Does organ donation legislation affect individuals' willingness to donate their own or their relative's organs? Evidence from European Union survey data.

PubMed

Mossialos, Elias; Costa-Font, Joan; Rudisill, Caroline

2008-02-27

Maintaining adequately high organ donation rates proves essential to offering patients all appropriate and available treatment options. However, the act of donation is in itself an individual decision that requires a depth of understanding that interacts with the social setting and the institutional framework into which an individual is embedded. This study contributes to understanding factors driving organ donation rates by examining how country regulation, individuals' awareness of regulatory setting, social interactions and socio-demographic determinants influence individuals' willingness to donate their own organs or those of a relative. We draw representative data from the Eurobarometer survey 58.2 undertaken in 2002 with respondents throughout the European Union to capture heterogeneity in institutional setting. We use logistic regression techniques to estimate the determinants of willingness to donate one's own organs and those of a deceased relative. We employ interaction terms to examine the relationship between institutional setting and respondent's awareness of organ donation legislation in their country. Our findings indicate that individuals are more likely to donate their organs than to consent to the donation of a relative's organs. Both decisions are affected by regulation (presumed consent), awareness of regulation and social interactions such as the ability to count on others in case of a serious problem (reciprocity). Furthermore, education (more educated), age (younger), expressing some sort of political affiliation determine willingness to donate one's own organs and consent to the donation of those of a relative. This study confirms and develops further previous research findings that presumed consent organ donation policy positively affects the willingness of individuals to donate their own organs and those of relative by highlighting the importance of awareness of this regulation and an individual's level of social interactions in making choices about donation. Results found using interaction terms underline the importance of population awareness of organ donation legislation as well as the legislation type itself. Findings also point to the role of social interactions in influencing individuals' willingness to donate their organs or those of a relative.

Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation.

PubMed

Siminoff, Laura A; Traino, Heather M

2009-06-01

Deficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems. To test the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD), a direct observation technique with a focused ethnographic strategy, for assessing hospitals' donation processes and identifying areas in need of continuous quality improvement interventions. A pre-post assessment of hospitals' barriers to patient identification and referral, and family consent to donation. Seventeen hospitals within the catchment area of a Northeastern organ procurement organization were assessed by using the RAPiD method. Hospital administrators, health care providers, and staff (N = 537) were interviewed as part of the assessments. Interventions, including on-site training and education, and the use of in-house coordinators, were specifically tailored to each hospital's unique set of barriers to donation. The interventions were delivered to the hospitals in the form of recommendations. The participating organ procurement organization was responsible for implementation of the interventions. The RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.

Current status of in-hospital donation coordinators in Japan: nationwide survey.

PubMed

Konaka, S; Shimizu, S; Iizawa, M; Ohkawara, H; Kato, O; Ashikari, J; Fukushima, N

2013-05-01

When the Japanese Organ Transplantation Act was issued, the Japanese Organ Transplantation Network (JOT) was established in 1997. JOT lists recipients, assesses and manages organ donors, and educates publics and headquarters for organ donations. JOT procurement transplant coordinators (PTC) play roles in obtaining consent from relatives for organ donation, donor evaluation and management, organ recovery management, organ transport, and care of donor families during and after donation. Every prefecture has at least one PTC who is mainly working in public education and hospital development. They also help the JOT PTC at the time of organ procurement. Most prefectures commission hospital staff in the procurement hospital to be an in-hospital PTC (In-Hp PTC), who make their hospital staff aware of organ donation and support organ procurement. Although the Act was revised in 2010 with brain-dead organ donation increased from 13 to 44 cases yearly, the number was still extremely smaller than other developed countries. In these circumstances, In-Hp PTC may play greater roles to increase donation and smooth procurement procedures Our primary aim was to describe the current status of In-Hp PTC in Japan. Between December 15, 2011, and January 31, 2012, we invited 1889 In-Hp PTC to complete a letter survey using a self-designed questionnaire. In all, 56 In-Hp PTC (40%) completed and returned it. The occupation of the respondents was nurse (66%), physician (18%), or other (16%). Although 52% of respondents belonged to the hospital, which was designated for brain-death organ donation by the government, only 46% had any experience with a cadaveric donor. Only 2% were full-time In-Hp PTC. They mainly played a role in preparing their own manual for organ procurement (57%), providing in-hospital lectures (44%) or their own simulation exercise (29%), as well as coordinating donation cases. Although 77% had attended seminar about organ donation provided by JOT or the prefecture PTC, 93% wanted more professional education. However, it was difficult for them to attend these activities, to manage a rare and sudden donation case, and to find time to learn about organ donation because they had another post. The topics that they wanted to learn were donor family care (72%), overall organ/tissue donation procedures (65%), the role of In-Hp PTC (67%), simulations of donation (65%), legislation and social system of organ donation (61%), medical indications for donation (61%), current status of donation and transplantation in Japan (57%), donor management (56%), and case studies (49%). There were significant variations in the topics of interest among the occupations. As they had another post, they could find only a short period (1 or 2 days) to take professional education, such as lectures. Therefore, it was difficult for them to attend practical on-the-job training. To establish an organ procurement system and increase organ donation, In-Hp PTC have important roles in Japan. However, none is a full-time In-Hp PTC. Most In-Hp PTC require more professional education. A systematic education program for each occupation must be established soon. Copyright © 2013 Elsevier Inc. All rights reserved.

[Level of information of students at the University of Regensburg concerning organ donation and transplantation--informed or not informed consent in organ donation?].

PubMed

Banas, B; Bleyer, B; Eckert, M; Gruber, H; Pfirstinger, J; Schaller, O; Dietl, B

2013-04-01

As a result of the actual amendment of the German transplantation law, every citizen will be regularly asked by health insurance companies about his attitude towards post-mortem organ donation--without the obligation to decide. The aim is to increase the willingness of donations as well as the availability of organs. Therefore, we investigated the level of information of students at the University of Regensburg and their agreement to organ transplantation regarding an informed consent. Using an interdisciplinary developed questionnaire (Medicine, Theology, Educational Science) the level of information concerning process and possibilities of organ donation, the possession of an organ donor card, as well as the active or passive consent to donate organs was investigated. Out of 1225 respondents 31.5% had an organ donor card, 49.1% wanted to donate organs, 32.1% were unsure. 98% generally favoured organ donation. However, serious information deficits about brain death were identified: 37.4% did not know that brain death is a prerequisite for a post-mortem organ donation, 18% thought brain death is reversible, 52.7% were not aware of the necessity of intensive medical care. Furthermore, providing information about other potential donor organs including lungs, pancreas, small intestine, and tissue is required. Health insurance companies and responsible authorities need to close the identified gaps in knowledge in order to achieve "informed" consent with organ donation, which might increase the availability and number of donor organs. © Georg Thieme Verlag KG Stuttgart · New York.

Predictors of public attitude toward living organ donation in Kano, northern Nigeria.

PubMed

Iliyasu, Zubairu; Abubakar, Isa S; Lawan, Umar M; Abubakar, Mustapha; Adamu, Bappa

2014-01-01

Organ shortage is a major public health challenge for transplant programs globally. The sustenance of such programs as an effective therapy for end-stage organ failure (ESOF) requires an exploration of public awareness and willingness to donate organs. This is imperative, especially in developing countries where ESOF is highly prevalent. We studied the awareness and predictors of public attitude toward organ donation in Kano city in northern Nigeria. Using interviewer-administered questionnaires, we assessed the awareness and willingness to donate solid organs among 400 adults in the Kano metropolis. Three hundred and five of the 383 respondents (79.6%) reported that they had heard about organ donation. There was a significant variation of awareness by education and ethnicity (P <0.05). Most respondents, 303 (79.1%), were willing to donate an organ. Gender [adjusted odds ratio (AOR) = 2.13; 95% confidence interval (CI): 1.40-4.95], educational attainment (AOR = 2.55; 95% CI: 1.35-5.88), marital status (AOR = 4.5; 95% CI: 2.97-9.1), religion (AOR = 3.40; 95% CI: 1.43-8.10) and ethnicity (AOR = 2.36; 95% CI 1.04-5.35) were significant predictors of willingness to donate an organ. Preferred organ recipients were parents (48.9%), children (21.3%), spouses (14.6%) and other relatives (13.4%). Reasons for willingness to donate organs included religion (51.2%), moral obligation (21.4%) and compassion (11.9%), among others. However, there was widespread ignorance of religious precepts concerning organ donation. The high level of awareness and willingness to donate organs in this society could be further enhanced by intensive information, education and communication strategies providing clear messages on societal benefits, religious aspects and bioethical guidance regarding organ donation.

[Organ donation after circulatory death].

PubMed

de Jonge, J; Kalisvaart, M; van der Hoeven, M; Epker, J; de Haan, J; IJzermans, J N M; Grüne, F

2016-02-01

Approximately 17 million inhabitants live in the Netherlands. The number of potential organ donors in 1999 was the lowest in Europe with only 10 donors per million inhabitants. Medical associations, public health services, health insurance companies and the government had to find common solutions in order to improve organ allocation, logistics of donations and to increase the number of transplantations. After a prolonged debate on medical ethical issues of organ transplantation, all participants were able to agree on socio-medico-legal regulations for organ donation and transplantation. In addition to improving the procedure for organ donation after brain death (DBD) the most important step was the introduction of organ donation after circulatory death (DCD). Measures such as the introduction of a national organ donor database, improved information to the public, further education on intensive care units (ICU), guidelines for end of life care on the ICU, establishment of transplantation coordinators on site, introduction of autonomous explantation teams and strict procedures on the course of organ donations, answered many practical issues about logistics and responsibilities for DBD and DCD. In 2014 the number of postmortem organ donations rose to 16.4 per million inhabitants. Meanwhile, up to 60 % of organ donations in the Netherlands originate from a DCD procedure compared to approximately 10 % in the USA. This overview article discusses the developments and processes of deceased donation in the Netherlands after 15 years of experience with DCD.

Public Perception of Cadaver Organ Donation in Hunan Province, China.

PubMed

Luo, A J; Xie, W Z; Luo, J J; Ouyang, W

2016-10-01

Our aim was to (1) survey public' perception and attitudes toward organ donation and (2) analyze the relationship between knowledge, attitudes, and willingness to donate. We developed a questionnaire, and conducted the survey with stratified random sampling. Overall, 600 residents, aged ≥18 who resided in Hunan, and 600 undergraduates from 3 universities in Hunan were surveyed randomly. For this study, 1085 valid questionnaires were completed, with a response rate of 90.4%. Of the 1085 participants, 581 (53.5%) were students, 504 (46.5%) were residents, and 519 (47.8%) were male and 566 (52.2%) female. The mean accuracy rate was 71.96%, and the students' mean accuracy rate was slightly higher than that of the resident population (73.06% vs 70.68%, respectively). The results showed that 82.2% of public support organ donation, and 53.5% were willing to donate their organs after death. Students scored higher than the residents (88% vs 75.6% and 55.6% vs 51.2%). Nearly 1.8% felt that organ donation was against their religion, 14.9% thought it was important to ensure the integrity of the body, 71.7% agreed that organ donation allowed a positive outcome after a person's death, and 61.5% agreed that organ donation represented a continuation of life, to help families cope with grief. Age and gender were related to attitudes. Public knowledge of organ donation and their attitudes were correlated positively (r = 0.666). Public knowledge of organ donation is poor, biased, and incomplete, and based on television, movies, and communication networks. Positive attitudes toward donation displayed in the surveys were not matched by actual organ donation. Copyright © 2016 Elsevier Inc. All rights reserved.

University hospital doctors: what are their beliefs about organ donation?

PubMed

Bassit, N H; Habiblah, M; Fadili, W; Laouad, I

2013-01-01

Organ and human tissue donation is not well developed in Morocco. This is due in part to the refusal of families, but also to a lack of awareness. We conducted a survey of a representative sample of doctors more exposed to the donation process to assess their knowledge and attitudes toward organ donation and their training needs. This is a cross-sectional study of physicians in Marrakech University Hospital. An anonymous questionnaire adapted to Moroccan context, assessing the knowledge, opinions, attitudes, and needs regarding organ donation was given to doctors. Among 130 distributed questionnaires, we collected 115 completely answered surveys. Respondees were as follows: 60.8% were females, 87 were residents and 28 interns, 80% were aged from 25 to 34 years, and 60% had practiced their profession for 1 to 5 years. Results showed that 28% don't know that tissue and organ donation from a cadaver is authorized in Morocco, 6% are aware of the organs and tissues that can be taken, 76% know the definition of brain death, 35% don't believe in this concept, 88% were favorable for the removal of organs and tissue of deceased persons, 10% ignore that Islam allows organ donation, 62% will give their organs and tissues after death, 25% refuse organ donation of a parent, and 30% refuse it of their children after death. Our findings show that there is discordance between knowledge and attitudes of doctors in our hospital toward organ donation. The promotion of organ donation requires good training of our teams to sensitize the population. Copyright © 2013 Elsevier Inc. All rights reserved.

Ethics Guide Recommendations for Organ-Donation-Focused Physicians: Endorsed by the Canadian Medical Association.

PubMed

Shemie, Sam D; Simpson, Christy; Blackmer, Jeff; MacDonald, Shavaun; Dhanani, Sonny; Torrance, Sylvia; Byrne, Paul

2017-05-01

Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.

On the impacts of traditional Chinese culture on organ donation.

PubMed

Cai, Yu

2013-04-01

This article examines the impact of traditional Chinese culture on organ donation from the perspective of Confucianism, Buddhism, and Taoism. In each of these cultural systems, it appears that there are some particular sayings or remarks that are often taken in modern Chinese society to be contrary to organ donation, especially cadaveric organ donation. However, this article argues that the central concerns of Buddhism, Confucianism, and Taoism are "great love," "ren," and "dao," which can be reasonably interpreted to support organ donation. The author understands that each cultural system, in order to play its cultural function, must have its central concerns as well as relevant ritual practices (li) that incarnate its religious and ethical commitments. That is, each plays a general cultural role, which influences organ donation in particular not merely through abstract or general ethical principles and teachings, but through a combination of ethical teachings and the forming of particular ritual practices. This article contends that the primary reason Chinese individuals fail to donate sufficient cadaveric organs for transplantation is not because particular remarks or sayings from each of these systems appear to conflict with donation. Neither is it that the central concerns of these systems cannot support cadaveric donation. Rather, it is that modern Chinese individuals have failed to develop and secure relevant ritual practices that support the central concerns of organ transplantation. The article concludes that in order to promote more donations, there is a need to form relevant ritual practices supporting organ donation in conformity with the central concerns of these cultural systems.

Successful international collaboration improves family donation conversations resulting in increased organ donation.

PubMed

Mulvania, P; Mehakovic, E; Wise, C; Cass, Y; Daly, T A; Nathan, H M

2014-01-01

Australian donation leaders recognized that to increase organ donation outcomes, health professionals conducting family donation conversations (FDCs) required support and specialist training. An international training institute with programs based on proven results was engaged to create and implement a customized training program to influence change in FDC practice and culture. The goal was to increase donation rates by developing and implementing a customized, self-sustaining training program to enhance FDC practices of health professionals. Other goals included providing training and communications skills to lead FDC, supporting families in making decisions, and influencing health professionals to adopt FDC practices. To gain support and determine program suitability, two 1-day pilot training sessions were provided to 45 Australian donation leaders in 2011. Training was further customized with an emphasis on creating changes to achieve and sustain desired results. A comprehensive national training plan was implemented over 18 months. Twenty-six 2-day FDC training workshops were held in 8 cities (646 participants). Program evaluations and debriefings showed distinct shifts in perspectives and an enthusiasm to implement new processes. In 2012 to 2013, an instructor program was developed to transition training facilitation. The training institute remains involved in development and training to build and sustain skill and expertise. There was a 58% increase in organ donors in Australia from 2009 to 2013 (data reflect 2013 Australian end-of-year organ donation information). This represents a 36% increase in organ donors (2009-2011); the remaining 22% increase was achieved in the 2 years since the FDC training was implemented in Australia (2011-2013). Improved skills training in the conduct of FDCs seem to have contributed to improved donation outcomes in national identification, request, and consent rates. The integration of another organization's process poses distinct challenges; thoughtful collaboration, sensitive to cultural aspects and family care, communication, and donation practices, can result in successful customized training that shifts perspectives, provides new skills, and achieves and sustains an increase in organ donation rates. Copyright © 2014 Elsevier Inc. All rights reserved.

Inappropriate drug donations: what has happened since the 1999 WHO guidelines?

PubMed

van Dijk, D P; Dinant, G; Jacobs, J A

2011-08-01

Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.

Professional education and hospital development for organ donation.

PubMed

Fukushima, N; Konaka, S; Kato, O; Ashikari, J

2012-05-01

Because of the strict Organ Transplantation Act, only 81 brain dead (BD) organ donations had been performed in Japan for 13 years since 1997. The Act was revised on July 17, 2010, allowing, organs to be donated after BD with consent from the family, if the subject had not denied organ donation previously. This act has lead to an expectation of a 6-7-fold increase in BD donation. The 82 organ procurement coordinators (OPC) in Japan include 32 belonging to the Japanese Organ Network (JOT) and the others to each administrative division. JOT has guideline manuals of standard roles and procedures of OPC during organ procurement from BD and cardiac death donors. To manage the increased organ donations after the revision of the act, we have modified the education system. First, we modified the guideline manuals for OPC to correspond to the revised Transplant Act and governmental guidelines. Second, all OPC gathered in a meeting room to learn the new organ procurement system to deal with the revised Transplant Act and guidelines. Third, a special education program for 2 months was provided for the 10 newcomers. Last, the practical training in each donor case for newcomers was performed by older OPC. Topics of the education program were the revised transplant act and guidelines, family approach to organ donation, BD diagnosis, donor evaluation and management, organ procurement and preservation, allocation system, hospital development and family care. In the future, each OPC will be divided into special categories, such as the donor family OPC, the donor management OPC, and the operating room OPC. Therefore, we need to construct separate special education programs for each category. Copyright © 2012 Elsevier Inc. All rights reserved.

"Project ACTS": An Intervention to Increase Organ and Tissue Donation Intentions among African Americans

ERIC Educational Resources Information Center

Arriola, Kimberly; Robinson, Dana H.; Thompson, Nancy J.; Perryman, Jennie P.

2010-01-01

This study sought to evaluate the effectiveness of "Project ACTS: About Choices in Transplantation and Sharing," which was developed to increase readiness for organ and tissue donation among African American adults. Nine churches (N = 425 participants) were randomly assigned to receive donation education materials currently available to consumers…

Willingness toward Organ and Body Donation among Anatomy Professors and Students in Mexico

ERIC Educational Resources Information Center

Quiroga-Garza, Alejandro; Reyes-Hernández, Cynthia Guadalupe; Zarate-Garza, Pablo Patricio; Esparza-Hernández, Claudia Nallely; Gutierrez-de la O, Jorge; de la Fuente-Villarreal, David; Elizondo-Omaña, Rodrigo Enrique; Guzman-Lopez, Santos

2017-01-01

Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students,…

Cadaveric organ donation in China: A crossroads for ethics and sociocultural factors.

PubMed

Wu, Yijin; Elliott, Robert; Li, Linzi; Yang, Tongwei; Bai, Yusen; Ma, Wen

2018-03-01

In this paper, we will discuss several ethical issues concerning cadaveric organ donation from the perspective of sociocultural factors that are unique to China under the condition that China has ended the use of executed prisoner's organs for transplants. It is found that though great developments have been made in organ transplantation, the ethical issues relating to organ transplantation still face dilemmas in China. It is argued that organ donation and transplantation in China could make further progress if the ethical issues proposed in this paper can be carefully considered.

Cadaveric organ donation in China

PubMed Central

Wu, Yijin; Elliott, Robert; Li, Linzi; Yang, Tongwei; Bai, Yusen; Ma, Wen

2018-01-01

Abstract In this paper, we will discuss several ethical issues concerning cadaveric organ donation from the perspective of sociocultural factors that are unique to China under the condition that China has ended the use of executed prisoner's organs for transplants. It is found that though great developments have been made in organ transplantation, the ethical issues relating to organ transplantation still face dilemmas in China. It is argued that organ donation and transplantation in China could make further progress if the ethical issues proposed in this paper can be carefully considered. PMID:29517702

Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development.

PubMed

Vileito, A; Siebelink, M J; Verhagen, Aae

2018-05-01

Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. PubMed, Web of Science, EMBASE and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates. This comprised title, abstract and then full-text screening of relevant data. We included 12 papers and two electronic sources that were mainly from North America and Europe. Most discussed donations after cardiac death. The recurring themes included identifying potential donors, approaching parents, palliative care and collaboration with organ procurement organisations. Most papers called for paediatric donation policies to be standardised. Scientific publications in English on paediatric donation protocols are very scarce. No comprehensive paediatric donation protocol was found. We identified several recurring themes in the literature that could be used to develop such protocols. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

[Lean thinking and brain-dead patient assistance in the organ donation process].

