voluntarily participated in the study. Since this was an online survey, written consent was not obtained.

Study Design

This descriptive survey investigated the current workforce of organ transplant coordinators to assess the criticality, difficulty, and frequency of their tasks. The study specifically targeted nurses working as organ transplant coordinators at HOPOs or hospitals affiliated with KODA.

Description of Participants and Data Collection

The participants were recruited from the Korea Organ Transplant Coordinator Organization (KOTCO). An email was sent to its members, detailing the study’s purpose, content, procedures, confidentiality measures, and the participants’ freedom to withdraw. An online survey was conducted from July 11, 2023, to August 4, 2023, involving members who consented to participate. As of July 2023, 120 out of the 150 organ transplant coordinators registered with KOTCO had completed the survey. However, 13 coordinators who solely managed brain-dead donors and organ retrieval at KODA, and did not engage in transplantation-related tasks, were excluded. Therefore, the study ultimately included 107 participants.

Instruments for Job Analysis

Developing A Curriculum (DACUM) is a methodology used to identify the specific duties and tasks required for a job, as well as to analyze the necessary knowledge, skills, attitudes, and emerging trends [7]. The DACUM process enables rapid, high-quality job analysis by conducting workshops with healthcare industry experts who possess a deep understanding of the role [7]. The role of organ transplant coordinators was analyzed using the DACUM method from December 16, 2022 to May 23, 2023. This analysis revisited the changes in the tasks of coordinators managing brain-dead donors and organ transplantation over the past decade, based on the results of a previous job analysis conducted in 2014 [3]. The analysis also assessed the addition or removal of certain tasks due to legislative changes. The analysis team included three experienced organ transplant coordinators and one nursing professor, who identified five duties, 13 tasks, and 84 task elements. Content validity was evaluated by eight organ transplant coordinators. As a result of this process, one task and 13 task elements were added, bringing the total to five duties, 14 tasks, and 97 task elements (Supplementary Tables 1–3).

In the role of organ transplant coordinators, considering 97 elements, a higher score reflects a greater level of criticality (range, 1–4), difficulty (range, 1–4), and frequency (range, 0–3). The reliability of the instruments used to measure criticality, difficulty, and frequency was confirmed by Cronbach’s α values of 0.976, 0.987, and 0.977, respectively.

General Characteristics

The general characteristics of the participants encompassed age, sex, education level, years of experience as a coordinator, hospital size, type of facility, the nature of the coordinator's role (dual or exclusive), number of coordinators at the facility, region, salary satisfaction, primary responsibilities, the total number of transplants performed at the facility, and the total number of organs managed.

Data Analysis

Data were analyzed using SPSS ver. 21.0 (IBM Corp.). The general characteristics of the participants were analyzed and presented as actual numbers with percentages, along with means and standard deviations. The criticality, difficulty, and frequency of job tasks were also presented as means and standard deviations. Differences in the criticality, difficulty, and frequency of job tasks according to general characteristics were analyzed using the independent t-test and analysis of variance, followed by a Scheffé post hoc comparison.

Table 1 presents the general characteristics of the participants. The mean age was 39.29 years, and 97.2% were female. The most common career lengths were <3 years (29.9%) and ≥10 years (29.0%). The majority of participants (81.3%) exclusively worked as organ transplant coordinators, whereas 18.7% performed dual roles. Notably, 58 participants (54.2%) managed both transplantation and brain-dead donors. Most participants handled a total of 30 or fewer transplant cases per year (50.5%), and 39.6% were responsible for managing two or more organs (Table 1). Supplementary Table 4 provides detailed career information for organ transplant coordinators in 1-year increments.

Table 1. Characteristics of the organ transplantation coordinators

Characteristic	Value (n=107)
Age (yr)	39.29±7.50 (25–59)
≤29	9 (8.4)
30–39	44 (41.1)
40–49	46 (43.0)
≥50	8 (7.5)
Sex	-
Female	104 (97.2)
Male	3 (2.8)
Education
College/University	64 (60.4)
Postgraduate	42 (39.6)
Data not available	1 (0.9)
Career length of coordinator (yr)
<3	32 (29.9)
3–5	25 (23.4)
6–9	19 (17.8)
≥10	31 (29.0)
No. of hospital beds
<700	13 (12.1)
≥700	94 (87.9)
Type of workplace
HOPO	70 (65.4)
Transplant medical institution (contracting agency)	37 (34.6)
Type of job
Concurrent position	20 (18.7)
Exclusive position	87 (81.3)
No. of coworkers	3.47±2.44 (1–10)
1	20 (18.7)
2	39 (36.4)
3–5	17 (15.9)
6–10	31 (29.0)
Regiona)
Zone 1	72 (67.3)
Zone 2	11 (10.3)
Zone 3	24 (22.4)
Satisfaction with salary
Satisfaction	15 (14.0)
Average	44 (41.1)
Insufficient/very insufficient	48 (44.9)
Main task
Transplantation	45 (42.1)
Brain death management	4 (3.7)
Transplantation and brain death management	58 (54.2)
Total number of transplants (per year)
<10	21 (19.6)
11–20	13 (12.1)
21–29	19 (17.8)
≥30	54 (50.5)
Total number of transplant organs within the scope of the coordinator’s responsibility
1	34 (33.7)
2	40 (39.6)
3–5	27 (26.7)
Data not available	6 (5.6)

Values are presented as mean±standard deviation or number (%).

