**3. Conclusion**

Further studies are needed to evaluate the effectiveness of an open intensive care unit and of a new systematic approach to communication between relatives and medical staff to decrease the rate of donation refusals. In our ICU, we applied this new approach based on the introduction of a multidisciplinary team and an increased attention for the patient and his family. In our single-center study, the higher increase in organ donations was registered in the 2014–2015 period, 1 year after the introduction of the new communication approach. This increase was also confirmed in the years following 2015. These results highlight the importance of effective communication with patient's relatives and the need to dedicate attention and time to them, especially in the ICU.