PubMed

Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini

2013-02-01

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Estimating the Number of Organ Donors in Australian Hospitals—Implications for Monitoring Organ Donation Practices

PubMed Central

Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen

2015-01-01

Background The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone. Methods All intubated patient deaths at contributing hospitals were analyzed. Univariate comparisons of donors to nondonors were performed. A logistic regression model was developed to estimate expected donor numbers from data collected between July 2012 and December 2013. This was validated using data from January to April 2014. Results Between July 2012 and April 2014, 6861 intubated patient deaths at 68 hospitals were listed on the DonateLife Audit of whom 553 (8.1%) were organ donors. Factors independently associated with organ donation included age, brain death, neurological diagnoses, chest x-ray findings, PaO2/FiO2, creatinine, alanine transaminase, cancer, cardiac arrest, chronic heart disease, and peripheral vascular disease. A highly discriminatory (area under the receiver operatory characteristic, 0.940 [95% confidence interval, 0.924-0.957]) and well-calibrated prediction model was developed which accurately estimated donor numbers. Three hospitals appeared to have higher numbers of actual donors than expected. Conclusions It is possible to estimate the expected number of organ donors. This may assist benchmarking of donation outcomes and interpretation of changes in donation rates over time. PMID:25919766

Undergraduate nursing students' knowledge and attitudes towards organ donation in Korea: Implications for education.

PubMed

Kim, Jung-Ran Theresa; Fisher, Murray J; Elliott, Doug

2006-08-01

Organ donation from brain dead patients is a contentious issue in Korea within the cultural context of Confucian beliefs. Each year thousands of patients wait for organ donation note poor donation rates and importance of nurses in identifying potential donors. It is therefore important to identify knowledge levels and attitudes towards organ donation from brain dead patients of nursing students as future health workers. Using a 38-item instrument previously developed by the researchers, 292 undergraduate students in a Korean nursing college were surveyed in 2003 in Korea (response rate 92%). Validity and reliability of the instrument was demonstrated using a multiple analytical approach. A lack of knowledge regarding diagnostic tests and co-morbid factors of brain death were noted among students. Their attitudes toward organ donation were somewhat mixed and ambiguous, but overall they were positive and willing to be a potential donor in the future. While this study identified that an effective educational program is necessary for nursing students in Korea to improve their knowledge of brain death and organ donation, further research is also required to verify these single-site findings and improve the generalisability of results.

An Analysis of Organ Donation Policy in the United States.

PubMed

Ahmad, Ghazi; Iftikhar, Sadia

2016-05-02

There is currently an organ shortage crisis in the United States. This paper analyzes the magnitude of the problem, the organ procurement programs in other developed countries as compared to the US, and discusses the changes that can be made to address this problem. With the opt-in or explicit-consent method currently practiced in the US, less that one third of the population consents to organ donation. In order to narrow the gap between the demand and supply of organs, steps need to be taken to improve the organ procurement infrastructure. The public needs to be educated about the dire need, the benefits and risks in organ donation, and living vs. deceased donation. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].

Benefits of Transplant Procurement Management (TPM) specialized training on professional competence development and career evolutions of health care workers in organ donation and transplantation.

PubMed

Istrate, Melania G; Harrison, Tyler R; Valero, Ricard; Morgan, Susan E; Páez, Gloria; Zhou, Quan; Rébék-Nagy, Gábor; Manyalich, Martí

2015-04-01

Training on organ donation and transplantation is relevant for transplantation improvement. This study aimed at investigating the perceived benefits of Transplant Procurement Management training programs on professional competence development and career evolutions of health care workers in organ donation and transplantation. An online survey was developed in 5 languages (Spanish, English, Italian, French, and Portuguese) and its link was emailed to 6839 individuals. They were asked to forward it to other professionals in organ donation and transplantation. The link was also shared on Facebook and at relevant congresses. Two research questions on the perceived influence of specialized training programs were identified. A total of 1102 participants (16.1%) took the survey; 87% reported participating in Transplant Procurement Management training programs, of which 95% selected Transplant Procurement Management courses as the most influential training they had participated in. For research question one, 98% reported influence on knowledge (score 4.5 [out of 5]), 93% on technical (4.2) and communication skills (4.1), 89% on attitude toward organ donation and transplantation (4.1), 92% on motivation to work (4.2), 91% on desire to innovate (4.0), 87% and 79% on ability to change organ donation and trans plantation practices (3.9) and policies (3.5). For research question 2, main and interaction effects for position at the time of training and type of training were reported. Transplant Procurement Management training programs had positive perceived effects.

Organ Donation in the 50+ Age Demographic: Survey Results on Decision Rationale and Information Preferences.

PubMed

Tartaglia, Alexander; Dodd-McCue, Diane; Myer, Kevin A; Mullins, Andrew

2016-09-01

The rate of organ donation by older potential donors is significantly declining even though recent studies show positive clinical outcomes with organs transplanted from older donors. This study examined the 50+ age demographic to identify the rationale for donation decisions, preferred media methods of donation information delivery, and responsiveness to an age-tailored donation message. Results from 579 surveys, 87% from the 50+ age demographic, found respondents prone to self-select themselves as medically ineligible based on current medication and health status, even though they might be medically suitable donors. Their incentive to pursue additional information on donation is limited except when motivated by personal accounts within their families and communities. In addition, even when computer literate, they continue to favor the printed or spoken word for donation information delivery. The results suggest an opportunity for those working with older adults to develop more personalized, localized donation education programs targeting this age demographic. © The Author(s) 2014.

Promoting deceased organ and tissue donation registration in family physician waiting rooms (RegisterNow-1 trial): study protocol for a pragmatic, stepped-wedge, cluster randomized controlled registry.

PubMed

Li, Alvin H; Garg, Amit X; Prakash, Versha; Grimshaw, Jeremy M; Taljaard, Monica; Mitchell, Joanna; Matti, Danny; Linklater, Stefanie; Naylor, Kyla L; Dixon, Stephanie; Faulds, Cathy; Bevan, Rachel; Getchell, Leah; Knoll, Greg; Kim, S Joseph; Sontrop, Jessica; Bjerre, Lise M; Tong, Allison; Presseau, Justin

2017-12-21

There is a worldwide shortage of organs available for transplant, leading to preventable mortality associated with end-stage organ disease. While most citizens in many countries with an intent-to-donate "opt-in" system support organ donation, registration rates remain low. In Canada, most Canadians support organ donation but less than 25% in most provinces have registered their desire to donate their organs when they die. The family physician office is a promising yet underused setting in which to promote organ donor registration and address known barriers and enablers to registering for deceased organ and tissue donation. We developed a protocol to evaluate an intervention to promote registration for organ and tissue donation in family physician waiting rooms. This protocol describes a planned, stepped-wedge, cluster randomized registry trial in six family physician offices in Ontario, Canada to evaluate the effectiveness of reception staff providing patients with a pamphlet that addresses barriers and enablers to registration including a description of how to register for organ donation. An Internet-enabled tablet will also be provided in waiting rooms so that interested patients can register while waiting for their appointments. Family physicians and reception staff will be provided with training and/or materials to support any conversations about organ donation with their patients. Following a 2-week control period, the six offices will cross sequentially into the intervention arm in randomized sequence at 2-week intervals until all offices deliver the intervention. The primary outcome will be the proportion of patients visiting the office who are registered organ donors 7 days following their office visit. We will evaluate this outcome using routinely collected registry data from provincial administrative databases. A post-trial qualitative evaluation process will assess the experiences of reception staff and family physicians with the intervention and the stepped-wedge trial design. Promoting registration for organ donation in family physician offices is a potentially useful strategy for increasing registration for organ donation. Increased registration may ultimately help to increase the number of organs available for transplant. The results of this trial will provide important preliminary data on the effectiveness of using family physician offices to promote registration for organ donation. ClinicalTrials.gov, ID: NCT03213171 . Registered on 11 July 2017.

From motivation to acceptability: a survey of public attitudes towards organ donation in Denmark.

PubMed

Nordfalk, Francisca; Olejaz, Maria; Jensen, Anja M B; Skovgaard, Lea Larsen; Hoeyer, Klaus

2016-01-01

Over the past three decades, public attitudes to organ donation have been a subject of numerous studies focusing on donor motivation. Here, we present a fresh approach. We suggest focusing on public acceptability instead of motivation. The point is to understand public attitudes well enough to avoid risking public support for organ transplantation. We conducted the study in Denmark because there have been significant developments in public attitudes to organ donation in this country. In the 1990s, Denmark was a country with very low public support for organ donation and Denmark was the last country in Europe to introduce brain death as a legal criterion of death, whereas today Eurobarometer surveys rate Denmark as one of the European countries with the highest support for deceased organ donation from brain dead donors. We conducted a telephone survey in Denmark (N = 1195). A questionnaire was developed on the basis of preceding qualitative studies and pilot testing and included reuse of one item from earlier surveys to facilitate historical comparison. The analysis of the data was carried out using IBM SPSS Statistics 22 and focused on descriptive statistics. A clear majority of 91.9 % are positive or very positive towards organ donation; 85.8 % like the idea of their body being used after their death, 85.0 % is willing to donate their own organs, 82.1 % to donate their tissue and only 2.3 % find that too much has been done to promote organ donation. There is limited support for monetary incentives for organ donation (5.8 %) and presumed consent (30.4 %), while a majority (63.9 %) supports making it mandatory to register a personal decision. Religious self-identification has limited impact on attitudes. We can identify a shift over the past three decades from marked opposition to organ transplantation to strong support as well as a pattern in the contemporary public attitudes, which can help explain what is central to public acceptability: self-determination. Policies fostering choice are met with a majority of positive attitudes, while presumed consent and monetary incentives are met with more negative attitudes. Our approach calls for comparative studies in other countries to generate a better overall understanding of the conditions of acceptability, which need to be in place to ensure the long-term social robustness of organ donation and thereby safeguard this important medical technology.

Effect of media presentations on willingness to commit to organ donation.

PubMed

Harel, Inbal; Kogut, Tehila; Pinchas, Meir; Slovic, Paul

2017-05-16

We examine how presentations of organ donation cases in the media may affect people's willingness to sign organ donation commitment cards, donate the organs of a deceased relative, support the transition to an "opt-out" policy, or donate a kidney while alive. We found that providing identifying information about the prospective recipient (whose life was saved by the donation) increased the participants' willingness to commit to organ donation themselves, donate the organs of a deceased relative, or support a transition to an "opt-out" policy. Conversely, identifying the deceased donor tended to induce thoughts of death rather than about saving lives, resulting in fewer participants willing to donate organs or support measures that facilitated organ donation. A study of online news revealed that identification of the donor is significantly more common than identification of the recipient in the coverage of organ donation cases-with possibly adverse effects on the incidence of organ donations.

Guinean Population Emigrant to Spain Has Very Little Awareness of the Donation and Transplantation of Organs.

PubMed

Ríos, A; Carrillo, J; López-Navas, A I; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

The Guinean population is an emerging group in Europe, but the group's awareness of organ donation and transplantation has not been studied. To analyze the attitude toward organ donation among the population born in Guinea living in Spain. The population older than 15 years, born in Guinea, and resident in Spain was studied, stratified by age and sex, according to census data and immigrant assistance associations. The valuation tool used was the attitude questionnaire toward organ donation PCID-DTO RIOS (questionnaire on "Donor International Collaborative Project" on organ donation and transplantation developed by Dr Ríos). A random selection of people to survey was based on stratification. Support from African immigration support associations was needed to advise on the location of potential respondents. The completion was anonymous and self-administered. A descriptive statistic was performed, and Student t, χ 2 , and Fisher tests and a logistic regression analysis were applied. In all, 181 Guineans were surveyed, of whom 32% (n = 58) were in favor of the donation of their own organs after death, 32% (n = 57) were against, and 36% (n = 66) were undecided. The variables that are associated with attitude toward donation are separated mainly into 4 large groups (P < .001): (1) knowledge about the process of donation and organ transplantation; (2) attitude toward the manipulation of the body; (3) religious variables; and (4) sociofamily variables, especially in relation to the couple. The Guinean population emigrant to Spain has an unfriendly attitude toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.

African Americans' knowledge about organ donation: closing the gap with more effective persuasive message strategies.

PubMed

Morgan, Susan E; Cannon, Thomas

2003-11-01

In spite of increasing interest in the area of African Americans' willingness to donate organs, little empirical knowledge exists that can be used to create more effective public communication campaigns. In this study, 310 African Americans responded to seven knowledge items (based on myths and misconceptions about organ donation) shown in past studies to discriminate between donors and nondonors. The rate of accurate responses varied from 33% to 78% to individual knowledge items. Beliefs that the organ allocation system is inequitable (favoring whites and the rich) and the belief that donors pay extra medical bills strongly distinguished donors from nondonors. In addition, the information sources reported by African Americans willing to donate were more likely to include family members. Implications of these findings to the development of more effective organ donation campaigns targeting African Americans are offered.

Intensive care medicine and organ donation: exploring the last frontiers?

PubMed

Escudero, D; Otero, J

2015-01-01

The main, universal problem for transplantation is organ scarcity. The gap between offer and demand grows wider every year and causes many patients in waiting list to die. In Spain, 90% of transplants are done with organs taken from patients deceased in brain death but this has a limited potential. In order to diminish organ shortage, alternative strategies such as donations from living donors, expanded criteria donors or donation after circulatory death, have been developed. Nevertheless, these types of donors also have their limitations and so are not able to satisfy current organ demand. It is necessary to reduce family denial and to raise donation in brain death thus generalizing, among other strategies, non-therapeutic elective ventilation. As intensive care doctors, cornerstone to the national donation programme, we must consolidate our commitment with society and organ transplantation. We must contribute with the values proper to our specialization and try to reach self-sufficiency by rising organ obtainment. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Outcomes of organ donation in brain-dead patient's families: Ethical perspective.

PubMed

Ahmadian, Shamsi; Rahimi, Abolfazl; Khaleghi, Ebrahim

2017-01-01

The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. The main category of the data was "Decision to organ donation: a challenge from conflict to transcendence." This main category consisted of 10 subcategories and 3 general categories. The general categories were "challenging outcomes," "reassuring outcomes," and "transcending outcomes." Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.

Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement.

PubMed

Kotloff, Robert M; Blosser, Sandralee; Fulda, Gerard J; Malinoski, Darren; Ahya, Vivek N; Angel, Luis; Byrnes, Matthew C; DeVita, Michael A; Grissom, Thomas E; Halpern, Scott D; Nakagawa, Thomas A; Stock, Peter G; Sudan, Debra L; Wood, Kenneth E; Anillo, Sergio J; Bleck, Thomas P; Eidbo, Elling E; Fowler, Richard A; Glazier, Alexandra K; Gries, Cynthia; Hasz, Richard; Herr, Dan; Khan, Akhtar; Landsberg, David; Lebovitz, Daniel J; Levine, Deborah Jo; Mathur, Mudit; Naik, Priyumvada; Niemann, Claus U; Nunley, David R; O'Connor, Kevin J; Pelletier, Shawn J; Rahman, Omar; Ranjan, Dinesh; Salim, Ali; Sawyer, Robert G; Shafer, Teresa; Sonneti, David; Spiro, Peter; Valapour, Maryam; Vikraman-Sushama, Deepak; Whelan, Timothy P M

2015-06-01

This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.

Expanding the Donor Pool Through Intensive Care to Facilitate Organ Donation: Results of a Spanish Multicenter Study.

PubMed

Domínguez-Gil, Beatriz; Coll, Elisabeth; Elizalde, José; Herrero, Jaime E; Pont, Teresa; Quindós, Brígida; Marcelo, Bella; Bodí, María A; Martínez, Adolfo; Nebra, Agustín; Guerrero, Francisco; Manciño, José M; Galán, Juan; Lebrón, Miguel; Miñambres, Eduardo; Matesanz, Rafael

2017-08-01

Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. Achieving Comprehensive Coordination in Organ Donation (ACCORD)-Spain consisted of an audit of the donation pathway from patients who died as a result of a devastating brain injury (possible donors) in 68 hospitals during November 1, 2014, to April 30, 2015. We focused on possible donors whose families were interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome. Of the 1970 possible donors in ACCORD-Spain, in 257, the family was interviewed once the decision had been made not to intubate/ventilate (n = 105), with the patient under intubation/ventilation outside of the intensive care unit (n = 59), or with the patient intubated/ventilated within the intensive care unit (n = 93).Consent to ICOD was obtained in 174 cases. Consent was higher when the donor coordinator participated in the interview (odds ratio, 2.32; 95% confidence interval, 1.33-4.11; P = 0.003). One hundred thirty-one patients developed BD, of whom 117 transitioned to actual donation after BD. Of the 35 patients who did not develop BD, 2 transitioned to actual donation after circulatory death. Sixteen patients subject to ICOD were finally medically unsuitable organ donors.ICOD contributed to 24% of the 491 actual donors registered in ACCORD-Spain. Despite the complexity of the interview, the majority of families consented to ICOD. Estimating the probability of BD and assessing medical suitability are additional challenges of the practice. ICOD represents a clear opportunity to increase the donor pool and ensures organ donation is posed at every end-of-life care pathway.

Attitudes of resident doctors toward different types of organ donation in a Spanish transplant hospital.

PubMed

Ríos, A; Conesa, C; Ramírez, P; Galindo, P J; Rodríguez, J M; Rodríguez, M M; Martínez, L; Parrilla, P

2006-04-01

Our aim was to analyze acceptance of cadaveric and living organ donation for transplantation among resident doctors, given that they are the new professionals of medicine who will have to encourage and develop transplant programs. A random survey was performed on resident doctors in a third-level hospital with an organ transplant program which is accredited for undergraduate and postgraduate education (n = 171). Attitudes toward cadaveric and living donation were evaluated using a questionnaire including various psychosocial variables that might affect such attitudes. We used the Student t test and the chi-square test. The sample was composed of responses by 171 resident doctors of mean age 28 +/- 4 years with 56% women. Attitudes toward cadaveric donation were favorable in 92% (n = 157). As for living donation, the percentage in favor of nonrelated donation was low: 23% for kidney and 19% for liver. However, when the donation was from a relative, the percentages increased to levels similar to those of cadaveric donation, namely 88% and 85% for kidney and liver, respectively. No differences were observed in attitudes toward cadaveric or living donation according to various psychosocial variables. The trainee doctors showed favorable attitudes toward human cadaveric organ donation as well as living related donation, which suggests a relaunch of living donors in the near future. However, there was not much acceptance of nonrelated donation, as has also been seen in studies of the general public in our geographical area.

Communication strategies for organ donation.

PubMed

Gajiwala, Astrid Lobo

2008-03-01

A country, state or hospital may have the latest medical technology and infrastructure as well as qualified professionals for organ transplantation, but unless there is an adequate donor population the waiting lists for transplants will continue to be long and for some patients, hopeless. Public and professional awareness programmes are key factor in the donation process. Social education that explains the life-saving benefits of organ transplantation, the enormous need for organ donation, the concept of brain death and religious teachings related to these issues is vital for creating a conducive environment for the organ transplant co-ordinator or physician soliciting the donation. The education of hospital medical, nursing and administrative personnel is also essential to both miximise opportunities for donation, as well as to prevent loss of potential organs after donor consent. Other target populations are medical examiners or coroners, and police personnel under whose jurisdiction the donations occur, as their co-operation and guidance is necessary for meeting statutory requirements. The involvement of government officials and politicians is also valuable, as their active intervention is essential for the introduction and amendment of rules and laws to promote the donation and transplantation of organs. The present paper describes communication strategies for the development of an efficient education plan that will provide information about organ transplantation, explain the desired outcome, address potential queries, misconceptions or obstacles, and identify potential sources of support.

Harms of unsuccessful donation after circulatory death: An exploratory study.

PubMed

Taylor, Lauren J; Buffington, Anne; Scalea, Joseph R; Fost, Norman; Croes, Kenneth D; Mezrich, Joshua D; Schwarze, Margaret L

2018-02-01

While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life-giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Study of education program of in-hospital procurement transplant coordinators in Japan.

PubMed

Fukushima, N; Konaka, S; Yasuhira, M; Izawa, M

2014-01-01

As the number of donated organs is still extremely small in Japan compared with other developed countries, in-hospital procurement transplant coordinators (In-Hp PTC) may play an important role in increasing organ donation and making the procurement procedure smoother. In this study, our education program of In-Hp PTC is described. In May 2012, our department started the In-Hp PTC Education Program. In the first semester, a 2-hour lecture is provided every 2 weeks for 5 months to 15 In-Hp PTCs working near Osaka. In the second semester, 20 lectures were provided for 3 consecutive days to 31 In Hp PTCs, more than 80% of whom work far from Osaka. Lecture topics were the history and current status of organ donation in Japan, social regulation of organ donation, care of transplant recipients, overall procedures of organ donation, the role of In-Hp PTC, donor family care, donor indications, and donor assessment and management. Lectures also included simulations of the organ donation process. Participants were surveyed for their opinions after the program, Most participants were satisfied with the program, topics and duration. As most of them are not full-time In-Hp PTCs, they preferred to attend the 3-day program. Many participants are currently working as main In-Hp PTCs and establishing their own organ donation system in their hospital. In-Hp PTCs have an important role to play in establishing an organ procurement system and increasing organ donation in Japan. This program may help establish a systematic education program for this occupation in Japan. Copyright © 2014 Elsevier Inc. All rights reserved.

Transplant Procurement Management Model Training: Marked Improvement in the Mindset of In-Hospital Procurement Coordinators at Hyogo Prefecture, Japan.