HOPO, hospital-based organ procurement organization.

^a)Zone 1: Seoul, Gyeonggi-do, Gangwon-do, Jeju. Zone 2: Chungcheong-do, Jeolla-do. Zone 3: Gyeongsang-do.

Table 2 presents the levels of criticality, difficulty, and frequency for each duty and task. The most critical duty identified for organ transplant coordinators was donor management (3.83/4), followed by recipient management (3.76/4), organ transplantation administration (3.67/4), facilitation of organ donation (3.50/4), and professional development (3.40/4). The most difficult duty was professional development (3.00/4), followed by organ transplantation administration (2.98/4), facilitation of organ donation (2.95/4), donor management (2.90/4), and recipient management (2.83/4). The most frequently performed duty was recipient management (2.50/3), followed by organ transplantation administration (2.06/3), donor management (1.99/3), professional development (1.76/3), and facilitation of organ donation (1.50/3).

Table 2. Degree of criticality, difficulty, and frequency of each duty and task (n=107)

Duty/task		Criticality	Difficulty	Frequency
Total		3.74±0.25	2.91±0.44	2.08±0.55
A. Recipient management		3.76±0.24	2.83±0.49	2.50±0.58
	A1. Pretransplant management	3.81±0.23	2.83±0.48	2.52±0.67
	A2. Posttransplant management	3.65±0.37	2.76±0.55	2.46±0.70
	A3. Waiting list management	3.79±0.30	2.82±0.54	2.57±0.63
	A4. Coordination of organ recovery	3.86±0.34	3.06±0.83	2.26±0.88
B. Donor management		3.83±0.23	2.90±0.54	1.99±0.77
	B1. Living donor pretransplant management	3.84±0.26	2.84±0.59	2.45±0.79
	B2. Living donor posttransplant management	3.73±0.40	2.71±0.61	2.23±0.88
	B3. Brain death donor determine and transfer	3.88±0.23	2.99±0.61	1.80±0.84
	B4. Process of confirmation of brain	3.82±0.36	2.97±0.62	1.78±1.06
	B5. Organ Procurement process	3.76±0.38	2.81±0.61	1.67±0.98
	B6. Management after organ procurement	3.76±0.37	2.78±0.68	1.48±1.08
C. Organ donation activation management		3.50±0.58	2.95±0.62	1.50±0.75
	C1. Public information and education	3.50±0.58	2.95±0.62	1.50±0.75
D. Organ transplantation administration		3.67±0.42	2.98±0.51	2.06±0.71
	D1. Data management	3.65±0.49	2.55±0.59	2.41±0.77
	D2. Administration process management	3.69±0.42	3.28±0.56	1.81±0.87
E. Professional capability development		3.40±0.55	3.00±0.54	1.76±0.69
	E1. Research, education, self‐development	3.40±0.55	3.00±0.54	1.76±0.69

Values are presented as mean±standard deviation.

The criticality assigned to the role of facilitating organ donation varied by age and the primary responsibilities of the organ transplant coordinators. Furthermore, the perceived importance of administrative duties showed significant differences based on sex (Table 3).

Table 3. Differences in importance according to the participants’ general and job-related characteristics (n=107)

Variable	Total			Recipient management			Donor management			Organ donation activation management			Organ transplantation administration			Professional capability development
	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value
Age (yr)		1.818	0.149		1.533	0.210		1.399	0.247		3.413	0.020		0.615	0.607		1.685	0.175
≤29	3.72±0.14			3.71±0.23			3.81±0.14			3.10±0.67			3.76±0.24			3.38±0.40	1.685
30–39	3.68±0.28			3.72±0.27			3.78±0.26			3.39±0.65			3.61±0.47			3.27±0.64	(0.175)
40–49	3.80±0.22			3.82±0.22			3.88±0.21			3.68±0.43			3.71±0.38			3.53±0.44	-
≥50	3.76±0.31			3.74±0.28			3.86±0.27			3.53±0.56			3.60±0.54			3.43±0.59	-
Sex		0.968	0.335		0.164	0.870		1.103	0.273		0.761	0.449		1.989	0.049		–0.236	0.814
Female	3.74±0.25			3.76±0.25			3.83±0.23			3.51±0.57			3.68±0.42			3.40±0.55
Male	3.60±0.36			3.74±0.27			3.68±0.38			3.25±0.90			3.20±0.17			3.48±0.50
Education		–1.809	0.073		–1.111	0.269		–1.732	0.086		–1.204	0.232		–1.335	0.185		–0.964	0.337
College/University	3.70±0.27			3.74±0.26			3.80±0.26			3.44±0.56			3.62±0.44			3.36±0.54
Postgraduate	3.79±0.21			3.80±0.22			3.87±0.19			3.58±0.60			3.73±0.38			3.47±0.56
Career length of coordinator (yr)		0.040	0.989		0.319	0.811		0.563	0.641		0.795	0.499		0.409	0.747		0.947	0.421
<3	3.73±0.27			3.80±0.23			3.81±0.25			3.39±0.67			3.66±0.45			3.39±0.59
3–5	3.74±0.19			3.73±0.23			3.88±0.18			3.54±0.62			3.70±0.40			3.26±0.55
6–9	3.75±0.24			3.77±0.27			3.84±0.22			3.47±0.52			3.73±0.36			3.44±0.55	-
≥10	3.73±0.28			3.75±0.26			3.80±0.26			3.61±0.47			3.61±0.45			3.51±0.50	-
No. of hospital beds		0.135	0.893		0.322	0.748		–0.019	0.985		–0.261	0.795		–0.273	0.785		1.017	0.312
<700	3.75±0.29			3.78±0.26			3.83±0.32			3.46±0.44			3.64±0.45			3.55±0.44
≥700	3.74±0.24			3.76±0.24			3.83±0.22			3.51±0.60			3.67±0.42			3.38±0.56
Type of workplace		–0.155	0.877		0.209	0.835		–0.015	0.988		–0.731	0.466		–0.040	0.968		–1.420	0.159
HOPO	3.73±0.25			3.77±0.24			3.83±0.23			3.47±0.61			3.67±0.43			3.35±0.58
Transplant medical institution (contracting agency)	3.74±0.24			3.76±0.26			3.83±0.24			3.56±0.51			3.67±0.40			3.50±0.46
Type of job		–1.201	0.232		–1.235	0.229		–0.944	0.347		–0.942	0.349		–1.028	0.314		–0.028	0.978
Concurrent position	3.68±0.30			3.69±0.31	–1.235		3.78±0.27			3.39±0.56			3.57±0.49			3.40±0.67
Exclusive position	3.75±0.23			3.78±0.23			3.84±0.22			3.53±0.58			3.69±0.40			3.40±0.52
No. of coworkers		0.129	0.943		0.148	0.931		0.244	0.865		0.790	0.502		0.180	0.910		0.798	0.498
1	3.76±0.26			3.77±0.26			3.84±0.25			3.45±0.51			3.64±0.47			3.56±0.55
2	3.72±0.27			3.74±0.28			3.81±0.23			3.50±0.60			3.64±0.42			3.34±0.59
3–5	3.75±0.20			3.78±0.21			3.83±0.23			3.70±0.41			3.71±0.40			3.36±0.54
6–10	3.74±0.25			3.77±0.20			3.85±0.23			3.43±0.67			3.69±0.41			3.41±0.50
Regiona)		0.998	0.372		0.701	0.498		1.179	0.312		1.131	0.327		0.392	0.677		0.876	0.420
Zone 1	3.75±0.24			3.77±0.25			3.85±0.22			3.51±0.60			3.68±0.40			3.45±0.51
Zone 2	3.64±0.29			3.68±0.24			3.73±0.28			3.27±0.68			3.56±0.49			3.31±0.60
Zone 3	3.73±0.24	-		3.77±0.22	-		3.82±0.25	-		3.59±0.45	-		3.69±0.45	-		3.30±0.63	-
Satisfaction with salary		1.384	0.255		0.613	0.544		0.833	0.437		0.411	0.664		1.982	0.143		1.427	0.245
Satisfaction	3.81±0.23			3.80±0.22			3.89±0.20			3.58±0.74			3.74±0.32			3.54±0.52
Average	3.70±0.25			3.73±0.26			3.80±0.24			3.44±0.58			3.57±0.46			3.30±0.54
Insufficient/very insufficient	3.75±0.24			3.78±0.24			3.84±0.23			3.53±0.53			3.73±0.40			3.45±0.55
Main task		2.013	0.139		2.069	0.132		3.069	0.051		6.466	0.002		1.821	0.167		0.458	0.634
Transplantation	3.79±0.22			3.82±0.18			3.89±0.21			3.64±0.54			3.76±0.38			3.45±0.48
Brain death management	3.58±0.32			3.67±0.29			3.75±0.17			2.63±0.92			3.53±0.46			3.21±0.85
Transplantation and brain death management	3.71±0.26			3.73±0.28			3.79±0.24			3.47±0.53	b<a,c		3.61±0.44			3.38±0.58
Total number of transplants (per year)		0.161	0.922		0.198	0.898		0.237	0.870		0.712	0.547		0.045	0.987		1.534	0.210
<10	3.74±0.25			3.75±0.28			3.82±0.25			3.55±0.46			3.67±0.40			3.55±0.44
10–20	3.78±0.26			3.72±0.32			3.88±0.20			3.58±0.55			3.69±0.45			3.52±0.63
21–29	3.72±0.24			3.77±0.24			3.82±0.18			3.33±0.63			3.69±0.46			3.21±0.66
≥30	3.73±0.25			3.78±0.21			3.83±0.25			3.53±0.61			3.66±0.42			3.39±0.51
Total number of transplant organs within the scope of the coordinator’s responsibility		0.250	0.780		0.628	0.536		0.017	0.984		0.079	0.924		0.367	0.694		1.317	0.273
1	3.73±0.27			3.75±0.28			3.83±0.28			3.51±0.60			3.62±0.42			3.34±0.54
2	3.73±0.24			3.75±0.25			3.83±0.21			3.54±0.49			3.69±0.43			3.39±0.57
3–5	3.77±0.24			3.81±0.21			3.82±0.22			3.57±0.54			3.70±0.42			3.56±0.46