PubMed

Yoshikawa, M; Yoshinaga, K; Imamura, Y; Hayashi, T; Osako, T; Takahashi, K; Kaneko, M; Fujisawa, M; Kamidono, S

2016-09-01

The organ donation rate in Japan is much lower than that in other developed countries for several reasons. An advanced educational program for in-hospital procurement coordinators is a possible solution for this. We introduced a Transplant Procurement Management (TPM) educational program at Hyogo Prefecture, Japan. Ten healthcare professionals at Hyogo Prefecture participated in the Advanced International TPM course to educate themselves on TPM and held 2 TPM Model Organ Procurement Training Workshops at Hyogo Prefecture for in-hospital procurement coordinators. Furthermore, we held 2 workshops outside Hyogo Prefecture and at the same time undertook a pre-workshop questionnaire survey to evaluate the ability and motivation with respect to organ donation. To evaluate the effectiveness of the workshops, we conducted post-workshop and 3-months-after workshop questionnaire surveys. The results of the pre-workshop survey revealed that in-hospital procurement coordinators lacked the knowledge regarding the entire organ donation process, the current status of organ donation in Japan, and the definition of brain death. Moreover, they did not completely understand the meaning of "organ donation." The results of the post-workshop questionnaire survey showed that the educational program was effective to improve the knowledge and skills of organ donation and motivated behavioral changes among the participants. The survey results showed that our TPM model educational program offered sufficient knowledge and skills to increase organ donation at Hyogo Prefecture. We will continue this program and make an effort to further contribute to the Japanese organ donation activities. Copyright © 2016 Elsevier Inc. All rights reserved.

The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale.

PubMed

Schweda, Mark; Schicktanz, Silke

2009-02-18

The increasing debate on financial incentives for organ donation raises concerns about a "commodification of the human body". Philosophical-ethical stances on this development depend on assumptions concerning the body and how people think about it. In our qualitative empirical study we analyze public attitudes towards organ donation in their specific relation to conceptions of the human body in four European countries (Cyprus, Germany, the Netherlands and Sweden). This approach aims at a more context-sensitive picture of what "commodification of the body" can mean in concrete clinical decisions concerning organ donation. We find that moral intuitions concerning organ donation are rooted in various conceptions of the human body and its relation to the self: a) the body as a mechanical object owned by the self, b) the body as a part of a higher order embodying the self, and c) the body as a hierarchy of organs constitutive of the self. The language of commodification is much too simple to capture what is at stake in everyday life intuitions about organ donation and organ sale. We discuss how the plurality of underlying body-self conceptions can be taken into account in the ethical debate, pointing out consequences for an anthropologically informed approach and for a liberal perspective.

A pilot programme of organ donation after cardiac death in China.

PubMed

Huang, Jiefu; Millis, J Michael; Mao, Yilei; Millis, M Andrew; Sang, Xinting; Zhong, Shouxian

2012-03-03

China's aims are to develop an ethical and sustainable organ transplantation system for the Chinese people and to be accepted as a responsible member of the international transplantation community. In 2007, China implemented the Regulation on Human Organ Transplantation, which was the first step towards the establishment of a voluntary organ donation system. Although progress has been made, several ethical and legal issues associated with transplantation in China remain, including the use of organs from executed prisoners, organ scarcity, the illegal organ trade, and transplantation tourism. In this Health Policy article we outline the standards used to define cardiac death in China and a legal and procedural framework for an organ donation system based on voluntary donation after cardiac death that adheres to both China's social and cultural principles and international transplantation standards. Copyright © 2012 Elsevier Ltd. All rights reserved.

Encouraging family discussion on the decision to donate organs: the role of the willingness to communicate scale.

PubMed

Smith, Sandi W; Kopfman, Jenifer E; Lindsey, Lisa L Massi; Yoo, Jina; Morrison, Kelly

2004-01-01

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.

The beauty of the gift: the wonder of living organ donation.

PubMed

Spital, Aaron; Jacobs, Cheryl L

2007-01-01

In a recent opinion piece, Nancy Scheper-Hughes provides a sweeping indictment of living organ donation, even in cases where the gift is directed to a close family member. She describes the process with caustic powerful phrases such as "sacrificial violence" and a "call to 'self-sacrifice.'" She concludes that living organ donation "should be consigned to a back seat as an exceptional back-up to deceased donation." But her conclusions are based on anecdotes and data that are not representative of donor practice and motivation in the United States and other developed countries. At reputable transplant centers great care is taken to identify genuine volunteers and to protect their interests. Under these circumstances living organ donation remains a generally safe and beneficial procedure for the donor as well as the recipient, and a wonderful example of the goodness of people.

Organ and tissue donation: are minorities willing to donate?

PubMed

Daniels, D E; Smith, K; Parks-Thomas, T; Gibbs, D; Robinson, J

1998-01-01

The Task Force on Organ Transplantation (DHHS,1986) addressed the issue of increasing organ donation. The Report of the Task Force recommended that "educational efforts aimed at increasing organ donation among minority populations be developed and implemented, so that the donor population will more closely reflect the ethnicity of potential transplant recipients, in order to gain the advantage of improved donor and recipient immunologic matching (DHHS,1986). Donor rates for minorities has increased as follows: 16% in 1988 to 23% in 1995 among cadaveric donors and 24% in 1988 to 28% in 1995 among living donors. The improvement in donor rates among minorities may positively affect the transplantation success rate experienced by organ recipients of the same race. Strategies must be implemented that will increase the effectiveness and frequency of communication between minority patients and the medical community. An increase in the effectiveness of communication between potential minority donor families and the health care community will contribute to the process of Consciousness Raising as discussed by Prochasksa. The result of increased awareness of the organ donation and transplantation process may have a favorable impact on organ donation. The media has, through public service announcements, paid advertising and entertainment programming, attempted to promote discussion of organ donation in the community and within families. Johnson et al. discussed Mexican-American and Anglo-American Attitudes Toward Organ Donation. The primary impediment contributing to the disparity of consent rates between Mexican-American and Anglo-American population occurs with regard to the donation of organs of relatives. Johnson stated that this impediment to organ donation can be effectively addressed by promoting family discussion. Communication within families will inform surviving next of kin of the desire of the deceased to be an organ donor and hence improve the likelihood of the donor family consenting to organ donation (Johnson et al., 1988). The promotion of communication within families must continue to be a goal of the transplant community regardless of race/ethnicity. Despite the efforts of the government, the transplant community, the media and the corporate sector to address the critical shortage of donors in the United States, the reality is that no community has the supply of donor organs suitable to meet the need.

Effects of phased education on attitudes toward organ donation and willingness to donate after brain death in an Asian country.

PubMed

Park, Ui Jun; Han, Sang Youb; Han, Kum Hyun; Oh, Se Won; Jang, Hye-Yeon; Kim, Hyoung Tae; Roh, Young-Nam

2018-05-23

This study aims to investigate the effects of phased education on attitudes toward organ donation and willingness to donate after brain death. A survey was conducted using a questionnaire to examine attitudes toward organ donation of the families of patients admitted to a surgical intensive care unit (SICU) between March 1, 2014 and September 30, 2016. Ninety-two people voluntarily participated in this survey. Before reviewing the educational material, 75.0% had a positive attitude toward organ donation, 60.9% were willing to donate their own organs, and 38.0% were willing to donate a family member's organs. After reviewing the educational material, these figures increased to 92.4%, 80.4%, and 56.5%, respectively. Before receiving an education, there was a significant difference in consistency between people's attitudes and willingness to donate their own organs, versus donating a family member's organs (79.3% vs 54.3%, p < 0.001). With phased education, these percentages increased from 79.3% to 85.9% with regard to donating one's own organs, and from 54.3% to 64.1% with regard to donating a family member's organs. Phased education was effective overall, but it had a limited effect on changing the willingness to donate a family member's organs. It increased the consistency between people's attitudes toward organ donation and willingness to donate their own, or a family member's organs. Copyright © 2018. Published by Elsevier Taiwan.

Importance of education in organ donation.

PubMed

Yilmaz, Tonguc Utku

2011-12-01

Transplanting is the sole therapy for the majority of organ insufficiencies, but the lack of organ donation limits transplanting. We evaluated the effect of education about "Organ Donation and Transplantation" over the false beliefs of the participants. This interventional study was performed in a military unit between January and March 2010. Data on organ donation and demographic characteristics were collected by a questionnaire. The researcher gave the lesson, and then collected the data by the same questionnaire 2 months later. The rate of volunteering for organ donation increased from 45.4% to 84.8% (P < .001). Rate of consent for organ donations by relatives increased from 41% to 80.3% (P < .001). Also, general knowledge about organ donation increased from 34.8% to 93.7% (P < .001). Wrong beliefs about organ donation disappeared after the education. The entire organ donation rate among the volunteer participants increased from 60% to 84% (P < .001). No significant relation was found between volunteering to donate organs, and education and economic status. Education could correct false information and might lead to higher organ donation rates. This education (which gave positive results in a military unit) could become widespread.

Awareness and attitudes towards organ donation among medical students at King Abdulaziz University, Jeddah, Saudi Arabia.

PubMed

Sayedalamin, Zaid; Imran, Muhammad; Almutairi, Osama; Lamfon, Mohammed; Alnawwar, Majd; Baig, Mukhtiar

2017-04-01

To assess awareness and attitude of medical students about organ donation. This cross-sectional study was conducted in 2014 at King Abdulaziz University, Jeddah, Saudi Arabia, and comprised medical students. The participants were asked about their religious and other beliefs towards organ donation, their reasons for not donating organs, and their personal opinions about organ donation through a questionnaire. SPSS 21 was used for data analysis. Of the 481 participants, 250(52%) were females, and 231(48%) were males. The overall mean age was 21.36±1.63 years. Besides, 437(90.9%) students knew what organ donation means, 433(90%) supported organ donation, and 90(18.7%) knew someone who had donated an organ. Moreover, 245(50.9%) participants were willing to donate their organ to their family alone, 198(41.2%) were willing to donate to any deserving patient while 439(91.3%) rejected that religion precluded organ donation, and 354(73.6%) did not know about the grafting of organs from a man to a woman and vice versa. Awareness and attitude towards organ donation were not up to the mark among the participants.

Attitudes toward organ donation among personnel from the University Hospital of Rabat.

PubMed

Flayou, Kaoutar; Kouam, Nada; Miara, H; Raoundi, O; Ouzeddoun, Naima; Benamar, Loubna; Bayahia, Rabiaa; Rhou, Hakima

2016-01-01

The medical staff could play a major role in promoting for organ donation. The aim of our study was to assess the attitudes of the medical staff toward organ donation. It is a prospective study conducted over a period of six months. A questionnaire was distributed and explained to the medical staff in our institute. Fifteen questions were designed to include four main themes: sociodemographic information, attitude toward organ donation, perceived knowledge about organ donation, and reasons for refusal or acceptance of organ donation. Among the 245 respondents, 36.3% had prior knowledge about organ transplantation, 31.8% knew about the law of organ donation, 43.2% had already donated blood sometimes, 65.7% expressed their consent to organ donation during their lifetime, and 82.8% expressed their agreement to donation after their death. The grounds for refusal were generally: a misunderstanding of risks, desire for respect of corpse. The religious and the ethical motive were present too as a ground for decision making. The medical staff is the key for organ donation. To promote organ transplantation, personnel should be well informed about ethical, moral, and religious dimensions of organ donation and transplantation.

Impact Factors and Attitudes Toward Organ Donation Among Transplantation Patients and Their Caregivers in China.

PubMed

Zhang, Q-X; Xie, J-F; Zhou, J-D; Xiao, S-S; Liu, A-Z; Hu, G-Q; Chen, Y; Wang, C-Y

2017-11-01

This study's purpose was to investigate the attitudes toward organ donation among renal transplantation patients and their caregivers. In addition, we sought to explore the impact factors that affect their attitudes toward deceased organ donation. A self-administrated questionnaire was used, which consisted of two parts: 1) demographic data, and 2) transplantation and donation-related data. This study was conducted in three transplantation follow-up centers in three hospitals using a cross-sectional approach. SPSS 17.0 software was used to analysis descriptive and inferential statistics for data. The responses were analyzed using descriptive statistics and logistic regression analysis. We received 426 effective questionnaires. The renal transplantation patients' mean age was 40.84 years. Among these patients, 67.8% were willing to accept the organ transplantation surgery for their relatives, 67.4% were willing to donate a living kidney to a close relative, 62.7% were willing to donate organs after death, 53.5% were willing to register in the national organ donation system, and 51.4% were willing to sign the organ donation consent when facing their relatives becoming a potential organ donor. Age, marriage status, education level, understanding of transplantation procedures and understanding of donation procedures had statistical significance in the difference of the attitudes toward donate their organs after death (P < .05). Renal transplantation patients in our study are more willing to donate organs after death than their caregivers, but both their attitudes toward deceased donation were not very optimistic. There is a significant relationship between participants' willingness and knowledge of organ donation; patients with more understanding of the transplantation and donation procedure were more willing to donate organs after death. Affected by traditional values such as Confucianism, many people still cannot accept registering in the national organ donation system or sign the organ donation consent when facing their relatives becoming potential organ donors. There is a need to give adequate training regarding donation to increase donation rates. The government must provide education from the perspective of scientific knowledge to change the traditional views of the public, which may then increase the donation rate in China. Copyright © 2017 Elsevier Inc. All rights reserved.

Prospective audit to evaluate the potential of the coronial system to increase solid organ donation

PubMed Central

Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James

2016-01-01

Objectives Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Design Prospective audit. Setting All acute National Health Service Hospitals in the UK where deceased organ donation was considered. Participants 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Main outcome measures Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Results Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Conclusions Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. PMID:27401356

Willingness to communicate organ donation intention.

PubMed

McDonald, Deborah Dillon; Ferreri, Ruth; Jin, Carol; Mendez, Anthea; Smail, Julie; Balcom, Patricia; Shoemaker, Sheila; Kamuzora, Paul Lwekaza; Durham, Rebecca; Dibble, Jaqueline

2007-01-01

The study tested an intervention exposing people who planned to donate organs to written information about communicating with family their intention to donate organs. A pretest posttest double-blind experiment compared participants given written information about communicating with family and basic organ donation information, with participants given written information about only basic organ donation information. Participants included 109 adults who had not yet communicated their plans with family. Participants first responded to previous experience with organ donation, thoughts about organ donation, willingness to communicate with family about organ donation, and knowledge about organ donation. After reading the respective pamphlet, participants again responded to thoughts about communicating with their family and willingness to communicate with family. Both groups responded with the same high willingness to communicate before the intervention and a small but significant increase in willingness to communicate afterwards. Participants expressed a high degree of willingness to communicate about their organ donation intentions even though they had thus far not communicated their intentions. Factors in addition to willingness to communicate need to be identified in order to encourage better communication about organ donation intentions.

Understanding disparities in donor behavior: race and gender differences in willingness to donate blood and cadaveric organs.

PubMed

Boulware, L Ebony; Ratner, Lloyd E; Cooper, Lisa A; Sosa, Julie Ann; LaVeist, Thomas A; Powe, Neil R

2002-02-01

Recent efforts to recruit blood and organ donors have only marginally improved demographic disparities in willingness to donate. Few studies have examined which factors are most important in explaining race and gender disparities in willingness to donate. To assess race and gender differences in willingness to donate blood and cadaveric organs, and to determine the extent to which several factors (including sociodemographic characteristics and attitudes about religion and mistrust of hospitals) might explain differences in willingness to donate. Cross-sectional telephone survey of Maryland households contacted via random-digit dialing. Past blood donation, organ-donor status on driver's license, and measures of medical mistrust and religious and spiritual salience. Persons age 18 to 75 living in the Baltimore, Maryland metropolitan area. Of 385 respondents (84% of randomized households), 114 were black females, 46 were black males, 110 were white females, and 69 were white males. Before adjustment, black females were least willing to donate blood (41%), and black males were least willing to become cadaveric donors (19%) among all race-gender groups. Adjustment for respondent concerns about mistrust of hospitals and discrimination in hospitals explained most differences in willingness to donate blood, whereas adjustment for respondents' beliefs regarding the importance of spirituality and religion explained most differences in willingness to donate cadaveric organs. Both race and gender are important identifiers of those less willing to donate. To maximize efficiency, donor recruitment efforts should focus on race-gender groups with lowest levels of willingness. Potential donor concerns regarding mistrust in hospitals and religion/spirituality may serve as important issues to address when developing programs to improve donation rates.

Financial incentives for cadaver organ donation: an ethical reappraisal.

PubMed

Arnold, Robert; Bartlett, Steven; Bernat, James; Colonna, John; Dafoe, Donald; Dubler, Nancy; Gruber, Scott; Kahn, Jeffrey; Luskin, Richard; Nathan, Howard; Orloff, Susan; Prottas, Jeffrey; Shapiro, Robyn; Ricordi, Camillo; Youngner, Stuart; Delmonico, Francis L

2002-04-27

A panel of ethicists, organ procurement organization executives, physicians, and surgeons was convened by the sponsorship of the American Society of Transplant Surgeons to determine whether an ethically acceptable pilot trial could be proposed to provide a financial incentive for a family to consent to the donation of organs from a deceased relative. An ethical methodology was developed that could be applied to any proposal for monetary compensation to elucidate its ethical acceptability. An inverse relationship between financial incentives for increasing the families' consent for cadaver donation that clearly would be ethically acceptable (e.g., a contribution to a charity chosen by the family or a reimbursement for funeral expenses) and those approaches that would more likely increase the rate of donation (e.g., direct payment or tax incentive) was evident. The panel was unanimously opposed to the exchange of money for cadaver donor organs because either a direct payment or tax incentive would violate the ideal standard of altruism in organ donation and unacceptably commercialize the value of human life by commodifying donated organs. However, a majority of the panel members supported reimbursement for funeral expenses or a charitable contribution as an ethically permissible approach. The panel concluded that the concept of the organ as a gift could be sustained by a funeral reimbursement or charitable contribution that conveyed the appreciation of society to the family for their donation. Depending on the amount of reimbursement provided for funeral expenses, this approach could be ethically distinguished from a direct payment, by their intrusion into the realm of altruism and voluntariness. We suggest that a pilot project be conducted to determine whether this kind of a financial incentive would be acceptable to the public and successful in increasing organ donation.

Kidney Paired Donation and the "Valuable Consideration" Problem: The Experiences of Australia, Canada, and the United States.

PubMed

Toews, Maeghan; Giancaspro, Mark; Richards, Bernadette; Ferrari, Paolo

2017-09-01

As organ donation rates remain unable to meet the needs of individuals waiting for transplants, it is necessary to identify reasons for this shortage and develop solutions to address it. The introduction of kidney paired donation (KPD) programs represents one such innovation that has become a valuable tool in donation systems around the world. Although KPD has been successful in increasing kidney donation and transplantation, there are lingering questions about its legality. Donation through KPD is done in exchange for-and with the expectation of-a reciprocal kidney donation and transplantation. It is this reciprocity that has caused concern about whether KPD complies with existing law. Organ donation systems around the world are almost universally structured to legally prohibit the commercial exchange of organs. Australia, Canada, and the United States have accomplished this goal by prohibiting the exchange of an organ for "valuable consideration," which is a legal term that has not historically been limited to monetary exchange. Whether or not KPD programs violate this legislative prohibition will depend on the specific legislative provision being considered, and the legal system and case law of the particular jurisdiction in question. This article compares the experiences of Australia, Canada, and the United States in determining the legality of KPD and highlights the need for legal clarity and flexibility as donation and transplantation systems continue to evolve.

Mass media, online social network, and organ donation: old mistakes and new perspectives.

PubMed

Aykas, A; Uslu, A; Şimşek, C

2015-05-01

Contrary to TV programs projecting awareness about organ donation in society, concrete evidence exists about adverse influence of negative broadcasts on organ donation rates. We sought to determine the effect of mass media on public opinion toward organ donation and the efficacy of public campaigns and novel social media attempts on donation rates. We conducted a systematic review of relevant literature and national campaign results. Hoaxes about brain death and organ transplantation adversely affect organ donation rates in both Western and Eastern societies. Scientifically controversial and exaggerated press conferences and institutional advertisements create mistrust in doctors, thus reducing organ donation. The overall effect of public education campaigns in promoting organ donation is a temporary 5% gain. Increments in organ donation rates is expected with novel applications of social media (Facebook effect). Communication, based on mutual trust, must be established between medicine and the media. Continuing education programs with regard to public awareness on organ donation should be conducted over social media. Copyright © 2015 Elsevier Inc. All rights reserved.

Asian American adolescents' willingness to donate organs and engage in family discussion about organ donation and transplantation.