SD, standard deviation; t/F, T-statistic/F-statistic; HOPO, hospital-based organ procurement organization.

^a)Zone 1: Seoul, Gyeonggi-do, Gangwon-do, Jeju. Zone 2: Chungcheong-do, Jeolla-do. Zone 3: Gyeongsang-do.

The difficulty associated with professional development duties varied significantly based on age and education level. Similarly, the difficulty of recipient management and administration duties varied according to the length of one’s career. Furthermore, the challenges of facilitating organ donation and administration duties differed according to the type of facility (Table 4).

Table 4. Differences in difficulty according to participants’ general and job-related characteristics (n=107)

Variable	Total			Recipient management			Donor management			Organ donation activation management			Organ transplantation administration			Professional capability development
	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value
Age (yr)		2.376	0.074		1.861	0.141		1.622	0.189		2.136	0.101		2.374	0.075		4.245	0.007
≤29	3.05±0.33			2.95±0.27			2.98±0.46			2.97±0.39			3.30±0.34			3.44±0.56
30–39	2.89±0.38			2.84±0.38			2.83±0.49			3.02±0.66			2.99±0.53			2.98±0.50
40–49	2.96±0.44			2.85±0.52			2.99±0.54			2.97±0.56			2.96±0.47			3.00±0.53	a>d
≥50	2.55±0.72			2.45±0.86			2.60±0.77			2.39±0.79			2.66±0.66			2.55±0.44
Sex		1.270	0.207		0.728	0.468		1.100	0.274		0.804	0.424		1.273	0.206		1.551	0.124
Female	2.92±0.44			2.83±0.49			2.91±0.54			2.96±0.62			2.99±0.51			3.01±0.54
Male	2.59±0.38			2.62±0.45			2.56±0.33			2.67±0.58			2.61±0.34			2.52±0.44
Education		–0.067	0.947		0.095	0.924		–1.149	0.253		1.190	0.237		0.354	0.724		2.239	0.027
College/university	2.91±0.36			2.83±0.39			2.85±0.48			3.01±0.59			3.00±0.46			3.09±0.53
Postgraduate	2.92±0.55			2.82±0.63			2.97±0.61			2.86±0.67			2.96±0.58			2.85±0.52
Career length of coordinator (yr)		3.282	0.024		4.164	0.008		1.958	0.125		0.647	0.587		3.355	0.022		2.077	0.108
<3	3.05±0.44			3.01±0.43			3.03±0.59			3.05±0.62			3.10±0.49			3.10±0.59
3–5	2.98±0.33			2.89±0.39			2.98±0.41			2.99±0.55			3.09±0.51			3.01±0.51
6–9	2.88±0.39	a>d		2.80±0.36	a>d		2.83±0.47			2.81±0.49			2.99±0.44	a>d		3.12±0.44
≥10	2.73±0.50			2.60±0.61			2.73±0.57			2.91±0.75			2.75±0.51			2.80±0.53
No. of hospital beds		1.631	0.106		1.518	0.132		1.411	0.161		0.901	0.370		1.554	0.123		1.194	0.235
<700	3.10±0.44			3.02±0.41			3.10±0.51			3.10±0.43			3.18±0.46			3.16±0.55
≥700	2.89±0.44			2.80±0.50			2.87±0.54			2.93±0.65			2.95±0.51			2.97±0.54
Type of workplace		–1.876	0.063		–1.476	0.143		–1.754	0.082		–2.690	0.008		–2.373	0.019		–0.174	0.862
HOPO	2.85±0.45			2.77±0.52			2.83±0.53			2.83±0.64			2.89±0.51			2.99±0.53
Transplant medical institution (contracting agency)	3.02±0.42			2.92±0.41			3.02±0.53			3.16±0.52			3.14±0.48			3.01±0.57
Type of job		1.650	0.102		1.442	0.152		1.248	0.215		1.719	0.089		1.715	0.089		1.314	0.192
Concurrent position	3.06±0.44			2.97±0.43			3.04±0.56			3.16±0.66			3.15±0.49			3.14±0.65
Exclusive position	2.88±0.44			2.79±0.50			2.87±0.53			2.90±0.60			2.94±0.51			2.96±0.51
No. of coworkers		1.428	0.239		1.928	0.130		1.306	0.277		2.117	0.103		1.543	0.208		0.095	0.963
1	3.03±0.51			2.86±0.55			3.04±0.62			3.25±0.65			3.11±0.58			2.95±0.72
2	2.96±0.43			2.94±0.45			2.95±0.54			2.88±0.51			2.96±0.47			2.99±0.45
3–5	2.90±0.34			2.82±0.35			2.85±0.38			2.95±0.61			3.10±0.48			3.04±0.45
6–10	2.79±0.45			2.66±0.55			2.76±0.54			2.83±0.72			2.84±0.52			3.01±0.57
Regiona)		0.029	0.971		0.421	0.658		0.066	0.936		0.211	0.810		0.330	0.720		0.763	0.469
Zone 1	2.91±0.49			2.79±0.54			2.91±0.60			2.98±0.63			2.98±0.53	0.330		3.02±0.56
Zone 2	2.88±0.24			2.87±0.41			2.86±0.26			2.91±0.48			2.86±0.40			2.81±0.52
Zone 3	2.92±0.38			2.90±0.37			2.88±0.45			2.89±0.67			3.01±0.51			3.01±0.47
Satisfaction with salary		1.646	0.198		1.278	0.283		1.590	0.209		0.382	0.684		2.566	0.082		0.049	0.952
Satisfaction	2.75±0.57			2.71±0.61			2.68±0.67			3.02±0.78			2.77±0.44			2.96±0.66
Average	2.89±0.41			2.78±0.46			2.90±0.49			2.89±0.61			2.93±0.54			2.99±0.57
Insufficient/very insufficient	2.98±0.43			2.91±0.48			2.97±0.53			2.99±0.58			3.09±0.49			3.01±0.48
Main task		0.347	0.708		0.634	0.533		0.164	0.849		0.551	0.578		0.595	0.554		1.523	0.223
Transplantation	2.95±0.45			2.87±0.52			2.90±0.57			3.01±0.59			3.04±0.51			3.06±0.54
Brain death management	2.88±0.38			3.00±0.54			2.75±0.49			3.13±0.75			3.05±0.33			3.32±0.46
Transplantation and brain death management	2.88±0.44			2.78±0.47			2.90±0.52			2.90±0.64			2.93±0.52			2.93±0.54
Total number of transplants (per year)		0.601	0.616		1.005	0.394		0.694	0.558		1.482	0.224		0.504	0.680		0.137	0.938
<10	2.96±0.48			2.82±0.48			2.95±0.58			3.20±0.71			3.10±0.51			2.96±0.67
11–20	3.02±0.51			2.94±0.48			3.06±0.70			2.88±0.50			2.96±0.61			2.98±0.56
21–29	2.94±0.45			2.95±0.56			2.92±0.51			2.90±0.59			2.92±0.50			2.95±0.42
≥30	2.86±0.41			2.75±0.48			2.83±0.49			2.88±0.61			2.96±0.49			3.03±0.53
Total number of transplant organs within the scope of the coordinator’s responsibility		0.208	0.812		0.213	0.808		0.306	0.737		1.839	0.165		0.262	0.770		0.173	0.841
1	2.94±0.42			2.82±0.42			2.96±0.55			3.02±0.60			2.98±0.48			2.95±0.60
2	2.88±0.50			2.78±0.54			2.86±0.59			2.79±0.71			2.94±0.59			2.97±0.58
3–5	2.92±0.40			2.86±0.52			2.87±0.46			3.06±0.51			3.03±0.47			3.03±0.42

SD, standard deviation; t/F, T-statistic/F-statistic; HOPO, hospital-based organ procurement organization.

^a)Zone 1: Seoul, Gyeonggi-do, Gangwon-do, Jeju. Zone 2: Chungcheong-do, Jeolla-do. Zone 3: Gyeongsang-do.

Regarding the frequency scores, significant differences were observed in the frequency of recipient management, administration, and professional development duties based on age. Similarly, the frequency of administration and professional development duties varied significantly with career length. Hospital size was a determining factor for the frequency of donor management duties, while the number of coworkers influenced the frequency of recipient management, donor management, and facilitation of organ donation. Regional differences and salary satisfaction also affected the frequency of recipient management. Additionally, primary responsibilities significantly influenced the frequency of recipient management and professional development duties. Lastly, the total number of annual organ transplantation cases significantly impacted the frequency of recipient management and donor management duties (Table 5).

Table 5. Differences in performance according to participants’ general and job-related characteristics (n=107)

Variable	Total			Recipient management			Donor management			Organ donation activation management			Organ transplantation administration			Professional capability development
	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value	Mean±SD	t/F	P-value
Age (yr)		1.789	0.154		2.802	0.044		0.856	0.466		0.455	0.714		4.888 a<b,d	0.003		5.783 a<b,c,d	0.001
≤29	1.87±0.64			2.06±1.10			2.11±0.84			1.41±0.72			1.37±0.88			0.98±0.64
30–39	2.15±0.50			2.57±0.46			2.06±0.73			1.57±0.77			2.11±0.66			1.80±0.66
40–49	1.99±0.58			2.47±0.54	-		1.86±0.80			1.42±0.79			2.05±0.68			1.81±0.64
≥50	2.35±0.36			2.78±0.21			2.19±0.69			1.68±0.57			2.58±0.29			2.21±0.55
Sex		–1.543	0.126		–1.232	0.221		–1.187	0.238		0.133	0.895		–1.955	0.053		–0.338	0.736
Female	2.06±0.55			2.49±0.58			1.97±0.77			1.50±0.76			2.03±0.70			1.76±0.69
Male	2.55±0.13			2.90±0.09			2.50±0.41			1.44±0.51			2.83±0.29			1.90±0.36
Education		–1.281	0.203		–0.595	0.553		–1.104	0.272		–0.575	0.566		–1.029	0.306		–1.682	0.096
College/university	2.01±0.55			2.47±0.65			1.91±0.81			1.46±0.81			1.99±0.71			1.66±0.65
Postgraduate	2.15±0.52			2.53±0.46			2.07±0.69			1.55±0.68			2.13±0.70			1.89±0.71
Career length of coordinator (yr)		1.666	0.179		1.850	0.143		0.397	0.755		0.897	0.446		4.309 a<c	0.007		3.269	0.024
<3	1.97±0.56			2.36±0.69			1.96±0.78			1.40±0.74			1.76±0.82			1.57±0.78
3–5	2.04±0.65			2.48±0.55			2.00±0.89			1.59±0.90			1.97±0.58			1.59±0.70
6–9	2.32±0.41			2.75±0.40			2.15±0.66			1.71±0.67			2.37±0.63			2.02±0.42
≥10	2.06±0.50			2.49±0.54			1.91±0.72			1.41±0.69			2.24±0.61			1.95±0.62
No. of hospital beds		–1.619	0.108		–1.274	0.205		–2.340	0.021		–0.106	0.915		0.365	0.716		0.334	0.739
<700	1.85±0.64			2.31±0.70			1.51±0.75			1.48±0.83			2.12±0.64			1.82±0.57