PubMed

Trompeta, Joyce A; Cooper, Bruce A; Ascher, Nancy L; Kools, Susan M; Kennedy, Christine M; Chen, Jyu-Lin

2012-03-01

Despite the growing need for organ donation among Asian Americans, studies suggest that they are reluctant to donate. To examine the association of attitudes and knowledge about organ donation and transplantation with willingness to donate and willingness to engage in family discussion about organ donation among Asian American adolescents. A cross-sectional study. The Big Island of Hawaii. Self-identified Asian American adolescents (Japanese, Chinese, Filipino, Korean), ages 16 to 17 years old, and each adolescent's parent or guardian. Asian American adolescents provided demographic information and completed the Modified Organ Donation Attitude Survey, the Organ Donation and Transplantation Knowledge Survey, and the Suinn-Lew Asian Self-Identity Acculturation Scale. A parent or guardian also provided demographic information. Linear regression analyses were used to examine the associations with willingness to donate and to engage in family discussion about organ discussion. Willingness to donate was associated with positive knowledge related to general aspects about organ donation and cultural limitations in receiving an organ transplant, a high level of acculturation, and a low level of negative attitudes (R2 = 0.402, F = 18.86, P = .005). Asian American adolescents with approving or positive attitudes were likely to engage in family discussion about organ donation (R2 = 0.195, F = 27.93, P = .005). To reinforce and maintain high levels of knowledge and positive attitudes, organ donation education is most likely needed in high schools.

The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale

PubMed Central

Schweda, Mark; Schicktanz, Silke

2009-01-01

Background The increasing debate on financial incentives for organ donation raises concerns about a "commodification of the human body". Philosophical-ethical stances on this development depend on assumptions concerning the body and how people think about it. In our qualitative empirical study we analyze public attitudes towards organ donation in their specific relation to conceptions of the human body in four European countries (Cyprus, Germany, the Netherlands and Sweden). This approach aims at a more context-sensitive picture of what "commodification of the body" can mean in concrete clinical decisions concerning organ donation. Results We find that moral intuitions concerning organ donation are rooted in various conceptions of the human body and its relation to the self: a) the body as a mechanical object owned by the self, b) the body as a part of a higher order embodying the self, and c) the body as a hierarchy of organs constitutive of the self. Conclusion The language of commodification is much too simple to capture what is at stake in everyday life intuitions about organ donation and organ sale. We discuss how the plurality of underlying body-self conceptions can be taken into account in the ethical debate, pointing out consequences for an anthropologically informed approach and for a liberal perspective. PMID:19226449

Risk Behavior and Reciprocity of Organ Donation Attitudes in Young Men.

PubMed

Vetterli, D C M; Lava, S A G; Essig, S; Milosevic, G; Cajöri, G; Uehlinger, D E; Moor, M B

2015-01-01

Lack of donor organs remains a major obstacle in organ transplantation. Our aim was to evaluate (1) the association between engaging in high-risk recreational activities and attitudes toward organ donation and (2) the degree of reciprocity between organ acceptance and donation willingness in young men. A 17-item, close-ended survey was offered to male conscripts ages 18 to 26 years in all Swiss military conscription centers. Predictors of organ donation attitudes were assessed in bivariate analyses and multiple logistic regression. Reciprocity of the intentions to accept and to donate organs was assessed by means of donor card status. In 1559 responses analyzed, neither motorcycling nor practicing extreme sports reached significant association with donor card holder status. Family communication about organ donation, student, or academic profession and living in a Latin linguistic region were predictors of positive organ donation attitudes, whereas residence in a German-speaking region and practicing any religion predicted reluctance. Significantly more respondents were willing to accept than to donate organs, especially among those without family communication concerning organ donation. For the first time, it was shown that high-risk recreational activities do not influence organ donation attitudes. Second, a considerable discrepancy in organ donation reciprocity was identified. We propose that increasing this reciprocity could eventually increase organ donation rates. Copyright © 2015 Elsevier Inc. All rights reserved.

Organ donation among undocumented hispanic immigrants: an assessment of knowledge and attitudes.

PubMed

Baru, Joshua S; Lucas, Brian R; Martinez, Carmen; Brauner, Daniel

2013-01-01

Undocumented immigrants can donate their organs, but lack access to organ transplantation.This challenges foundational principles of organ donation: fairness and informed consent. Little is known about undocumented immigrants' knowledge of barriers to their access to organ transplantation or how this might affect their decision to donate their organs. The study was performed in an urban, university-affiliated, safety-net hospital.We interviewed hospitalized patients who self-identified as undocumented immigrants and were unaware of having any contraindication to organ donation (for example, cancer). We first recorded their demographic characteristics and knowledge and attitudes regarding organ donation. We then assessed the effects of informing participants about limits to their access to organ transplants on their willingness to donate. This group of 59 uninsured Hispanic immigrants had adequate knowledge about organ donation. Participants were suspicious about inequality within the medical system, but most were willing to donate their organs (74 percent). Most participants (74 percent) were aware that they would have to pay to receive an organ, but they dramatically underestimated the out-of-pocket expenses.Yet willingness to donate their organs was unaffected by participants being explicitly informed of the low likelihood that they would be able to afford to receive an organ transplant. Despite being well informed about the organ donation system, undocumented Hispanic immigrants underestimate the costs and overestimate their likelihood of receiving an organ. Even when they are given this information, they remain willing to donate their own organs.

When do next-of-kin opt-in? Anticipated regret, affective attitudes and donating deceased family member's organs.

PubMed

Shepherd, Lee; O'Carroll, Ronan E

2014-12-01

This research assessed whether affective factors promote and prevent family members from donating their loved one's organs. Participants (N = 191) imagined that a family member had died and that they had to decide whether or not to donate their organs and body parts for transplantation purposes. The least organs and body parts were donated when the deceased opposed donation. Moreover, participants who were not registered organ donors donated fewer organs than registered donors. This effect was mediated by anticipated regret, disgust and the perceived benefits of donation. Organ donation campaigns should target such factors to increase donor rates. © The Author(s) 2013.

An analysis of knowledge and attitudes of hospice staff towards organ and tissue donation.

PubMed

Wale, J; Arthur, A; Faull, C

2014-03-01

Only a minority of hospice patients eligible to donate tissue and organs choose to do so. Hospice care staff play a key role in discussions about donation, but their willingness to engage in these discussions and their understanding of issues around tissue and organ donation is poorly understood. To (i) identify factors associated with the wish of hospice doctors, nurses and healthcare assistants to donate their own organs after death; (ii) survey the experience of discussing the subject with patients; (iii) determine staff members' knowledge of organ and tissue donation and (iv) identify factors associated with knowledge of organ and tissue donation. Cross-sectional questionnaire survey of hospice care staff. 76 of the 94 care staff of one large UK hospice completed and returned the questionnaire. Staff wishing to donate their organs after death (43/76 56.6%) were more likely to be doctors or nurses than healthcare assistants (p=0.011) and more likely to have discussed organ or tissue donation with their family (p<0.001). Staff reporting ever having discussed donation with patients had more years' experience (p=0.045) and had similarly discussed donation with their own family (p=0.039). Those with greater knowledge were more likely to have discussed organ or tissue donation with a patient (p=0.042). A reluctance to instigate discussions about organ and tissue donation may prevent palliative patients and their families being allowed the opportunity to donate. Suboptimal knowledge among hospice staff suggests the need for greater liaison between hospice staff, and the organ and tissue donation teams.

Awareness and beliefs towards organ donation in chronic kidney disease patients in western India.

PubMed

Balwani, Manish R; Kute, Vivek B; Patel, Himanshu; Shah, Pankaj R; Goswami, Jitendra; Ghule, Pravin; Shah, Maulin; Gattani, Vipul; Trivedi, Hargovind L

2015-01-01

Introduction: There is a wide discrepancy between demand for and availability of donor organs for organ transplantation. There is no study on awareness about organ donation in chronic kidney disease (CKD) patients in India. Objectives: To study the awareness and beliefs towards organ donation in CKD patients on hemodialysis in western India. Patients and Methods: Authors conducted a cross sectional study among 85 CKD patients to evaluate knowledge about and attitude towards organ donation at a tertiary hospital. Results: Age of respondents ranged from 15 to 75 years. All were aware of term organ donation and cadaver donation. About 47% of people heard about organ donation through hospital or from doctor. Strikingly, radio was not the source of information to any of the respondents, despite radio being one of the most common medium of mass communication. Almost one third of patients were unaware about any legislation regarding organ donation. All respondents felt that organs should go to the needy irrespective of their religion. About 70% feel that medical colleges should make decisions about organ donation in case of unclaimed dead bodies. About 31.76% believe that there is a danger that donated organs could be misused, abused or misappropriated. Conclusion: Our study shows about 31.76% of our participants believe that there is a danger that donated organs could be misused, abused or misappropriated. There seems to be paucity of information and awareness regarding organ donation among CKD patients. Mass media, religious and political leaders may be involved to maximize awareness about organ donation.

Awareness and beliefs towards organ donation in chronic kidney disease patients in western India

PubMed Central

Balwani, Manish R; Kute, Vivek B.; Patel, Himanshu; Shah, Pankaj R.; Goswami, Jitendra; Ghule, Pravin; Shah, Maulin; Gattani, Vipul; Trivedi, Hargovind L.

2015-01-01

Introduction: There is a wide discrepancy between demand for and availability of donor organs for organ transplantation. There is no study on awareness about organ donation in chronic kidney disease (CKD) patients in India. Objectives: To study the awareness and beliefs towards organ donation in CKD patients on hemodialysis in western India. Patients and Methods: Authors conducted a cross sectional study among 85 CKD patients to evaluate knowledge about and attitude towards organ donation at a tertiary hospital. Results: Age of respondents ranged from 15 to 75 years. All were aware of term organ donation and cadaver donation. About 47% of people heard about organ donation through hospital or from doctor. Strikingly, radio was not the source of information to any of the respondents, despite radio being one of the most common medium of mass communication. Almost one third of patients were unaware about any legislation regarding organ donation. All respondents felt that organs should go to the needy irrespective of their religion. About 70% feel that medical colleges should make decisions about organ donation in case of unclaimed dead bodies. About 31.76% believe that there is a danger that donated organs could be misused, abused or misappropriated. Conclusion: Our study shows about 31.76% of our participants believe that there is a danger that donated organs could be misused, abused or misappropriated. There seems to be paucity of information and awareness regarding organ donation among CKD patients. Mass media, religious and political leaders may be involved to maximize awareness about organ donation. PMID:28197478

Trend Analysis of Organ and Tissue Donation for Transplantation.

PubMed

Dos Santos, M J; Leal de Moraes, E; Santini Martins, M; Carlos de Almeida, E; Borges de Barros E Silva, L; Urias, V; Silvano Corrêa Pacheco Furtado, M C; Brito Nunes, Á; El Hage, S

2018-03-01

The goal of this study was to identify the tendency toward donations of tissue and organs from donors with brain death between 2001 and 2016 as registered by an organ procurement organization in São Paulo City. This quantitative, retrospective, exploratory study encompassed all Tissue and Organ Donation Terms signed between 2001 and 2016. A logistic regression model was applied to verify whether there was an upward or downward trend in donation. After statistical analysis, a significant change trend was identified in skin, bones, valve, vessel, heart, lung, and pancreas donations, indicating an increase in the donation rate through the years. The donation rate did not show changes over the years for donations of liver, kidneys, and corneas. The decision-making process regarding organ and tissue donation is restricted not only to the dilemma of whether to donate but another question then arises as well: which organs and tissues are to be donated? The discrepancy between the authorization for organ donation and the authorization for tissue donation, as well as the option for one or another organ and/or tissue, must be thoroughly examined because these factors directly affect the number of transplants and acquirements effectively accomplished. These factors may be related to explaining to one's relatives aspects of the surgery, body reassembling, and usage of such organs and/or tissues. They may also be related to the lack of knowledge concerning organ donation and the symbolism represented by the organ and/or tissue, among other factors. Copyright © 2018 Elsevier Inc. All rights reserved.

75 FR 15403 - Information Collection, Procurement of Agricultural Commodities for Foreign Donation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... Credit Corporation (CCC) is requesting comments from all interested individuals and organizations on an... opportunities for potential vendors while allowing CCC to efficiently acquire commodities. DATES: Comments on... sells or donates commodities to promote economic development. To accommodate these donations, CCC issues...

Clinical review: Moral assumptions and the process of organ donation in the intensive care unit

PubMed Central

Streat, Stephen

2004-01-01

The objective of the present article is to review moral assumptions underlying organ donation in the intensive care unit. Data sources used include personal experience, and a Medline search and a non-Medline search of relevant English-language literature. The study selection included articles concerning organ donation. All data were extracted and analysed by the author. In terms of data synthesis, a rational, utilitarian moral perspective dominates, and has captured and circumscribed, the language and discourse of organ donation. Examples include "the problem is organ shortage", "moral or social duty or responsibility to donate", "moral responsibility to advocate for donation", "requesting organs" or "asking for organs", "trained requesters", "pro-donation support persons", "persuasion" and defining "maximising donor numbers" as the objective while impugning the moral validity of nonrational family objections to organ donation. Organ donation has recently been described by intensivists in a morally neutral way as an "option" that they should "offer", as "part of good end-of-life care", to families of appropriate patients. In conclusion, the review shows that a rational utilitarian framework does not adequately encompass interpersonal interactions during organ donation. A morally neutral position frees intensivists to ensure that clinical and interpersonal processes in organ donation are performed to exemplary standards, and should more robustly reflect societal acceptability of organ donation (although it may or may not "produce more donors"). PMID:15469581

The challenges of social marketing of organ donation: news and entertainment coverage of donation and transplantation.

PubMed

Harrison, Tyler R; Morgan, Susan E; Chewning, Lisa V

2008-01-01

While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.

Organ and tissue donation in a regional paediatric intensive care unit: evaluation of practice.

PubMed

Carone, Laura; Alurkar, Shrirang; Kigozi, Phoebe; Vyas, Harish

2018-05-01

Approximately 2% of those on the organ transplant list in the UK are children. Early identification of donors and referral to organ donation teams (ODT) has proven to increase both the success rate of gaining consent and the number of organs actually retrieved. To evaluate the practice relating to organ donation for children receiving end-of-life care on a paediatric intensive care unit (PICU) measured against the National Guidelines. All children 0-18 who received their end-of-life care and died on the PICU. A retrospective cohort study of organ donation patterns including referral, approach, consent and donation. This involved a review of case notes on PICU between the years 2009 and 2014. One hundred five deaths were identified and 100 notes were examined and data analysed to ascertain if religion, age and length of stay on PICU impacted on practice. Eighty-six children met the early identification criteria for potential donors, 40 (46.5%) children were referred to the ODT and 33 (38.3%) families were approached regarding donation. Twenty-one (24.4%) families consented to donation. Seventeen donations took place with a total of 41 sets of organs/tissues retrieved. Despite the majority of children meeting early identification for potential donors, many were not being referred. All children on end-of-life care should be referred for potential organ donation. Organ donation needs to be seen as a priority for hospitals as a part of routine end-of-life care to help increase referral rates and give families the opportunity to donate. Many paediatric deaths are not referred for consideration of organ donation, despite guidelines stating that this process should be standard of care. Further optimization of referral rates may aid in increasing the number of organs available for donation. What is Known: • Shortage of organs continues to be a national problem. • NICE guidelines state that all patients who are on end-of-life care should have the option of organ donation explored. • Required referral both increases the number of donors and organs donated. What is New: • The process of identifying and referring children for paediatric organ donation. • Identifies that children are still not being referred for organ donation. • Organ donation is still not a priority for hospitals.

Prospective audit to evaluate the potential of the coronial system to increase solid organ donation.

PubMed

Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James

2016-07-08

Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Prospective audit. All acute National Health Service Hospitals in the UK where deceased organ donation was considered. 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial.

PubMed

Thornton, J Daryl; Sullivan, Catherine; Albert, Jeffrey M; Cedeño, Maria; Patrick, Bridget; Pencak, Julie; Wong, Kristine A; Allen, Margaret D; Kimble, Linda; Mekesa, Heather; Bowen, Gordon; Sehgal, Ashwini R

2016-08-01

Low organ donation rates remain a major barrier to organ transplantation. We aimed to determine the effect of a video and patient cueing on organ donation consent among patients meeting with their primary care provider. This was a randomized controlled trial between February 2013 and May 2014. The waiting rooms of 18 primary care clinics of a medical system in Cuyahoga County, Ohio. The study included 915 patients over 15.5 years of age who had not previously consented to organ donation. Just prior to their clinical encounter, intervention patients (n = 456) watched a 5-minute organ donation video on iPads and then choose a question regarding organ donation to ask their provider. Control patients (n = 459) visited their provider per usual routine. The primary outcome was the proportion of patients who consented for organ donation. Secondary outcomes included the proportion of patients who discussed organ donation with their provider and the proportion who were satisfied with the time spent with their provider during the clinical encounter. Intervention patients were more likely than control patients to consent to donate organs (22 % vs. 15 %, OR 1.50, 95%CI 1.10-2.13). Intervention patients were also more likely to have donation discussions with their provider (77 % vs. 18 %, OR 15.1, 95%CI 11.1-20.6). Intervention and control patients were similarly satisfied with the time they spent with their provider (83 % vs. 86 %, OR 0.87, 95%CI 0.61-1.25). How the observed increases in organ donation consent might translate into a greater organ supply is unclear. Watching a brief video regarding organ donation and being cued to ask a primary care provider a question about donation resulted in more organ donation discussions and an increase in organ donation consent. Satisfaction with the time spent during the clinical encounter was not affected. clinicaltrials.gov Identifier: NCT01697137.

Organ procurement: Spanish transplant procurement management.

PubMed

Manyalich, Martí; Mestres, Carlos A; Ballesté, Chloë; Páez, Gloria; Valero, Ricard; Gómez, María Paula

2011-06-01

Transplantation is an accepted therapeutic option to save or improve the quality of life when organ failure occurs or tissue replacements are needed. However, the lack of organs is the major limitation. The deceased organ procurement organization and professionals provide the solution to this international problem. In this review, we identify the elements involved in the organ procurement management process to analyze the possibility of implementation of deceased organ procurement for a transplantation program. While the donation rates are subject to several negative factors including religious, economic, cultural, and legal issues, the existence of well-trained professionals may considerably increase them. Professional training in organ donation along with the establishment of a solid organizational system has been identified as the crucial factor in developing efficient organ donation and transplantation programs.

Brazilian Healthcare Professionals: A Study of Attitudes Toward Organ Donation.

PubMed

Araujo, C; Siqueira, M

2016-12-01

Healthcare professionals have a crucial role in organ donation and transplantation processes. Their attitude toward organ donation can affect public opinion and the donation decision made by deceased donors' relatives. The objectives of the study were to analyze the attitude of medical and nursing personnel toward deceased organ donation in two hospitals in Rio de Janeiro, Brazil, and the factors that can affect this attitude. A random sample (n = 162) was selected from the population of nurses and physicians in the hospitals analyzed. The sample was stratified by age, sex, marital status, religion, professional category, and educational level. A validated questionnaire addressing psychosocial aspects of organ donation was used to evaluate attitudes. The χ 2 and Mann-Whitney U tests were applied for statistical analysis. Of personnel surveyed, 86.4% (n = 140) were in favor of deceased organ donation, whereas 11.1% (n = 18) were not sure and 2.5% (n = 4) were against. The favorable attitude was related to the following aspects: (1) educational level, (2) having spoken with family members about organ donation, (3) having a chronic disease, (4) favorable attitude of one's family, (5) belief that organ donation can save lives, (6) concerns about body manipulation, illegal trade of organs, and organ donation being against God's will, (7) feeling proud of working with organ donation/transplantation, (8) self-assessment of experience and knowledge in organ donation/transplantation activities (P < .05). Deceased organ donation is well accepted among the healthcare professionals surveyed, and the attitude is affected by socio-personal variables. Copyright © 2016 Elsevier Inc. All rights reserved.

Kidney organ donation: developing family practice initiatives to reverse inertia

PubMed Central

2010-01-01

Background Kidney transplantation is associated with greater long term survival rates and improved quality of life compared with dialysis. Continuous growth in the number of patients with kidney failure has not been matched by an increase in the availability of kidneys for transplantation. This leads to long waiting lists, higher treatment costs and negative health outcomes. Discussion Misunderstandings, public uncertainty and issues of trust in the medical system, that limit willingness to be registered as a potential donor, could be addressed by community dissemination of information and new family practice initiatives that respond to individuals' personal beliefs and concerns regarding organ donation and transplantation. Summary Tackling both personal and public inertia on organ donation is important for any community oriented kidney donation campaign. PMID:20478042

Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation.

PubMed

Traino, H M; Molisani, A J; Siminoff, L A

2017-06-01

Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from nine partnering organ procurement organizations and interview data from 1339 family decision makers (FDMs) were compared across eight geographically distinct US donor service areas (DSAs). Authorization for organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process, discussion of the least donation-related topics, the highest levels of pressure to donate, and the least comfort with the donation decision. Organ procurement organization region predicted authorization (odds ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters' communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Organ Donation: Don't Let These Myths Confuse You

MedlinePlus

... organ donation. Myth: Organ donation is against my religion. Fact: Organ donation is consistent with the beliefs of most major religions. These religions include Roman Catholicism, Islam, most branches ...

Attitudes and beliefs about organ donation among different racial groups.

PubMed Central

Yuen, C. C.; Burton, W.; Chiraseveenuprapund, P.; Elmore, E.; Wong, S.; Ozuah, P.; Mulvihill, M.