≥700	2.11±0.53			2.52±0.56			2.05±0.75			1.50±0.75			2.05±0.72			1.76±0.70
Type of workplace		1.270	0.207		1.736	0.087		1.229	0.222		–0.347	0.729		–0.530	0.597		0.491	0.625
HOPO	2.12±0.50			2.57±0.55			2.05±0.74			1.48±0.79			2.03±0.75			1.79±0.69
Transplant medical institution (contracting agency)	1.98±0.62			2.36±0.61			1.86±0.80			1.54±0.71			2.11±0.63			1.72±0.69
Type of job		–1.630	0.106		–2.007	0.056		–1.441	0.153		–0.011	0.991		–0.523	0.602		–1.551	0.124
Concurrent position	1.90±0.64			2.24±0.67			1.76±0.76			1.50±0.80			1.98±0.70			1.55±0.74
Exclusive position	2.12±0.52			2.56±0.54			2.04±0.76			1.50±0.75			2.07±0.71			1.81±0.67
No. of coworkers		4.934 a<b,c	0.003		6.003 a<b,c	0.001		2.963	0.036		2.918	0.038		1.627	0.188		1.128	0.341
1	1.79±0.70			2.12±0.71			1.61±0.81			1.44±0.63			1.93±0.73			1.59±0.72
2	2.20±0.48			2.63±0.33			2.10±0.69			1.61±0.73			2.24±0.63			1.80±0.64
3–5	2.35±0.42			2.79±0.30			2.29±0.66	-		1.84±0.73	-		2.07±0.86			1.98±0.71
6–10	1.95±0.48			2.41±0.71			1.91±0.81			1.19±0.81			1.90±0.68			1.71±0.70
Regiona)		1.296	0.278		3.179	0.046		1.515	0.225		0.424	0.656		0.330	0.720		0.519	0.597
Zone 1	2.02±0.56			2.44±0.61			1.90±0.78			1.45±0.75			2.07±0.69			1.81±0.69
Zone 2	2.12±0.53			2.31±0.57			2.16±0.69			1.61±0.58			2.16±0.46			1.61±0.63
Zone 3	2.22±0.49			2.74±0.39			2.17±0.73			1.59±0.86			1.96±0.86			1.70±0.71
Satisfaction with salary		1.425	0.245		4.905 a<b,c	0.009		1.172	0.314		0.093	0.911		0.203	0.816		0.199	0.820
Satisfaction	2.01±0.52			2.10±0.90			2.01±0.73			1.43±0.63			2.05±0.80			1.70±0.66
Average	1.99±0.57			2.51±0.49			1.86±0.79			1.53±0.80			2.01±0.72			1.74±0.77
Insufficient/very insufficient	2.17±0.52			2.61±0.47			2.10±0.75			1.50±0.76			2.10±0.68			1.81±0.62
Main task		0.625	0.537		28.559 b<a,c	<0.001		1.184	0.310		0.641	0.529		2.611	0.078		3.521 b<a,c	0.033
Transplantation	2.04±0.65			2.56±0.50			1.92±0.96			1.41±0.82			2.04±0.72			1.79±0.69
Brain death management	1.84±0.49			0.49±0.19			2.53±0.30			1.38±0.83			1.30±1.04			0.89±0.72
Transplantation and brain death management	2.12±0.46			2.55±0.45			2.00±0.59			1.58±0.70			2.12±0.66			1.81±0.65
Total number of transplants (per year)		4.705 a<c	0.004		3.642	0.015		4.391	0.006		1.450	0.233		1.697	0.172		0.935	0.427
<10	1.76±0.68			2.16±0.70			1.50±0.77			1.48±0.76			1.94±0.77			1.67±0.79
11–20	2.27±0.39			2.55±0.35			2.19±0.56			1.81±0.56			2.27±0.51			1.97±0.47
21–29	2.33±0.31			2.70±0.26	a<c		2.30±0.43	a<c		1.64±0.52			2.30±0.51			1.90±0.57
≥30	2.06±0.53			2.55±0.61			2.01±0.83			1.37±0.86			1.96±0.76			1.70±0.69
Total number of transplant organs within the scope of the coordinator’s responsibility		1.968	0.145		0.670	0.514		2.630	0.077		0.894	0.412		1.630	0.201		0.240	0.787
1	1.93±0.58			2.49±0.52			1.71±0.82			1.34±0.76			1.97±0.71			1.83±0.62
2	2.09±0.54			2.54±0.46			2.01±0.74			1.57±0.80			2.02±0.69			1.73±0.73
3–5	2.20±0.48			2.63±0.42			2.13±0.69			1.54±0.65			2.26±0.58			1.81±0.63

SD, standard deviation; t/F, T-statistic/F-statistic; HOPO, hospital-based organ procurement organization.

^a)Zone 1: Seoul, Gyeonggi-do, Gangwon-do, Jeju. Zone 2: Chungcheong-do, Jeolla-do. Zone 3: Gyeongsang-do.

Among the 107 organ transplant coordinators included in this study, 53.3% had less than 5 years of experience. These findings highlight a significant trend of high turnover among coordinators within their first 5 years. Notably, there is a scarcity of research on the actual turnover rates among organ transplant coordinators in Korea, with only one study in 2020 investigating turnover intentions among 80 coordinators [8]. Therefore, our findings indirectly reveal a substantial turnover issue among new organ transplant coordinators by showing the distribution of their career lengths, emphasizing the need for strategies to reduce turnover among these professionals.

In the United States, the enactment of the Organ Transplant Act in 1984 significantly influenced the establishment of professional standards for organ transplant coordinators. Following this, the North American Transplant Coordinators Organization (NATCO) formed the American Board of Transplant Coordinators in 1987. By 1988, a certification system had been implemented [9]. NATCO offers four types of certifications for coordinators: Certified Procurement Transplant Coordinator, Certified Clinical Transplant Coordinator, Certified Clinical Transplant Nurse, and Certified Transplant Preservationist. Coordinators obtain the certification that aligns with their specific roles [10]. In contrast, South Korea has not developed any formal qualifications for organ transplant coordinators, even after enacting its Organ Transplant Act in 2000.