1998-01-01

Many people on the waiting list for organ donation die each year without receiving organs. The shortage of organs is even more pronounced in minority communities. Despite the fact that minorities are at higher risk, they may be less likely to support or consent to organ donation. This investigation was undertaken to study racial factors in organ donation, by focusing on differences in awareness, attitudes, and behavior. Three family practice centers in the Bronx with racially diverse but socioeconomically homogenous communities were studied. The study population consisted of a convenience sample of 163 patients who were approached for participation while they waited to see a doctor. Respondents filled out a 25-item survey that measured demographic information; their exposure to, awareness of, and attitudes toward organ donation; and whether they had signed an organ donor card. The results demonstrated overwhelming support for organ donation across all racial groups. Racial differences were found on awareness of and attitudes toward organ donation, and in the signing of organ donation cards. In contrast to other studies, racial minorities were not less likely than whites to support organ donation. These results suggest that making it easier for racial minorities to obtain organ donor cards could increase their rates of consenting to donate organs. PMID:9473924

Donor and procurement related issues in vascularized composite allograft transplantation.

PubMed

McDiarmid, Sue V

2013-12-01

To understand the unique requirements of vascularized composite allograft (VCA) donation and procurement practices and the integral role of the established nationwide organ procurement organizations in organ procurement. The recent issuance of a Final Rule (July 2013) by the United States Secretary of Health that redefines VCAs as organs rather than tissues, opens up the potential to formalize policies and procedures, under the auspices of the Organ Procurement and Transplantation Network, that can improve VCA donation, procurement practices, develop allocation algorithms and provide transparent oversight. Improved VCA donation rates, procurement procedures and broader sharing nationwide of VCA donors will have important implications in advancing the emerging field of VCA transplantation.

Intentionality of organ/tissues donation for transplantation within a Brazilian hospital complex.

PubMed

Houri, L F; de Oliveira, C D; de Souza, C V; de Moura, M R; de Araújo Ferreira, L M; Oliveira, V D M M; Pereira, W A

2012-10-01

Considering the challenges faced by members of the Intrahospital Committee of Organ and Tissue Donation for Transplantation (CIHDOTT) of a Brazilian hospital complex in Santa Casa of Belo Horizonte in the execution of multiple donations of organs and tissues, this study aimed to investigate the issues involved in the intention to donate within this population. This research sought to promote the work of CIHDOTT by planning strategies for conducting of family interviews to best meet the needs of this population, thereby contributing to reduce the wait-list for transplantations in this state hospital of Minas Gerais. The survey was performed by applying a standard questionnaire to 602 respondents comprising patients and families/caregivers. The analysis of the collected data was developed from studies of contingency tables based on chi- square and Fisher exact tests. The analysis revealed that 94% of the population to be favorable to donation. It also showed a significant influence of the following factors to determining the likelihood of organ donation: knowledge of religion (35%), spouse's opinion (17%), as well as belief in the possibility of interference or delay of the funeral as a result of donation (6%). Although the population expressed a willingness to donate, there were significant contravening factors that may be addressed by professional training and informational activities. Copyright © 2012 Elsevier Inc. All rights reserved.

Anatomists' views on human body dissection and donation: an international survey.

PubMed

Arráez-Aybar, Luis-Alfonso; Bueno-López, José Luis; Moxham, Bernard John

2014-12-01

A survey was conducted to test three hypotheses: anatomists believe that dissection by students conveys not just anatomical knowledge but also essential skills and attitudes, including professionalism; anatomists approve of the donation of their own bodies or body parts/organs for medical/health-care training and research; attitudes towards body dissection and donation are not dependent upon gender or upon the extent of teaching experience, but are related to transcendental convictions relating to beliefs in the afterlife. Eighty-one anatomists, from 29 countries responded to the survey; 80% indicated that they required medical/health-care students to dissect human cadavers (60% females-86% males, p=0.02). Most teachers recorded that dissection was an instrument for training undergraduate students, an instrument for the development of professional skills, and an instrument to help to control emotions in the future doctor rather than being only a means of teaching/learning anatomy facts. Males were more receptive to the concept that dissection helps to control emotions in the future doctor (p=0.02). Most teachers (75%) said they were willing to donate their bodies, 41% saying they would donate body organs only, 9% would donate their entire bodies only, 25% would separately donate organs and also the entire body. The willingness to donate increased significantly with the years of teaching experience (p=0.04). Teachers who were not believers in the afterlife were more likely to donate their organs/bodies than were believers (p=0.03). Our findings showed that anatomists' attitudes towards body dissection and donation are dependent upon gender, upon the extent of teaching experience, and upon transcendental convictions.

Awareness of Religious Leaders’ Fatwa and Willingness to Donate Organ

PubMed Central

Afzal Aghaee, M.; Dehghani, M.; Sadeghi, M.; Khaleghi, E.

2015-01-01

Background: It is believed that religious leaders’ positive attitude towards organ donation can be an effective factor in Muslims’ inclination to donate organs. Objective: To assess the knowledge of freshmen students in Mashhad University of Medical Sciences about religious leaders’ fatwa on organ donation and its effect on their willingness to donate organs. Methods: This cross-sectional study was conducted in 2013 on 400 freshmen of various medical disciplines, selected using a simple random sampling in Mashhad, Iran. Data were collected by a valid and reliable researcher-made questionnaire. Data were analyzed by multiple logistic regression analysis. Results: 41.5% of the students were aware of religious authorities’ views on organ donation and 55.6% were willing to donate organs. Participants’ main reasons for lack of willingness to donate organs included the fear of organ donation before the brain death is confirmed (52%), unwillingness to disfigure their body (51%), and belief in the burial of organs (50%). The willingness to organ donation for students who were aware of religious leaders opinion was more than twice more than those who were not (OR: 2.56, 95% CI: 1.75–4.52). Also, female gender, the Shia religion and awareness of the correct definition of brain death were associated factors affecting the desire to donate organs, although their effects were not statistically significant on regression model. Conclusion: A considerable proportion of students were not aware of the religious leaders’ fatwa on organ donation. The most important factor for the desire to donate organs was the awareness of religious leaders’ fatwa. Therefore, it seems necessary that religious leaders’ fatwa be known to all by appropriate methods. PMID:26576261

Organ donation and transplantation: Awareness and roles of healthcare professionals-A systematic literature review.

PubMed

Jawoniyi, Oluwafunmilayo; Gormley, Kevin; McGleenan, Emma; Noble, Helen Rose

2018-03-01

To examine the role of healthcare professionals in the organ donation and transplantation process. Globally, there remains a perennial disequilibrium between organ donation and organ transplantation. Several factors account for this disequilibrium; however, as healthcare professionals are not only strategically positioned as the primary intermediaries between organ donors and transplant recipients, but also professionally situated as the implementers of organ donation and transplantation processes, they are often blamed for the global organ shortage. Mixed-method systematic review using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist. Databases were searched including CINAHL, MEDLINE, Web of Science and EMBASE using the search terms "organ donation," "healthcare professionals," "awareness" and "roles" to retrieve relevant publications. Thirteen publications met the inclusion criteria. The global organ shortage is neither contingent upon unavailability of suitable organs nor exclusively dependent upon healthcare professionals. Instead, the existence of disequilibrium between organ donation and transplantation is necessitated by a web of factors. These include the following: healthcare professionals' attitudes towards, and experience of, the organ donation and transplantation process, underpinned by professional education, specialist clinical area and duration of professional practice; conflicts of interests; ethical dilemmas; altruistic values towards organ donation; and varied organ donation legislations in different legal jurisdictions. This review maintains that if this web of factors is to be adequately addressed by healthcare systems in different global and legal jurisdictions, there should be sufficient organs voluntarily donated to meet all transplantation needs. There is a suggestion that healthcare professionals partly account for the global shortage in organ donation, but there is a need to examine how healthcare professionals' roles, knowledge, awareness, skills and competencies might impact upon the organ donation and transplantation process. © 2017 John Wiley & Sons Ltd.

Incentivizing deceased organ donation: a Swedish priority-setting perspective.

PubMed

Omar, Faisal; Tinghög, Gustav; Welin, Stellan

2011-03-01

The established deceased organ donation models in many countries, relying chiefly on altruism, have failed to motivate a sufficient number of donors. As a consequence organs that could save lives are routinely missed leading to a growing gap between demand and supply. The aim of this paper is twofold; firstly to develop a proposal for compensated deceased organ donation that could potentially address the organ shortage; secondly to examine the compatibility of the proposal with the ethical values of the Swedish healthcare system. The proposal for compensating deceased donation is grounded in behavioural agency theory and combines extrinsic, intrinsic and signalling incentives in order to increase prosocial behaviour. Furthermore the compatibility of our proposal with the values of the Swedish healthcare system is evaluated in reference to the principles of human dignity, needs and solidarity, and cost effectiveness. Extrinsic incentives in the form of a 5,000 compensation towards funeral expenses paid to the estate of the deceased or family is proposed. Intrinsic and signalling incentives are incorporated by allowing all or part of the compensation to be diverted as a donation to a reputable charity. The decision for organ donation must not be against the explicit will of the donor. We find that our proposal for compensated deceased donation is compatible with the values of the Swedish healthcare system, and therefore merits serious consideration. It is however important to acknowledge issues relating to coercion, commodification and loss of public trust and the ethical challenges that they might pose.

Financial incentives to increase Canadian organ donation: quick fix or fallacy?

PubMed

Gill, John S; Klarenbach, Scott; Barnieh, Lianne; Caulfield, Timothy; Knoll, Greg; Levin, Adeera; Cole, Edward H

2014-01-01

Unlike the United States, the potential to increase organ donation in Canada may be sufficient to meet the need for transplantation. However, there has been no national coordinated effort to increase organ donation. Strategies that do not involve payment for organs, such as investment in health care resources to support deceased donor organ donation and introduction of a remuneration framework for the work of deceased organ donation, should be prioritized for implementation. Financial incentives that may be permitted under existing legislation and that pose little risk to existing donation sources should be advanced, including the following: payment of funeral expenses for potential donors who register their decision on organ donation during life (irrespective of the decision to donate or actual organ donation) and removal of disincentives for directed and paired exchange living donation, such as payment of wages, payment for pain and suffering related to the donor surgery, and payment of directed living kidney donors for participation in Canada's paired exchange program. In contrast, it would be premature to contemplate a regulated system of organ sales that would require a paradigm shift in the current approach to organ donation and legislative change to implement. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The Effect of Standardized Interviews on Organ Donation.

PubMed

Corman Dincer, Pelin; Birtan, Deniz; Arslantas, Mustafa Kemal; Tore Altun, Gulbin; Ayanoglu, Hilmi Omer

2018-03-01

Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate. We retrospectively evaluated the final decisions of families of 52 brain-dead donors treated at our institution between 2014 and 2017. Data underwent descriptive analyses. The standard interview content was generated after literature search results were reviewed by the authors. Previously, we examined the impact of standardized interviews done by intensive care unit physicians with relatives of potential brain-dead donors regarding decisions to donate or reasons for refusing organ donation. After termination of that study, interviews were done according to the intensivist's orientation, resulting in significantly decreased donation rates. Standardized interviews were then started again, resulting in increased donation rates. Of 17 families who participated in standardized interviews, 5 families (29.4%) agreed to donate organs of their brain-dead relatives. In the other group of families, intensivists governed informing the families of donation without standardized interviews. In this group of 35 families, 5 families (14.3%) approved organ donation. The decision regarding whether to agree to organ donation was statistically different between the 2 family groups (P < .05). Conducting a standard interview between relatives of brain-dead donors and the intensivists, facilitating visits between relatives and the brain-dead patients, and informing relatives about the donation process resulted in an increased rate of organ donation compared with routine protocols.

Awareness and Attitudes toward Organ Donation in Rural Puducherry, India.

PubMed

Balajee, K L; Ramachandran, N; Subitha, L

2016-01-01

For many of the end-stage organ diseases, organ transplantation is the most preferred treatment. The need for the organ transplantation is higher than the availability. For the transplantation program to be successful, awareness regarding organ donation is needed and people must have a positive attitude toward donating organs. This study aims to assess the awareness and attitudes regarding organ donation among the rural population and to evaluate the sociodemographic factors associated with their awareness. This community-based cross-sectional study was conducted among 360 people living in 4 villages of Puducherry. Face-to-face interviews were carried out using pretested questionnaire, which included the sociodemographic data. Data were entered into Excel and analyzed using Statistical Package for Social Sciences. Of 360 participants, 88% (317/360) were aware of organ donation. Among these 317 participants, awareness was highest in the age group 18-30 years 98.8% (87/88), male 91% (147/161), higher secondary and above 100% (58/58), and Class 1 socioeconomic status 92% (13/14). Source of awareness about organ donation was primarily through media 83% (263/317). The majority of the participants 88% (281/317) felt that the purpose of organ donation was to save life. Most of the participants 91% (290/317) said that all healthy adults are eligible organ donors and 87% (275/317) of the participants said that monetary benefits could not be accepted for organ donation. Most of the participants 70% (223/317) were willing to donate their organs after death. Among the participants who refused to donate their organs, family refusal 57% (25/44) was the most common reason. This study shows that there is a high level of awareness about organ donation among rural people and most of the participants are willing to donate their organs.

The Influence of Neighbor Effect and Urbanization Toward Organ Donation in Thailand.

PubMed

Wongboonsin, Kua; Jindahra, Pavitra; Teerakapibal, Surat

2018-03-01

Toward population wellness, an extreme scarcity of organ supply is proven to be an enormous hindrance. Preferences toward organ donation are vital to raise the organ donation rate. Notably, the area people live in can address the social influence on individual preference toward organ donation. This article studies the impact of the neighbor effect on organ donation decisions, addressing the social influence of urbanization on preferences. How neighborhood-specific variables, population density, and socioeconomic status drive the neighbor effect is investigated. The pursuit of organ donor traits is to be answered. The study uses organ donation interview survey data and neighborhood-specific data from Thailand to estimate a series of logistic regression models. Individuals residing in urban areas exhibit a greater likelihood to sign the donor card than those in rural areas. The neighborhood socioeconomic status is the key driver. An individual is more willing to be an organ donor when having neighbors with higher socioeconomic statuses. Results also reveal positive influences of males and education on the organ donation rate. This article documents the "neighbor effect" on the organ donation decision via living area type, offering an alternative exposition in raising the organ donation rate. In shifting the society norm toward organ donation consent, policy-makers should acknowledge the benefit of urbanization on organ donation decision derived from resourceful urban areas. Moreover, raising education levels does improve not only citizens' well-being but also their tendency to exhibit an altruistic act toward others.

Survey of the Knowledge of Brainstem Death and Attitude Toward Organ Donation Among Relations of Neurosurgical Patients in Nigeria.

PubMed

Rabiu, T B; Oshola, H A; Adebayo, B O

2016-01-01

Organ transplantation is a developing field in Nigeria, and availability of organs for donation would be a determining factor of the success of the transplant programs. Patients with brainstem death (BSD) are a major source of organs for transplantation. The level of knowledge of BSD as well as attitudes toward organ donation are very important determinants of people's willingness or otherwise to donate organs. We conducted a survey of relations of our in-service neurosurgical patients to assess their knowledge of brainstem death and attitude toward organ donation. To our knowledge, this is the first study of its kind among the growing Nigerian neurosurgery patient and patient-relations population. Convenience sampling of randomly selected relations of neurosurgical patients on admission using interviewer-administered questionnaires was performed. Demographic information and information about brainstem death, attitude toward brainstem death, knowledge of organ donation, and attitude toward organ donation were obtained. The study comprised 127 respondents with a mean age of 36 years (range, 19-72). The majority of the respondents (87, 62.4%) were Christians, 122 (96.1%) were Yorubas, and 66 (52.0%) were women. Eighty-five (66.9%) of the respondents had at least a secondary level of education, and 77 (60.6%) were of low socioeconomic status. Twenty-eight (22.2%) of the respondents had heard of brainstem death. Twenty-six (92.9%) of those who had heard of brainstem death believed that the brain could die long before life finally ceases. One hundred twenty-five (98.4%) of the respondents believed that death only occurs when both breathing and heartbeat stop, and 107 (83.6%) would agree with the physician on a diagnosis of brainstem death in the relation. Sixty-five (51.2%) would want such patients put on a ventilator, and, of these, 43 (66.2%) would want such patients on the ventilator in hope that he or she may recover. One hundred twelve (88.2%) of the relations were aware of organ donation, 109 (85.8%) knew that the kidney can be transplanted, and 27 (21.6%) and 17 (13.4%), respectively, were aware of heart and cornea transplant. One hundred five (82.7%) supported organ transplantation, 85 (66.9%) would donate an organ, and 97 (76.4%) would accept a transplanted organ. The majority of the respondents (76, 59.8%) would generally not allow an organ to be taken from their relation, although 70 (55.1%) would allow organ(s) to be harvested from their relation if the person had consented to it before death. More men are likely to donate organs and allow organs to be harvested from their relations than were women. Likewise, respondents with at least a secondary level of education had better awareness of brainstem death and were more likely to donate organs and allow organs to be harvested from their relations than were their less-educated counterparts. The knowledge of brainstem death was low among respondents, although most of them would agree with the physician if such diagnosis was made for their relation. Most of the respondents were aware of organ donation and supported it, but the majority would not allow an organ to be harvested from their relations. Hence, education of the Nigerian people about brainstem death and organ donation is essential to increase the pool of available organs for transplantation in our community. Copyright © 2016 Elsevier Inc. All rights reserved.

New Study Shows 59 Percent of Americans Will Develop Kidney Disease in Their Lifetime

MedlinePlus

... Patients Organ Donation & Transplantation Professionals Events Advocacy Donate NEW STUDY SHOWS 59 PERCENT OF AMERICANS WILL DEVELOP ... Urine Screening for All Americans Over Age 60 New York, NY (August 1, 2013) – Nearly six of ...

Awareness about organ donation especially kidney donation in Nurpur Shahan, a rural community area in Islamabad, Pakistan.

PubMed

Maroof, Sana; Kiyani, Nimrah; Zaman, Zahra; Gul, Raisa Khan; Nayyar, Sarah; Azmat, Ayesha; Anwar, Nageen; Shah, Rahim; Iqbal, Saima; Junaid, Aliya

2011-08-01

To assess the level of awareness and ethical issues related to organ donation especially kidney donation and the willingness to donate a kidney among the rural population of Pakistan. A cross sectional study was conducted in a sample of 324 subjects residing in Nurpur Shahan by means of a pre tested questionnaire. Data collection was carried out via a face to face interview and the data was analyzed using SPSS 10.0 and associations were tested using the Chi-square test. Knowledge about organ donation was significantly associated with age (p = 0.00) and education (p = 0.024). Allowance of organ donation in religion was an important factor in determining the attitude of individuals towards organ donation and their willingness to donate. Media emerged as a major source of information for the population of Nurpur Shahan; kidney was the organ most known for its donation. Most (69%) respondents did not consider organ vending to be ethically correct but a sizeable proportion (25%) thought it may be considered in times of dire need. Awareness of organ donation in our sample was high and more than half of the people were willing to become donors.

Questionnaire on Brain Death and Organ Procurement.

PubMed

Hammad, Saleh; Alnammourah, Manal; Almahmoud, Farah; Fawzi, Mais; Breizat, Abdel-Hadi

2017-02-01

The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old). We included people from universities, colleges, and the general public and asked questions on the circumstances of death, the conditions of conversations around organ donation, and reasons for acceptance or refusal of donation. The identical questionnaire, consisting of 8 questions, was administered twice: before and after a teaching session on brain death and organ procurement. The study was approved by our Ethical Review Committee and in accordance with the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from all participants. We found that 72.1% understood brain death in the prequestionnaire and 88% understood brain death in the postquestionnaire, with 63.8% versus 68% accepting the concept of brain death, 50.6% versus 58.3% thinking that their religion is against brain death, 11.3% versus 11.3% carrying a donor card, 50.7% versus 58.9% wanting to carry a donor card, 46.4% versus 56.4% agreeing to give consent for organ donation if a relative was diagnosed with brain death, 28.3% versus 50% aware of the laws and regulations concerning brain death and organ donation and transplant in Jordan, and 35.4% versus 40% in agreement with the Presumed Consent Law, respectively. In Jordan, along with legal requirements concerning brain death and organ donation and transplant, there is a lack of acceptance of organ donation after brain death, necessitating further work and activities to achieve self-sufficiency from donated organs.

Kidney donation and transplantation in the UK from 1998 to 2007.

PubMed

Johnson, Rachel; Collett, Dave; Birch, Rhiannon; Fuggle, Susan; Rudge, Chris

2008-01-01

There are many changes happening in donation and transplantation in the UK and this review provides a baseline against which the success of future developments can be assessed. There has been a decrease in donation after brain death over the 10-year review period, but increases in both donation after cardiac death and living kidney donation. Antibody incompatible transplantation and paired and altruistic donation programmes are starting to have an impact on the number of living donor transplants carried out and are expected to make a more marked impact in the years ahead. A new national Kidney Allocation Scheme for deceased donors after brain death was introduced in 2006 to replace the previous scheme implemented in 1998. The 2006 scheme aims to improve equity of access to transplant and is showing significant benefits for long-waiting patients. To ensure that all UK transplant centres continue to achieve high standards, both within- and across-centre monitoring of graft and patient outcomes is routinely undertaken and reported. The most important factor in increasing organ donation and transplantation in the UK is the government funding that has been provided to develop national organ donation infrastructures. These major changes are expected to have a significant impact on numbers of donors and transplants in the next 5 years.