This study classified the role of organ transplant coordinators into five duties, 14 tasks, and 97 task elements, revealing one additional task and 13 more task elements compared to those identified in the study by Kim et al. [2].

Our study identified donor management as the most critical duty of organ transplant coordinators, followed by recipient management, administration, facilitation of organ donation, and professional development. Consistent with results of previous studies both donor management and recipient management have consistently been identified as the most important duties of organ transplant coordinators [2,3,5].

This study identified professional development as the most challenging responsibility for organ transplant coordinators, followed by administration, facilitation of organ donation, donor management, and recipient management. These results are inconsistent with previous research, which indicated that facilitating organ donation was more difficult [3,5]. These findings suggest the need for further research.

Regarding the perceived importance of facilitating organ donation based on general characteristics, coordinators in their 40s and 50s considered it more critical compared to their counterparts in their 20s. Younger coordinators placed a higher priority on direct care activities, such as managing recipients and donors, and viewed the facilitation of organ donation as less essential. This perception may be influenced by the widespread promotion of organ donation in the mass media and the management of brain-dead donation campaigns by KODA, according to the current business agreement.

Regarding the perceived difficulty according to the general characteristics of coordinators, a significant difference was observed between coordinators with less than 3 years of experience and those with 10 or more years of experience (Table 5). A qualitative study of 16 organ transplant coordinators in Spain, a country with a high organ donation rate, revealed that these coordinators were responsible for supporting donor families, managing tight schedules to ensure timely surgeries, and facilitating communication among interdisciplinary teams. Consequently, the study concluded that the role of organ transplant coordinator is not suitable for novice nurses [11]. These findings suggest that coordinators with more experience find their roles less challenging due to their extensive hands-on experience. Additionally, professional development was found to be less challenging for coordinators aged 50 years and older compared to those in their 20s, and for those with a master's degree or higher compared to those with less education. Professional development, which includes research, education, and self-improvement, cannot be fully achieved through undergraduate education alone. Furthermore, those who do not continuously advance their expertise and knowledge through academic conferences and research may find these tasks challenging. To address these difficulties, it is crucial to create environments that provide ample opportunities for professional development and offer systematic training related to these responsibilities.

This study has certain limitations. The sample comprised organ transplant coordinators who manage organ donation and transplantation, drawn from a coordinator association affiliated with HOPOs and contracted hospitals. These participants, who provided informed consent, represented approximately 53.5% (n=107) of the total membership (n=200). Consequently, coordinators not affiliated with the association, including organ procurement coordinators from KODA and nurses focused solely on posttransplantation care, were excluded. This exclusion restricts the ability to generalize the findings to all organ transplant coordinators. Future research should include a wider range of participants to enable a more precise job analysis for organ transplant coordinators and to generate valuable data for future certification systems.

This study surveyed 107 organ transplant coordinators, of whom 53.3% had less than 5 years of experience. The roles of organ transplant coordinators were analyzed using the DACUM method. Donor management emerged as the most critically perceived duty. Professional development and recipient management were identified as the most difficult and the most frequently performed duties, respectively. Compared to a similar study conducted in 2014, there was an increase in the perceived criticality of administrative duties, as well as in the difficulty associated with professional development and administration. However, the frequency of these duties remained consistent. Significant differences were also noted in the perceived difficulty of duties based on the coordinators’ level of experience, and in the frequency of duties based on the number of coordinators and the volume of transplant cases at the facility.

Based on these findings, we recommend the following: First, a survey should be conducted to investigate turnover intention and the underlying reasons among organ transplant coordinators with <5 years of experience to prevent turnover. Second, based on our findings, a standardized education program and refresher curriculum should be developed to promote continued learning and self-improvement, thereby cultivating professional organ transplant coordinators. Finally, establishing legal qualification standards for organ transplant coordinators and setting specific staffing guidelines that consider the type and number of transplants are crucial.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Funding/Support

This study was supported by a research grant from the Korea Society for Transplantation (KST-P2204).

Author Contributions

Conceptualization: all authors. Data curation: SK, SYS, MKJ, HSK, JYP. Formal analysis: SK, HSK, SYS. Funding acquisition: SYS. Investigation: SYS. Methodology SK. Project administration: MKJ. Visualization SK. Writing–original draft: SK, SYS. Writing–review & editing: all authors. All authors read and approved the final manuscript.

Additional Contributions

Members of the Korean Organ Transplant Coordinator Organization actively cooperated with the survey, providing valuable practical support.

Supplementary Materials

Supplementary materials can be found via https://doi.org/10.4285/ctr.24.0037.