Knowledge and attitudes toward organ donation: a community-based study comparing rural and urban populations.

PubMed

Alghanim, Saad Abdullah

2010-01-01

The study was set to determine whether knowledge and attitudes toward organ donation differ according to geographical location. Self-administered questionnaires were employed to collect data such as demographic characteristics, basic knowledge, attitudes and source of information about organ donation from subjects in rural and urban areas. The questionnaires were distributed randomly to 1,000 individuals in both areas during 2008. The data were analyzed in a descriptive fashion. Despite similarities in knowledge and attitudes of respondents in both areas, rural respondents were less likely to have information about organ donation, to report willingness to donate organs, and to have knowledge about "brain death" or the "organ donation card" than their counterparts in urban areas. The study identified that the principle respondents' source of information about organ donation was the television. More than 90% of respondents in rural and urban areas reported that the contribution of health care providers in providing them with knowledge about organ donation and transplantation was "none" or "little". Respondents identified several reasons, which may influence their decisions to donate organs. In conclusion, the deficit in knowledge and attitudes of rural respondents about organ donation may be justified by the lack of information about this significant issue. Accordingly, health facilities, local mass media and educational institutions should provide intensive educational programs to encourage the public donate organs.

Organ Donation European Quality System: ODEQUS project methodology.

PubMed

Manyalich, M; Guasch, X; Gomez, M P; Páez, G; Teixeira, L

2013-01-01

Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals. Copyright © 2013 Elsevier Inc. All rights reserved.

Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation

PubMed Central

Traino, HM; Molisani, AJ; Siminoff, LA

2017-01-01

Although federal mandate prohibits the allocation of solid organs for transplantation based on “accidents of geography,” geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from 9 partnering Organ Procurement Organizations and interview data from 1,339 family decision makers (FDMs) were compared across 8 geographically distinct US donor service areas (DSA). Authorization to organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process; discussion of the least donation-related topics; the highest levels of pressure to donate; and, the least comfort with the donation decision. OPO region predicted authorization (Odds Ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters’ communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation. PMID:27982508

Current status of transplantation and organ donation in the Balkans--could it be improved through the South-eastern Europe Health Network (SEEHN) initiative?

PubMed

Spasovski, Goce; Busic, Mirela; Pipero, Pellumb; Sarajlić, Lada; Popović, Andreja Subotić; Dzhaleva, Theodora; Codreanu, Igor; Ratković, Marina Mugosa; Popescu, Irinel; Lausević, Mirjana; Avsec, Danica; Raley, Lydia; Ekberg, Henrik; Ploeg, Rutger; Delmonico, Francis

2012-04-01

Organ donation and transplantation activity in the majority of Balkan countries (Albania, Bosnia and Herzegovina, Croatia, Macedonia, Moldova, Montenegro, Serbia, Romania and Bulgaria) are lagging far behind international averages. Inadequate financial resources, unclear regional data and lack of government infrastructure are some of the issues which should be recognized to draw attention and lead to problem-solving decisions. The Regional Health Development Centre (RHDC) Croatia, a technical body of the South-eastern Europe Health Network (SEEHN), was created in 2011 after Croatia's great success in the field over the last 10 years. The aim of the RHDC is to network the region and provide individualized country support to increase donation and transplantation activity in collaboration with professional societies (European Society of Organ Transplantation, European Transplant Coordinators Organization, The Transplantation Society and International Society of Organ Donation and Procurement). Such an improvement would in turn likely prevent transplant tourism. The regional data from 2010 show large discrepancies in donation and transplantation activities within geographically neighbouring countries. Thus, proposed actions to improve regional donation and transplantation rates include advancing living and deceased donation through regular public education, creating current and accurate waiting lists and increasing the number of educated transplant nephrologists and hospital coordinators. In addition to the effort from the professionals, government support with allocated funds per deceased donation, updated legislation and an established national coordinating body is ultimately recognized as essential for the successful donation and transplantation programmes. By continuous RHDC communication and support asked from the health authorities and motivated professionals from the SEEHN initiative, an increased number of deceased as well as living donor kidney transplantations in the future should be more realistic.

Attitude and awareness towards organ donation in western India.

PubMed

Balwani, Manish R; Gumber, Manoj R; Shah, Pankaj R; Kute, Vivek B; Patel, Himanshu V; Engineer, Divyesh P; Gera, Dinesh N; Godhani, Umesh; Shah, Mehin; Trivedi, Hargovind L

2015-05-01

To determine the knowledge, attitudes and practices regarding organ donation in western India. Convenience sampling was used to generate a sample of 250; 200 interviews were successfully completed and used for analysis. Data collection was carried out via face to face interviews based on a pre-tested questionnaire in selected public areas of Ahmedabad, Gujarat state of India. Data entry was made in excel software in codes and analysis was done by SPSS software. About 86% of participants were aware of the term organ donation but knowledge about its various aspects was low. About 48% aware people heard about organ donation through medical fraternity, whereas only about 21% became aware through mass media. About 59% of aware people believed there is a potential danger of donated organs being misused, abused or misappropriated. About 47% of aware people said they would consider donating organs, while only 16% said they would definitely donate irrespective of circumstances. Around 97.67% participants said they would prefer to donate to nonsmokers. About 74.41% participants were unaware about any legislation regarding organ donation. About 77% participants showed their will to donate to mentally sound persons, and 42.04% participants showed their will to donate even physically challenged people. Around 78 participants felt that they would donate organs to persons irrespective of their religion. About 81% of aware people were of the opinion that consent for organ donation after death should be given by family members. None of the interviewed participants had a donor card. Better knowledge and awareness will help in promoting organ donation. Effective campaign needs to be driven to educate people with relevant information with the involvement of media, doctors and religious scholars.

The impact of knowledge and religion on organ donation as seen by immigrants in Sweden.

PubMed

Krupic, Ferid; Sayed-Noor, Arkan S; Fatahi, Nabi

2017-12-01

Transplantation of organs is one of the most successful medical advances of the past 60 years and transplantation is the treatment of choice for severe organ failure worldwide. Despite this situation, and the general acknowledgement of organ donation as a global priority, demand for organs outstrips supply in virtually every country in the world. The aim of the study was to elucidate factors that influence immigrant's decisions regarding organ donation. Data were collected through three group interviews using open-ended questions and qualitative content analysis. 32 participants, 16 men and 16 women from Bosnia and Herzegovina, Somalia, Lebanon and Kosovo participated in focus group interviews (FGI). Analysis of the collected data resulted in two main categories: 'Information about organ donation' and 'Religious aspects of organ donation and a number of subcategories'. Some of the influencing factors concerning organ donation were mainly related to limited information from society as well as limited information from healthcare professionals. Religious aspects, fear and prejudices about organ donation were other factors that mentioned by participants as hamper regarding organ donation. In order to improve immigrants' attitude towards organ donation, information about this issue and identification of the hampering factors, particularly culturally related factors such as the religious aspect, is essential. In this context, different intervention studies are needed to increase monitories groups' attitude towards organ donations. © 2016 Nordic College of Caring Science.

Marketing human organs: the autonomy paradox.

PubMed

Marshall, P A; Thomasma, D C; Daar, A S

1996-03-01

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a "gift of life" and a "commodity exchange." The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources.

Culturally competent methods to promote organ donation rates among African-Americans using venues of the Bureau of Motor Vehicles.

PubMed

Zaramo, C E B; Morton, T; Yoo, J W; Bowen, G R; Modlin, C S

2008-05-01

The diversity of the nation is one of society's greatest assets, but this feature is overshadowed by the disproportionate burden of disease that exists among America's minorities. Evidence of the disparate health status has been documented in low life expectancy, cancer, diabetes, cardiovascular, and kidney disease as well as a plethora of disorders that necessitate organ transplantation. Many minorities have been reluctant to register to become organ donors. This circumstance can be alleviated by educating the public regarding the necessity of organ transplantation. We have developed a "unique" collaborative outreach program designed to promote acceptance of organ donation in African-Americans (AAs). Our outreach curriculum at Bureau of Motor Vehicles (BMV) has resulted in increased registrations and awareness regarding the need and positive perceptions toward donation. We developed a culturally sensitive outreach program: cultural sensitivity indicates how culture has the ability to influence communication between patients and health providers. An "Outreach Promotional Contest" was strategically targeted toward 28 Ohio BMVs to promote and assist in an outreach educational program regarding organ donation/registry. The consequence/results has been an increase of 3.4% in the BMV locations. The one BMV, with the highest increase was attended predominantly by AAs which moreover, won first place in the contest (6.425%; P < .05). To increase the number of people willing to register, we believe that both community education regarding the need and importance, as well as culturally sensitive promotion of organ donation, is the best way to increase organ donor registries particularly among minority populations.

Ethical and legal issues related to the donation and use of nonstandard organs for transplants.

PubMed

Cronin, Antonia J

2013-12-01

Transplantation of nonstandard or expanded criteria donor organs creates several potential ethical and legal problems in terms of consent and liability, and new challenges for research and service development; it highlights the need for a system of organ donation that responds to an evolving ethical landscape and incorporates scientific innovation to meet the needs of recipients, but which also safeguards the interests and autonomy of the donor. In this article, the use of deceased donor organs for transplants that fail to meet standard donor criteria and the legitimacy of interventions and research aimed at optimizing their successful donation are discussed. Copyright © 2013. Published by Elsevier Inc.

The Impact of Race on Organ Donation Authorization Discussed in the Context of Liver Transplantation

PubMed Central

Bodenheimer, Henry C.; Okun, Jeffrey M.; Tajik, Waheed; Obadia, Julienne; Icitovic, Nikolina; Friedmann, Patricia; Marquez, Emmanuel; Goldstein, Michael J.

2012-01-01

Inadequate organ donation limits transplantation for many in need of a life-saving organ. Race of donor families and requesting coordinators may impact the authorization rate for organ donation. We evaluated authorization rates for organ donation within the New York Organ Donor Network by race during 2009 and 2010. The donation authorization rate varied considerably according to the race of the donor. The authorization rate was 57% for Hispanic, 53% for Caucasian, 48% for African-American, and 23% for Asian donor families. Fifty-five percent of donor families agreed to donation when there was racial concordance between coordinator and donor. Donation authorization was 49% when a racial mis-match existed. When adjusted for coordinator training and experience, racial discordance had a lesser impact on authorization rates. Our findings suggest the need for education and communication strategies to overcome racial-associated perception during the organ donation process. PMID:23303969

A Focused Educational Program after Religious Services to Improve Organ Donation in Hispanic Americans

PubMed Central

Salim, Ali; Berry, Cherisse; Ley, Eric J; Schulman, Danielle; Navarro, Sonia; Zheng, Ling; Chan, Linda S

2012-01-01

Religion is an important determinant in Hispanic Americans (HA) becoming organ donors as HA often believe religion forbids donation. We investigated the effect of an educational program targeting HA organ donation in places of worship. A prospective observational study was conducted at four Catholic churches with a high percentage of HA. A 45 minute ‘culturally sensitive’ educational program, conducted in Spanish, was implemented. Organ donation awareness, knowledge, perception and beliefs, as well as the intent to become an organ donor, were measured before and after the intervention. Differences between before and after the intervention were analyzed. A total of 182 surveys were collected before and 159 surveys were collected after the educational program. A significant increase was observed in organ donation knowledge (54% vs. 70%, p<0.0001), perception (43% vs. 58%, p<0.0001) and beliefs (50% vs. 60%, p=0.0001). However, no significant difference was found in the willingness to discuss donation with family, intent-to-donate, or registering to donate after the intervention. This study demonstrates that a focused educational program in places of worship can significantly improve HA knowledge, perceptions, and beliefs regarding organ donation. Further work is needed to understand why intent-to-donate does not increase despite the increase in organ donation awareness. PMID:23106648

A focused educational program after religious services to improve organ donation in Hispanic Americans.

PubMed

Salim, Ali; Bery, Cherisse; Ley, Eric J; Schulman, Danielle; Navarro, Sonia; Zheng, Ling; Chan, Linda S

2012-01-01

Religion is an important determinant in Hispanic Americans (HA) becoming organ donors as HA often believe religion forbids donation. We investigated the effect of an educational program targeting HA organ donation in places of worship. A prospective observational study was conducted at four Catholic churches with a high percentage of HA. A 45-min "culturally sensitive" educational program, conducted in Spanish, was implemented. Organ donation awareness, knowledge, perception, and beliefs, as well as the intent to become an organ donor, were measured before and after the intervention. Differences between before and after the intervention were analyzed. A total of 182 surveys were conducted before and 159 surveys were conducted after the educational program. A significant increase was observed in organ donation knowledge (54% vs. 70%, p<0.0001), perception (43% vs. 58%, p<0.0001), and beliefs (50% vs. 60%, p=0.0001). However, no significant difference was found in the willingness to discuss donation with family, intent-to-donate, or registering to donate after the intervention. This study demonstrates that a focused educational program in places of worship can significantly improve HA knowledge, perceptions, and beliefs regarding organ donation. Further work is needed to understand why intent-to-donate does not increase despite the increase in organ donation awareness. © 2012 John Wiley & Sons A/S.

A Qualitative Study of Turning Points or Aha! Moments in Older Adults' Discussions About Organ Donation.

PubMed

Downing, Kimberly; Jones, Linda L

2018-01-01

Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as "Aha!" moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or "Aha!" moments of participants' decision-making about organ donation and organ donor registration. Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.

Attitudes and beliefs about deceased organ donation in the Arabic-speaking community in Australia: a focus group study

PubMed Central

Ralph, Angelique F; Alyami, Ali; Allen, Richard D M; Howard, Kirsten; Craig, Jonathan C; Chadban, Steve J; Irving, Michelle; Tong, Allison

2016-01-01

Objectives To describe the beliefs and attitudes to organ donation in the Arabic-speaking community. Design Arabic-speaking participants were purposively recruited to participate in 6 focus groups. Transcripts were analysed thematically. Participants 53 participants, aged 19–77 years, and originating from 8 countries, participated in 1 of 6 focus groups. Participants identified as Christian (73%), Islam (26%), Buddhist (2%) or did not identify with any religion (2%). Results 6 themes (with subthemes) were identified; religious conviction; invisibility of organ donation; medical suspicion; owning the decision; and reciprocal benefit. Conclusions Although organ donation is considered a generous life-saving ‘gift’, representative members of the Arabic-speaking community in Australia were unfamiliar with, unnerved by and sceptical about the donation process. Making positive decisions about organ donation would likely require resolving tensions between respecting family, community and religious values versus their individual autonomy. Providing targeted education about the process and benefits of organ donation within the Arabic community may clarify ambiguities surrounding cultural and religious-based views on organ donation, reduce taboos and suspicion towards donation, and in turn, lead to increased organ donation rates. PMID:26787253

Organ donation in the ICU: A document analysis of institutional policies, protocols, and order sets.

PubMed

Oczkowski, Simon J W; Centofanti, John E; Durepos, Pamela; Arseneau, Erika; Kelecevic, Julija; Cook, Deborah J; Meade, Maureen O

2018-04-01

To better understand how local policies influence organ donation rates. We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes. Documents were retrieved from Hamilton Health Sciences, an academic hospital system with a high volume of organ donation, from database inception to October 2015. We retrieved 12 active organ donation documents, including six protocols, two policies, two order sets, and two unclassified documents, a majority (75%) after the introduction of donation after circulatory death in 2006. Four major themes emerged: organ donation process, quality of care, patient and family-centred care, and the role of the institution. These themes indicate areas where documented institutional standards may be beneficial. Further research is necessary to determine the relationship of local policies, protocols, and order sets to actual organ donation practices, and to identify barriers and facilitators to improving donation rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physician perceptions about living organ donation in patients with Amyotrophic Lateral Sclerosis.

PubMed

Ansari, S; Bromberg, M B; Gibson, S B

2017-09-01

Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure. 52 complete responses were received from 121 invites. 67% (35/52) of neurologists expressed no concerns about living organ donation in ALS patients, and 33% had concerns. The concerns related to respiratory failure, anesthesia exposure and renal dysfunction. With their concerns addressed, 71% of neurologists reported that they would endorse living organ donation. 49% of neurologists reported being asked by a patient for information regarding living organ donation. ALS neurologists felt that 22.8% of ALS patients (median 19%) would be interested in learning more about organ donation, while only 6% of neurologists broach this subject with their patients. Our results indicate that 1 in every 4 ALS patients may be interested in exploring options for living organ donation, and this topic is not routinely addressed by ALS clinics. These results indicate an unexplored area of patient interest. To honor a patient's wishes to donate, the transplant community will have to accommodate living organ donation from terminally ill patients, and address neurologist concerns. Such a practice could benefit two groups of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Care pathways for organ donation after brain death: guidance from available literature?

PubMed

Hoste, Pieter; Vanhaecht, Kris; Ferdinande, Patrick; Rogiers, Xavier; Eeckloo, Kristof; Blot, Stijn; Hoste, Eric; Vogelaers, Dirk; Vandewoude, Koenraad

2016-10-01

A discussion of the literature concerning the impact of care pathways in the complex and by definition multidisciplinary process of organ donation following brain death. Enhancing the quality and safety of organs for transplantation has become a central concern for governmental and professional organizations. At the local hospital level, a donor coordinator can use a range of interventions to improve the donation and procurement process. Care pathways have been proven to represent an effective intervention in several settings for optimizing processes and outcomes. A discussion paper. A systematic review of the Medline, CINAHL, EMBASE and The Cochrane Library databases was conducted for articles published until June 2015, using the keywords donation after brain death and care pathways. Each paper was reviewed to investigate the effects of existing care pathways for donation after brain death. An additional search for unpublished information was conducted. Although literature supports care pathways as an effective intervention in several settings, few studies have explored its use and effectiveness for complex care processes such as donation after brain death. Nurses should be aware of their role in the donation process. Care pathways have the potential to support them, but their effectiveness has been insufficiently explored. Further research should focus on the development and standardization of the clinical content of a care pathway for donation after brain death and the identification of quality indicators. These should be used in a prospective effectiveness assessment of the proposed pathway. © 2016 John Wiley & Sons Ltd.

Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.

PubMed

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-03-01

Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness.

Factors Associated With Medical and Nursing Students’ Willingness to Donate Organs

PubMed Central

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-01-01

Abstract Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS’ willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS’ willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS’ attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS’ willingness. PMID:27015207

Effects of entertainment (mis) education: exposure to entertainment television programs and organ donation intention.

PubMed

Yoo, Jina H; Tian, Yan

2011-03-01

This study investigates antecedents and outcomes of entertainment television consumption in organ donation with the Orientation₁-Stimulus-Orientation₂-Response (O₁-S-O₂ -R) model. It reveals that organ donation knowledge seems significantly related to recall of entertainment television programs and attitudes toward organ donation. Meanwhile, recall of entertainment television programs significantly predicts people's perception of medical mistrust, which in turn negatively predicts attitudes toward organ donation, while attitudes toward organ donation significantly predict behavioral intention in signing a donor card. It also suggests significant mediation relationships among the pre-orientation variable, stimulus, post-orientation variable, and attitudinal and behavioral outcomes. This study provides an integrative theoretical framework to study media effects on organ donation and empirical evidence for "entertainment miseducation" (Morgan, Harrison, Chewning, Davis, & DiCorcia, 2007).

Aspects of deceased organ donation in paediatrics.

PubMed

Brierley, J; Hasan, A

2012-01-01

Organ transplantation offers children in acute or chronic severe organ failure similar opportunities to adults. However, while the number who might benefit is relatively low, significantly fewer cadaveric donors exist for any given child compared with an adult. Incompatible organ size and relatively low donation rates mean that despite living parental donation and innovations to reduce donated organ size, children die before organs become available. The severity of the UK situation is compounded by restrictions on paediatric living donation, uncertainties over the application of brain death criteria, and ethical concerns about the use of donation after circulatory death. The UK Department of Health's Organ Donation Task Force suggested the means by which the adult donor pool might be increased, recommending that outstanding ethical and legal issues be resolved, but made no specific recommendations about children.

Religion, altruism, knowledge and attitudes toward organ donation: a survey among a sample of Israeli college students.

PubMed

Khalaila, Rabia

2013-03-01

Previous studies have shown that religiosity level, religion, altruism, knowledge, attitudes toward organ donation and registration status are related to future organ donation. The current study examines this association in a multicultural society such as Israel, which had not been studied so far. A convenience sample of 563 students was included in this cross-sectional study. Data about the study measures were collected by a structured and valid questionnaire. Results showed that willingness to donate was positively related to altruism level, positive attitudes toward organ donation and donor registration. However, level of knowledge had no impact on willingness. Finally, while Christian students were more willing to donate organs than students of other religions, religiosity was negatively associated with willingness to donate organs. These results suggest that positive attitudes, a signed organ donor card and a high level of altruism may ultimately translate into an act of donation in the future. Religion and religiosity level are still barriers to future organ donations in a multicultural society such as Israel.

Knowledge and attitude towards organ donation of medicine students of a Northwestern Mexico public university

PubMed

Sebastián-Ruiz, María José; Guerra-Sáenz, Elda Karina; Vargas-Yamanaka, Anna Karen; Barboza-Quintana, Oralia; Ríos-Zambudio, Antonio; García-Cabello, Ricardo; Palacios-Saucedo, Gerardo Del Carmen

2017-01-01

To evaluate the knowledge and attitude towards organ donation of medicine students of a Northwestern Mexico public university. A prolective, descriptive, observational, and cross-sectional study. A 34 items cross-sectional survey evaluating knowledge and attitude towards organ donation in 3,056 medicine students during 2013-2015. Descriptive statistics were used as absolute frequencies, percentages, mean and standard deviation, as well as the Chi-square test. A p < 0.05 was considered significant. 74% of students would donate their own organs, mainly due to reciprocity (41%). 26% of students would not donate, 48% of them because of fear that their organs could be taken before death. 86% would donate organs from a relative. 64% have spoken about organ donation and transplantation with their family and 67% with friends. 50% said they had received no information about it. 68% understand the concept of brain death. Students received little information about organ donation during college. Despite that, most of them showed a positive attitude and are willing to donate. Copyright: © 2017 SecretarÍa de Salud

The impact of presumed consent legislation on cadaveric organ donation: a cross-country study.

PubMed

Abadie, Alberto; Gay, Sebastien

2006-07-01

In the U.S., Great Britain and in many other countries, the gap between the demand and the supply of human organs for transplantation is on the rise, despite the efforts of governments and health agencies to promote donor registration. In some countries of continental Europe, however, cadaveric organ procurement is based on the principle of presumed consent. Under presumed consent legislation, a deceased individual is classified as a potential donor in absence of explicit opposition to donation before death. This article analyzes the impact of presumed consent laws on donation rates. For this purpose, we construct a dataset on organ donation rates and potential factors affecting organ donation for 22 countries over a 10-year period. We find that while differences in other determinants of organ donation explain much of the variation in donation rates, after controlling for those determinants presumed consent legislation has a positive and sizeable effect on organ donation rates. We use the panel structure of our dataset to test and reject the hypothesis that unmeasured determinants of organ donation rates confound our empirical results.

Achievements and barriers in the organ donation process: a critical analysis of donation coordinators' discourse.

PubMed

Mercado-Martínez, Francisco J; Díaz-Medina, Blanca A; Hernández-Ibarra, Eduardo

2013-09-01

Donation coordinators play an important role in the success or failure of organ donation and transplant programs. Nevertheless, these professionals' perspectives and practices have hardly been explored, particularly in low- and middle-income countries. To examine donation coordinators' discourse on the organ donation process and the barriers they perceive. A critical qualitative study was carried out in Guadalajara, Mexico. Twelve donation coordinators from public and private hospitals participated. DATA GATHERING AND ANALYSIS: Data were gathered by using semistructured interviews and critical discourse analysis. Participants indicated that partial results have been achieved in deceased organ donation. Concomitantly, multiple obstacles have adversely affected the process and outcomes: at the structural level, the fragmentation of the health system and the scarcity of financial and material resources; at the relational level, nonegalitarian relationships between coordinators and hospital personnel; at the ideational level, the transplant domain and its specialists overshadow the donation domain and its coordinators. Negative images are associated with donation coordinators. Organ donation faces structural, relational, and ideational barriers; hence, complex interventions should be undertaken. Donation coordinators also should be recognized by the health system.

Liver transplantation in Japan.

PubMed

Soyama, Akihiko; Eguchi, Susumu; Egawa, Hiroto

2016-10-01

As of December 31, 2014, 7937 liver transplants (7673 living donor transplants and 264 deceased donor liver transplantations [DDLTs; 261 from heart-beating donors and 3 from non-heart-beating donors]) have been performed in 67 institutions in Japan. The revised Organ Transplant Law in Japan came into effect in July 2010, which allows organ procurement from brain-dead individuals, including children, with family consent if the patient had not previously refused organ donation. However, the number of deceased donor organ donations has not increased as anticipated. The rate of deceased organ donations per million population (pmp) has remained at less than 1. To maximize the viability of the limited numbers of donated organs, a system has been adopted that includes the partnership of well-trained transplant consultant doctors and local doctors. For compensating for the decreased opportunity of on-site training, an educational system regarding quality organ procurement for transplant surgeons has also been established. Furthermore, experts in the field of liver transplantation are currently discussing adoption of the Model for End-Stage Liver Disease score for allocation, promoting split-liver transplantation, arranging in-house coordinators, and improving the frequency of proposing the option to donate organs to the families. To overcome the shortage of donors during efforts to promote organ donation, living donor liver transplantation (LDLT) has been developed in Japan. Continuous efforts to increase DDLT in addition to the successful experience of LDLT will increase the benefits of liver transplantation for more patients. Liver Transplantation 22 1401-1407 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Evaluation of the Motivation to Consent to and to Refuse Organ Donation Among Participants of Educational Meetings Concerning Organ Transplantation.

PubMed

Milaniak, I; Wilczek-Rużyczka, E; Wierzbicki, K; Sadowski, J; Kapelak, B; Przybyłowski, P

2016-06-01

Improvement of the consent rate for solid organ donation from deceased donors is a key component of strategies applied in many countries aiming to increase the availability of organs for transplantation. Attitudes toward living and posthumous donation are favorable. Research shows that the outlook on organ donation and the degree of the willingness to become an organ donor are associated with a wide range of variables. The main objective of this study was to identify factors that influence the willingness to donate organs and the reasons for refusing consent. The study included 191 participants (135 female and 56 male) aged 16 to 61 years (mean age 26.86 ± 12.88). A cross-sectional study was conducted during educational meetings concerning organ donation that was addressed to students, teachers, and nurses. Survey tools included the Individual Questionnaire: Study of attitudes toward transplantation, consisting of 26 closed questions (with the consent of the Statistical Office in Krakow). In all, 97.4% of the respondents accepted transplantation from living donors, and 95.8% accepted deceased donations. Of the respondents, 78.5% agreed to posthumous life-saving organ donation. There was a significant difference between the respondents' sex, age, social group, place of living, and the reasons for their willingness to donate organs both posthumously and during their lifetime, as well as reasons for refusal. Our findings showed that the study group in general had favorable views on treatment involving transplantation and declared willingness to make a posthumous organ donation. These views vary depending on demographic variables. The education on the subject of organ and tissue donation has a positive impact on donation and transplantation rates. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge, attitudes, and behaviors of officials of religion about organ donation in Kahramanmaras, an eastern Mediterranean city of Turkey.

PubMed

Ozer, A; Ekerbicer, H C; Celik, M; Nacar, M

2010-11-01

To establish the knowledge, attitudes, and behaviors of the officials of religion, a group with potentially powerful influence on the society, in particular regarding organ donation. This study, performed in Kahramanmaras Province, Turkey, included 416 of 641 officials of religion (64.9%): 295 of 492 imams (59.9%) and 121 of 149 Koran course educators (81.2%). The mean (SD) age of the study group was 37.2 (8.2) years. Only 1.4% had stated that carried organ donation cards. Of participants who had not donated organs asked whether they thought of donation, 14.1% answered yes, 17.1% answered no, and 68.8% were undecided. Of the study group, 88.2% considered organ donation appropriate according to their religion. The imams compared with Koran course educators, and men compared with women demonstrated higher rates of considering organ donation appropriate according to their religion (P < .05). Among participants who stated they had knowledge about organ donation, the 3 leading information sources were television, newspapers or journals, and in-service training by the Directorate of Religious Affairs. The 3 primary organs the study group stated they were aware of being transplanted were kidneys, liver, and heart. Although 88.2% of religious officials in the present study stated that organ donation was appropriate according to their religion, only 1.4% agreed to donate organs. Officials of religion hold an important place in society, and should be well informed and educated about organ donation via in-service training courses, and encourage organ donation by members of society. Copyright © 2010 Elsevier Inc. All rights reserved.

Factors limiting deceased organ donation: focus groups' perspective from culturally diverse community.

PubMed

Wong, L P

2010-06-01

In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community. A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia. Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups. Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.

Awareness and Attitudes toward Organ Donation in Rural Puducherry, India

PubMed Central

Balajee, KL; Ramachandran, N; Subitha, L

2016-01-01

Background: For many of the end-stage organ diseases, organ transplantation is the most preferred treatment. The need for the organ transplantation is higher than the availability. For the transplantation program to be successful, awareness regarding organ donation is needed and people must have a positive attitude toward donating organs. Aim: This study aims to assess the awareness and attitudes regarding organ donation among the rural population and to evaluate the sociodemographic factors associated with their awareness. Subjects and Methods: This community-based cross-sectional study was conducted among 360 people living in 4 villages of Puducherry. Face-to-face interviews were carried out using pretested questionnaire, which included the sociodemographic data. Data were entered into Excel and analyzed using Statistical Package for Social Sciences. Results: Of 360 participants, 88% (317/360) were aware of organ donation. Among these 317 participants, awareness was highest in the age group 18–30 years 98.8% (87/88), male 91% (147/161), higher secondary and above 100% (58/58), and Class 1 socioeconomic status 92% (13/14). Source of awareness about organ donation was primarily through media 83% (263/317). The majority of the participants 88% (281/317) felt that the purpose of organ donation was to save life. Most of the participants 91% (290/317) said that all healthy adults are eligible organ donors and 87% (275/317) of the participants said that monetary benefits could not be accepted for organ donation. Most of the participants 70% (223/317) were willing to donate their organs after death. Among the participants who refused to donate their organs, family refusal 57% (25/44) was the most common reason. Conclusion: This study shows that there is a high level of awareness about organ donation among rural people and most of the participants are willing to donate their organs. PMID:28503345

[Multivariate study of the psychosocial factors affecting public attitude towards organ donation].

PubMed

Conesa, C; Ríos, A; Ramírez, P; Canteras, M; Rodríguez, M M; Parrilla, P

2005-01-01

Organ transplantation is a therapy which depends on society for its development. The objectives here are: 1) to understand the structure of public opinion towards organ donation in the population aged over 15 years of age in our Community; 2) to analyse the psychosocial variables which affect this opinion and 3) to define the population profiles on this matter. Random sample (n = 2.000) stratified for age, sex and geographical location (error for 95.5%, e +/- 2.24) to whom we apply a questionnaire about the psychosocial aspects of organ donation. Descriptive statistics, Student's t-test, Chi-squared test and logistical regression analysis. 63% have a favourable attitude towards organ donation, of which 11% have a donor's card. A statistical association has been observed between favourable public opinion and different psychosocial variables (p < 0.05), with some independent variables persisting in the multivariate analysis such as age, level of education (OR = 1.78), information given by family members (OR = 1.62), health workers (OR = 2.01) and talks in educational centres (OR = 2.13); previous experience with donation and transplantation (OR = 2.02), knowledge of the concept of brain death (OR = 1.4); partner's favourable opinion towards donation (OR = 2.6), being a blood donor (OR = 3), taking part in prosocial activities (OR = 1.6) and attitude towards incineration of the cadaver after death (OR = 1.8). The profile of a person who is against donation is of a man or woman, > 50 years of age, with primary studies or below, with no previous experience of the matter, who does not understand the concept of brain death nor their partner's opinion towards donation, who has not found out any information about donation through specialised forums, with an unfavourable opinion towards blood donation or pro-social activities and who is fearful of manipulation of the cadaver after death.

Organ procurement organizations Internet enrollment for organ donation: Abandoning informed consent

PubMed Central

Woien, Sandra; Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

2006-01-01

Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent. PMID:17187671

Virginia Henderson's principles and practice of nursing applied to organ donation after brain death.

PubMed

Nicely, Bruce; DeLario, Ginger T

2011-03-01

Registered nurses were some of the first nonphysician organ transplant and donation specialists in the field, both in procurement and clinical arenas. Nursing theories are abundant in the literature and in nursing curricula, but none have been applied to the donation process. Noted nursing theorist Virginia Henderson (1897-1996), often referred to as the "first lady of nursing," developed a nursing model based on activities of living. Henderson had the pioneering view that nursing stands separately from medicine and that nursing consists of more than simply following physicians' orders. Henderson's Principles and Practice of Nursing is a grand theory that can be applied to many types of nursing. In this article, Henderson's theory is applied to the intensely focused and specialized area of organ donation for transplantation. Although organ donation coordinators may have backgrounds as physicians' assistants, paramedics, or other allied health professions, most are registered nurses. By virtue of the inherent necessity for involvement of the family and friends of the potential donor, Henderson's concepts are applied to the care and management of the organ donor, to the donor's family and friends, and in some instances, to the caregivers themselves.

Incentives for Organ Donation: Proposed Standards for an Internationally Acceptable System

PubMed Central

2012-01-01

Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation. We believe that if systems based on these guidelines were developed, harms would be no greater than those to today’s conventional donors. Ultimately, until there are trials of incentives, the question of benefits and harms cannot be satisfactorily answered. PMID:22176925

Beyond the organ donor card: the effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members.

PubMed

Morgan, Susan E; Miller, Jenny K

2002-01-01

Although numerous studies have examined many of the predictors of signing an organ donor card, including knowledge, attitudes, values, and demographic variables, very few have examined the factors associated with individuals' willingness to communicate about organ donation with family members. Because organ donation does not take place without the permission of a person's next-of-kin, government agencies and organ procurement organizations have targeted communication with family members as a primary objective of organ donation campaigns. This study reports the results of a survey of a stratified random sample of adults at 2 local sites of a national employer. Results indicate that knowledge, attitude, and altruism are significantly related to 2 measures of willingness to communicate: past behavior (whether respondents had already discussed organ donation with family members) and a scale measuring willingness to communicate about organ donation in the future. Because the quality of discussions between the potential donor and his or her family will depend on how well the donor is able to address vital issues regarding donation, it is concluded that campaigns seeking to promote communication between family members about organ donation must simultaneously seek to increase knowledge, debunk myths, and bolster positive attitudes about donation.

The View of Religious Officials on Organ Donation and Transplantation in the Zeytinburnu District of Istanbul.

PubMed

Tarhan, Merve; Dalar, Levent; Yildirimoglu, Huseyin; Sayar, Adnan; Altin, Sedat

2015-12-01

One of the obstacles to organ donation and transplantation in Turkey is that of religious beliefs and, at this point, religious officials constitute a key aspect of this problem. Positive or negative viewpoints held by religious officials regarding organ donation and transplantation are influential in guiding the public. This descriptive study was conducted for the purpose of describing religious officials' viewpoints on this subject. To determine the opinions of 40 religious officials from among the imams and muezzins working in Zeytinburnu District Mufti (Religious Officials Superior) Station who participated in a normal meeting in April and who fully completed the survey. A 27-question survey form was used that consisted of open-ended and closed questions, 5 of which were on socio-demographic characteristics, 13 on viewpoints on organ donation and transplantation, and 9 on the Islamic viewpoint regarding organ donation and transplantation. For the analysis of the results, Student's t test and one-way ANOVA tests were used. It was found that all of the religious officials believed in the importance of organ donation, 80 % considered donating their organs, and 5 % had made an organ donation. Of the religious officials who had not donated organs, 35 % gave an answer that there was no specific reason and 27.5 % stated that they had never considered the subject. While the number of those stating that they would donate the organs of a close associate who had died, 77.5 % of them who did not want to donate gave as their reason the idea that if it were him, he would perhaps not want to give his organs after death. Of the religious officials questioned, 92.5 % asserted that the religion of Islam looked positively on organ donation and transplantation, 55 % stated that the knowledge of religious officials in the country was inadequate regarding this subject, and 65 % said that for interest in organ donation to increase, religious officials should make speeches and raise the issue with the public in conversations, meetings, and sermons. Fully 85 % asserted that for interest in organ donation in Turkey to increase, religious officials have to lead on the subject. Of those questioned, 52.5 % considered their knowledge on organ donation and transplantation to be adequate and that they had obtained 52.5 % of such information from seminars/conferences, 50 % from television/radio, and 45 % from Directorate of Religious Affairs publications. However, 40 % expressed that they did not know where organ donations were made. One reason for inadequate organ donation in Turkey is that of incorrect religious beliefs. Thus, it is necessary that informative efforts are made by the Directorate of Religious Affairs through in-house training programs, and that healthcare, religious, and legal officials work jointly to inform the public about organ donation, organ transplantation, and brain death. Additionally, religious officials should donate organs by the way of example and, to increase their sensitivity, healthcare professionals should go more frequently to mosques and Mufti Stations.

The View of Religious Officials on Organ Donation and Transplantation in the Zeytinburnu District of Istanbul.

PubMed

Tarhan, Merve; Dalar, Levent; Yildirimoglu, Huseyin; Sayar, Adnan; Altin, Sedat

2014-03-22

One of the obstacles to organ donation and transplantation in Turkey is that of religious beliefs and, at this point, religious officials constitute a key aspect of this problem. Positive or negative viewpoints held by religious officials regarding organ donation and transplantation are influential in guiding the public. This descriptive study was conducted for the purpose of describing religious officials' viewpoints on this subject. To determine the opinions of 40 religious officials from among the imams and muezzins working in Zeytinburnu District Mufti (Religious Officials Superior) Station who participated in a normal meeting in April and who fully completed the survey. A 27-question survey form was used that consisted of open-ended and closed questions, 5 of which were on socio-demographic characteristics, 13 on viewpoints on organ donation and transplantation, and 9 on the Islamic viewpoint regarding organ donation and transplantation. For the analysis of the results, Student's t test and one-way ANOVA tests were used. It was found that all of the religious officials believed in the importance of organ donation, 80 % considered donating their organs, and 5 % had made an organ donation. Of the religious officials who had not donated organs, 35 % gave an answer that there was no specific reason and 27.5 % stated that they had never considered the subject. While the number of those stating that they would donate the organs of a close associate who had died, 77.5 % of them who did not want to donate gave as their reason the idea that if it were him, he would perhaps not want to give his organs after death. Of the religious officials questioned, 92.5 % asserted that the religion of Islam looked positively on organ donation and transplantation, 55 % stated that the knowledge of religious officials in the country was inadequate regarding this subject, and 65 % said that for interest in organ donation to increase, religious officials should make speeches and raise the issue with the public in conversations, meetings, and sermons. Fully 85 % asserted that for interest in organ donation in Turkey to increase, religious officials have to lead on the subject. Of those questioned, 52.5 % considered their knowledge on organ donation and transplantation to be adequate and that they had obtained 52.5 % of such information from seminars/conferences, 50 % from television/radio, and 45 % from Directorate of Religious Affairs publications. However, 40 % expressed that they did not know where organ donations were made. One reason for inadequate organ donation in Turkey is that of incorrect religious beliefs. Thus, it is necessary that informative efforts are made by the Directorate of Religious Affairs through in-house training programs, and that healthcare, religious, and legal officials work jointly to inform the public about organ donation, organ transplantation, and brain death. Additionally, religious officials should donate organs by the way of example and, to increase their sensitivity, healthcare professionals should go more frequently to mosques and Mufti Stations.

Exploring Donation Decisions: Beliefs and Preferences for Organ Donation in Australia

ERIC Educational Resources Information Center

Hyde, Melissa K.; White, Katherine M.

2010-01-01

The authors explored common beliefs and preferences for posthumous and living organ donation in Australia where organ donation rates are low and little research exists. Content analysis of discussions revealed the advantage of prolonging/saving life whereas disadvantages differed according to donation context. A range of people/groups perceived to…

Vascularized Composite Allograft Donation and Transplantation: A Survey of Public Attitudes in the United States.

PubMed

Rodrigue, J R; Tomich, D; Fleishman, A; Glazier, A K

2017-10-01

Vascularized composite allograft (VCA) transplantation has emerged as a groundbreaking surgical intervention to return identity and function following traumatic injury, congenital deformity, or disfigurement. While public attitudes toward traditional organ/tissue donation are favorable, little is known about attitudes toward VCA donation and transplantation. A survey was conducted of 1485 U.S. residents in August 2016 to assess VCA donation attitudes. Participants also completed the Revised Health Care System Distrust Scale. Most respondents were willing to donate hands/forearms (67.4%) and legs (66.8%), and almost half (48.0%) were willing to donate the face. Three-quarters (74.4%) of women were willing to donate the uterus; 54.4% of men were willing to donate the penis. VCA donation willingness was more likely among whites and Hispanics (p < 0.001), registered organ/tissue donors (p < 0.001), and those with less health care system distrust (p < 0.001) and media exposure to VCA transplantation (p = 0.003). Many who opposed VCA donation expressed concerns about psychological discomfort, mutilation, identity loss, and the reaction of others to seeing familiar body parts on a stranger. Attitudes toward VCA donation are favorable overall, despite limited exposure to VCA messaging and confusion about how VCA donation occurs. These findings may help guide the development and implementation of VCA public education campaigns. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Organ Donation

MedlinePlus

Organ donation takes healthy organs and tissues from one person for transplantation into another. Experts say that the organs ... and bone marrow Cornea Most organ and tissue donations occur after the donor has died. But some ...

48 CFR 52.226-6 - Promoting excess food donation to nonprofit organizations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... donation to nonprofit organizations. 52.226-6 Section 52.226-6 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.226-6 Promoting excess food donation to nonprofit organizations. As prescribed in 26.404, insert the following clause: PROMOTING EXCESS FOOD DONATION TO NONPROFIT ORGANIZATIONS...

48 CFR 52.226-6 - Promoting excess food donation to nonprofit organizations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... donation to nonprofit organizations. 52.226-6 Section 52.226-6 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.226-6 Promoting excess food donation to nonprofit organizations. As prescribed in 26.404, insert the following clause: PROMOTING EXCESS FOOD DONATION TO NONPROFIT ORGANIZATIONS...

48 CFR 52.226-6 - Promoting excess food donation to nonprofit organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... donation to nonprofit organizations. 52.226-6 Section 52.226-6 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.226-6 Promoting excess food donation to nonprofit organizations. As prescribed in 26.404, insert the following clause: PROMOTING EXCESS FOOD DONATION TO NONPROFIT ORGANIZATIONS...

48 CFR 52.226-6 - Promoting excess food donation to nonprofit organizations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... donation to nonprofit organizations. 52.226-6 Section 52.226-6 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.226-6 Promoting excess food donation to nonprofit organizations. As prescribed in 26.404, insert the following clause: Promoting Excess Food Donation to Nonprofit Organizations...

Knowledge and Ethical Issues in Organ Transplantation and Organ Donation: Perspectives from Iranian Health Personnel.

PubMed

Abbasi, Mahmoud; Kiani, Mehrzad; Ahmadi, Mehdi; Salehi, Bahare

2018-05-04

BACKGROUND Organ transplantation is one of the most critical topics in medical ethics that is commonplace in various countries. This study aimed to evaluate the knowledge and the ethical issues surrounding organ transplantation and organ donation among healthcare personnel in Tehran, Iran. MATERIAL AND METHODS In a cross-sectional study performed on 450 healthcare personnel, self-administered questionnaires were used to derive data from individuals. Among the 450 health personnel who received the questionnaires, 377 completed their questionnaires (83.77%). RESULTS The willingness and unwillingness to donate organs among individuals were 47.48% (n=179) and 52.51% (n=198), respectively. Among the individuals who signed the organ donation card, 96.5% (n=55) were willing to donate their organs and 3.5% (n=2) were unwilling to donate their organs. Most of the individuals that were willing (48.34%; n=175) and unwilling (51.66%; n=187) to donate their organs claimed religious support for organ donation (P=0.00). Out of these people, 110 willing people (67.48%) and 53 (32.52%) unwilling people were familiar with the idea of brain death. The individuals who selected cadavers (67.64%; n=255) and brain death (24.4%; n=92) were chosen as the best candidates for organ donation. Most individuals believed that young patients (n=123; 32.62%) and people who had not already had organ transplants (n=90; 23.87%) should be the preferred recipients of organs. Most individuals had learned about organ transplantation from television (30.24%; n=114), newspapers (23.61%; n=89), and the radio (19.89%; n=75). CONCLUSIONS In conclusion, there is a need for more educational programs for the improvement of knowledge and ethical consideration with regard to organ transplantation and organ donation among healthcare personnel.

Attitudes and beliefs about deceased organ donation in the Arabic-speaking community in Australia: a focus group study.

PubMed

Ralph, Angelique F; Alyami, Ali; Allen, Richard D M; Howard, Kirsten; Craig, Jonathan C; Chadban, Steve J; Irving, Michelle; Tong, Allison

2016-01-19

To describe the beliefs and attitudes to organ donation in the Arabic-speaking community. Arabic-speaking participants were purposively recruited to participate in 6 focus groups. Transcripts were analysed thematically. 53 participants, aged 19-77 years, and originating from 8 countries, participated in 1 of 6 focus groups. Participants identified as Christian (73%), Islam (26%), Buddhist (2%) or did not identify with any religion (2%). 6 themes (with subthemes) were identified; religious conviction; invisibility of organ donation; medical suspicion; owning the decision; and reciprocal benefit. Although organ donation is considered a generous life-saving 'gift', representative members of the Arabic-speaking community in Australia were unfamiliar with, unnerved by and sceptical about the donation process. Making positive decisions about organ donation would likely require resolving tensions between respecting family, community and religious values versus their individual autonomy. Providing targeted education about the process and benefits of organ donation within the Arabic community may clarify ambiguities surrounding cultural and religious-based views on organ donation, reduce taboos and suspicion towards donation, and in turn, lead to increased organ donation rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Basic ethical aspects of living organ donation].

PubMed

Nagel, E; Mayer, J

2003-06-01

A characteristic feature of transplanting organs from living donors is that not only patients in need for treatment but also healthy individuals are submitted to medical interventions. Ethical considerations in this field have to deal with the question of property attributes of the human body and conflicts with traditional medical principles. Altruistic organ donation, appreciated by Christianity as a sign of charity, is indeed contradictory to the classic maxim of medical ethics "primum nihil nocere, " meaning "first of all, do not harm." The autonomous choice of a potential donor has to be balanced thoroughly against his personal physical and psychological risks. Apart from organ donation with altruistic motives, commercial incentives or payment for organ donation, which are increasingly under discussion in many nations, need profound ethical reflection. Organ selling does not lead to long-term economic benefit for individual donors in developing countries and is associated with a decline in health. A market system of organ sales would foster exploitation of the poor, and it is substantially doubtful whether autonomy and self determination are valid under circumstances of poverty and coercion. Commodification of the human body risks viewing persons as marketable objects. The human body,however, is an integral element of an individual's personality and not a resource to be removed. It is therefore fundamental that the social good of altruism is preserved as the major principle in organ donation.

Knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in Malaysia's multi-ethnic society: a baseline study.

PubMed

Wong, Li Ping

2011-01-01

Malaysia's organ and tissue donation rates are among the lowest in the world. The study aims to explore the knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in the diverse ethnic communities in the state of Selangor, Malaysia. A cross-sectional, population-based, computer-assisted telephone interview exploring multi-ethnic participants' knowledge, attitudes, practices and behavioral on deceased organ donation and transplantation was conducted from February to April 2009. Although only 5.5% of the total participants (N = 1174) reported that they have registered to be organ donor, a further 35.2% of those who have not register for organ donation indicated willingness to donate their own. Significant socio-demographic disparities with respect to knowledge and attitudes scores were observed. In particular, Malays (20.7%) indicated lower willingness to donate organs compared to the Chinese (36.6%) and Indians (51.4%) (p < 0.001). In multivariate logistic regression analysis, willingness to donate one's own organ was associated with knowledge score (odds ratio [OR] = 1.17, 95% confidence interval [CI] = 1.13-1.22), attitude score (OR = 1.17, 95% CI = 1.05-1.31), secondary school education (OR = 1.46, 95% CI = 1.05-2.02), and Malay ethnicity (OR = 0.18, 95% CI = 0.03-0.94). Findings assist organ donation and transplantation organizations to reach out the diverse socio-demographic and ethnic communities with cultural-specific information about organ donation. © 2010 John Wiley & Sons A/S.

Abandoning the dead donor rule? A national survey of public views on death and organ donation

PubMed Central

Nair-Collins, Michael; Green, Sydney R; Sutin, Angelina R

2015-01-01

Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the ‘dead donor rule’, which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. PMID:25260779

Modification of the education system for organ procurement coordinators in Japan after the revision of the Japanese Organ Transplantation Act.

PubMed

Konaka, S; Kato, O; Ashikari, J; Fukushima, N

2012-05-01

From October 1997 to July 2010, only 86 brain-dead (BD) organ donations were obtained and no organs were retrieved from children under 15 years of age because of the strict Japan Organ Transplantation Act. The Act was revised on July 17, 2010, allowing organs to be donated after BD with family consent. To manage the increased donations after the revision, the Japan Organ Transplant Network (JOT) employed 10 organ procurement coordinators (OPCs) and modified its education systems. We retrospectively reviewed the modified education programs to evaluate whether they were effective and whether the processes of organ donation were promptly performed after the revision of the Act. The modifications of education program were: changing OPC to guideline manuals to correspond to the revised Transplant Act; OPCs were taught the new organ procurement system; and a special education program was provided for the 10 newcomers for 2 months. After 12 months of the revision, 58 BD organ donations were accomplished, whereas they had averaged 6.6 in a year before the revision. Two pediatric BD organ donations were accomplished without problem. One priority organ donation to a relative was performed uneventfully. After applying the modified education program, skilled JOT OPCs and leader JOT OPCs increased. To manage increased organ donations after the revision of the Act, the educational system was modified and 58 brain dead organ donations were performed safely. Copyright © 2012 Elsevier Inc. All rights reserved.

A sequential decision framework for increasing college students' support for organ donation and organ donor registration.

PubMed

Peltier, James W; D'Alessandro, Anthony M; Dahl, Andrew J; Feeley, Thomas Hugh

2012-09-01

Despite the fact that college students support social causes, this age group has underparticipated in organ donor registration. Little research attention has been given to understanding deeper, higher-order relationships between the antecedent attitudes toward and perceptions of organ donation and registration behavior. To test a process model useful for understanding the sequential ordering of information necessary for moving college students along a hierarchical decision-making continuum from awareness to support to organ donor registration. The University of Wisconsin organ procurement organization collaborated with the Collegiate American Marketing Association on a 2-year grant funded by the US Health Resources and Services Administration. A total of 981 association members responded to an online questionnaire. The 5 antecedent measures were awareness of organ donation, need acknowledgment, benefits of organ donation, social support, and concerns about organ donation. The 2 consequence variables were support for organ donation and organ donation registration. Structural equation modeling indicated that 5 of 10 direct antecedent pathways led significantly into organ donation support and registration. The impact of the nonsignificant variables was captured via indirect effects through other decision variables. Model fit statistics were good: the goodness of fit index was .998, the adjusted goodness of fit index was .992, and the root mean square error of approximation was .001. This sequential decision-making model provides insight into the need to enhance the acceptance of organ donation and organ donor registration through a series of communications to move people from awareness to behavior.

A Study on Nursing Students' Knowledge, Attitude, and Educational Needs for Brain-Death Organ Transplantation and Donation and Intent to Donate Organs.

PubMed

Ju, M K; Sim, M K; Son, S Y

2018-05-01

The purpose of this study was to identify the knowledge, attitude, educational needs, and will of nursing students on organ donation from brain-dead donors. Data were collected by using a 40-item questionnaire to measure knowledge, attitude, educational needs, and will for organ donation of 215 nursing college students in one university in Dangjin city from May 11 to May 31, 2017. The data were analyzed using SPSS 22 program (Data Solution Inc, Seoul). In the general characteristics, 85.1% of the subjects did not receive education on donation, and 99.5% of the subjects responded that education is needed. The desired methods of education were special lecture in school (55.3%), "webtoons" on the Internet (19.5%), formal curriculum (15.8%). Points to improve to increase brain-death organ transplantation and donation included "active publicity through pan-national campaign activities" (56.3%), "respecting prior consent from brain-dead donors" (21.9%), and "encouragement and increased support for organ donors" (12.1%). There was a significant difference in knowledge according to will for organ donation (t = 3.29, P = .001) and consent to brain-death organ donation in family members (t = 3.29, P = .001). There was a statistically significant positive correlation between attitude and knowledge of the subjects regarding brain-death organ donation. The knowledge, attitude, educational need, and will for organ donation of nursing students revealed in this study will be used as basic data to provide systematic transplant education including contents about organ transplantation in the regular nursing curriculum in the future. It will contribute to the activation of organ donation. Copyright © 2018 Elsevier Inc. All rights reserved.

Understanding the pros and cons of organ donation decision-making: Decisional balance and expressing donation intentions among African Americans.

PubMed

Flemming, Shauna St Clair; Redmond, Nakeva; Williamson, Dana Hz; Thompson, Nancy J; Perryman, Jennie P; Patzer, Rachel E; Arriola, Kimberly Jacob

2018-04-01

Increasing public commitment to organ donation is critical to improving donor kidney availability for end-stage renal disease patients desiring transplant. This study surveyed ( N = 1339) African Americans, measuring perceived pros relative to cons of organ donation, to evaluate an existing Transtheoretical Model decisional balance scale and associations between decisional balance and expressing donation intentions. Findings supported the existing scale structure. More positive decisional balance ratios were associated with 1.76 times the odds of expressing intentions (95% confidence interval = 1.52-2.04). Pros were more strongly linked to donation intentions than cons. Greater understanding of organ donation decision-making is valuable for informing interventions that encourage donation.

Organ donation as transition work: Policy discourse and clinical practice in The Netherlands.

PubMed

Paul, Katharina T; Avezaat, Cees J J; Ijzermans, Jan N; Friele, Roland D; Bal, Roland A

2014-07-01

An increasing number of patients become eligible for organ transplants. In the Netherlands, at the level of policy discourse, growing waiting lists are often referred to as a persistent "shortage" of organs, producing a "public health crisis." In this way, organ donation is presented as an ethical, social, and medical necessity. Likewise, policy discourse offers a range of seemingly unambiguous solutions: improving logistical infrastructure at the level of hospitals, developing organizational and legal protocols, as well as public information campaigns. Instead of taking these problem and solution definitions as given, we critically examine the relationship between policy discourse and clinical practice. Based on a historical review, first, we trace the key moments of transformation where organ donation became naturalized in Dutch policy discourse, particularly in its altruistic connotation. Second, based on in-depth interviews with medical professionals, we show how those involved in organ donation continue to struggle with the controversial nature of their clinical practice. More specifically, we highlight their use of different forms of knowledge that underlie clinicians' "transition work": from losing a patient to "gaining" a donor. © The Author(s) 2013.

Predictors of organ donation behavior among Hispanic Americans.

PubMed

Alvaro, Eusebio M; Jones, Sara Pace; Robles, Antonio Santa Maria; Siegel, Jason T

2005-06-01

Hispanic Americans have a substantial need for organ transplants and are underrepresented among organ donors, yet little is known about predictors of organ donation outcomes in this population. To assess factors that may function as significant predictors of organ donation behavior among Hispanic Americans. A random-digit-dial computer-assisted telephone-interview survey. Setting-Pima and Maricopa counties in Arizona. 1200 Hispanic Americans. Family discussion of organ donation and willingness to be an organ donor. Significant predictors of family discussion of organ donation include knowing someone willing to be an organ donor and disagreeing that carrying a donor card results in inadequate medical care. Willingness to be a donor is also predictive of family discussion. Significant predictors of willingness to be an organ donor are knowing someone willing to be an organ donor, being female, and disagreeing that thoughts about donation leads to thoughts about one's own mortality. Having a family discussion about organ donation is also predictive of willingness to be an organ donor. The data provide a springboard for larger studies encompassing the diversity and geographical dispersion of Hispanic Americans. The data also highlight the importance of educational efforts to make Hispanic Americans aware of people in their community who have donated in the past or who are now potential donors.

An Exploratory Study on University Students' Perceptions of Posthumous Organ Donation Base on the Theory of Reasoned Action.

PubMed

Wong, Shui Hung; Chow, Amy Yin Man

2017-08-01

In view of the general support for organ donation but low registration rate in Hong Kong, the present research attempted to understand the attitude-behavior inconsistency by identifying the underlying beliefs for organ donation through employing the theory of reasoned action. A qualitative approach using semi-structured focus groups was adopted and 19 students from three universities in Hong Kong participated; 10 constructs were identified: attitude, subjective norm, helping, continuation, contribution, body intact, distrust to the medical system, indifference to organ donation, negative affect, and family burden. Findings suggested that their attitudes toward organ donation were of both the cognitive and affective nature; subjective norm of family, friends, and people they respect were identified as influential to students' views on organ donation. The study provided insight in promoting organ donation, that the cognitive concerns about keeping the body intact, and the negative affects introduced should also be addressed.

A Confirmatory Analysis of the Organ Donation Readiness Index: Measuring the Potential for Organ Donations among African Americans

ERIC Educational Resources Information Center

Rice, Christopher; Tamburlin, Judith

2004-01-01

The need for transplant exceeds the number of available organs. Antigen compatible organs are particularly scarce for African Americans because of their proportionately lower rate of donations. This study presents a measure of organ donation readiness. Examination of the factor structure and a test of weak invariance were conducted on…

Relationships between Islamic religiosity and attitude toward deceased organ donation among American Muslims: a pilot study.

PubMed

Padela, Aasim I; Zaganjor, Hatidza

2014-06-27

Religion-rooted beliefs and values are often cited as barriers to organ donation among Muslims. Yet how Islamic religiosity relates to organ donation attitude among Muslims is less studied. Using a community based participatory research approach, we recruited adults from mosque communities to self-administer a questionnaire assessing levels of Islamic religiosity, attitude toward deceased organ donation, and sociodemographic descriptors. Of the 97 respondents, there were nearly equal numbers of men and women. Over a third were Arab American (n=36), and nearly a quarter were either South Asian (n=23) or African American (n=25). Respondents viewing difficulties in life as punishment from God had a decreased odds of believing deceased organ donation to be justified (OR 0.85, P<0.05). Other measures of Islamic religiosity, such as intrinsic religiosity, positive religious coping and one related to following Islamic ethical guidelines, were not associated with organ donation attitude. Arab Muslims were more likely to believe deceased organ donation to be justified than South Asian or African Americans (OR 7.06, P<0.05). Sociodemographic descriptors including age, sex, and country of origin, as well as self-reported health and trust of the American health-care system, were not significantly associated with attitude toward deceased organ donation. Higher levels of intrinsic religiosity or adherence to Islamic ethics do not appear to associate with negative attitudes toward deceased organ donation. Negative religious coping appears, however, to be related to lower rates of believing deceased organ donation to be justified. Future studies with larger samples that incorporate additional measures of religiosity can further clarify relationships between religiosity and organ donation attitude among Muslim communities.

Knowledge and attitudes of Canadian First Nations people toward organ donation and transplantation: a quantitative and qualitative analysis.

PubMed

Davison, Sara N; Jhangri, Gian S

2014-11-01

Organ donation and transplantation rates are low for aboriginal people in Canada, despite a high demand. An explanatory mixed-methods design was used to describe knowledge of and preferences for organ donation and transplantation among First Nations people and identify factors that may influence these preferences. We recruited on- and off-reservation First Nations adults. A 45-item survey was administered to 198 participants, of whom 21 were assessed further with a qualitative interview using a multiple case study approach. In an iterative process, themes were identified from qualitative data using critical realism as the theoretical framework. Critical realism is an approach that describes the interface between natural and social worlds to explain human behavior. Although 83% of participants were in favor of transplantation, only 38% were willing to donate their organs after death, 44% had not thought about organ donation, and 14% did not believe it was important. Only 18.7% of participants reported that their cultural beliefs influenced their views on organ donation and transplantation. In the multivariable analysis, the only factors associated with willingness to donate organs were higher education and considering organ donation important. Four themes emerged from qualitative data: importance of traditional beliefs, recognition of need due to the epidemic of diabetes among Canadian aboriginal people, reconciliation between traditional beliefs and need, and general apathy in the community. Cultural, socioeconomic, and political diversity exist between and within aboriginal groups. Findings may not be generalizable to other aboriginal communities. Willingness to donate organs was lower in these First Nations participants compared to the general population. Education to address knowledge deficits, emphasize the negative impact of organ failure on the community, and contextualize organ donation within the older traditional native beliefs to help First Nations people understand how organ donation may be integrated into native spirituality likely is required to increase donation rates. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Pediatric Donation After Circulatory Determination of Death: A Scoping Review.

PubMed

Weiss, Matthew J; Hornby, Laura; Witteman, William; Shemie, Sam D

2016-03-01

Although pediatric donation after circulatory determination of death is increasing in frequency, there are no national or international donation after circulatory determination of death guidelines specific to pediatrics. This scoping review was performed to map the pediatric donation after circulatory determination of death literature, identify pediatric donation after circulatory determination of death knowledge gaps, and inform the development of national or regional pediatric donation after circulatory determination of death guidelines. Terms related to pediatric donation after circulatory determination of death were searched in Embase and MEDLINE, as well as the non-MEDLINE sources in PubMed from 1980 to May 2014. Seven thousand five hundred ninety-seven references were discovered and 85 retained for analysis. All references addressing pediatric donation after circulatory determination of death were considered. Exclusion criteria were articles that did not address pediatric patients, animal or laboratory studies, surgical techniques, and local pediatric donation after circulatory determination of death protocols. Narrative reviews and opinion articles were the most frequently discovered reference (25/85) and the few discovered studies were observational or qualitative and almost exclusively retrospective. Retained references were divided into themes and analyzed using qualitative methodology. The main discovered themes were 1) studies estimating the number of potential pediatric donation after circulatory determination of death donors and their impact on donation; 2) ethical issues in pediatric donation after circulatory determination of death; 3) physiology of the dying process after withdrawal of life-sustaining therapy; 4) cardiac pediatric donation after circulatory determination of death; and 5) neonatal pediatric donation after circulatory determination of death. Donor estimates suggest that pediatric donation after circulatory determination of death will remain an event less common than brain death, albeit with the potential to substantially expand the existing organ donation pool. Limited data suggest outcomes comparable with organs donated after neurologic determination of death. Although there is continued debate around ethical aspects of pediatric donation after circulatory determination of death, all pediatric donation after circulatory determination of death publications from professional societies contend that pediatric donation after circulatory determination of death can be practiced ethically. This review provides a comprehensive overview of the published literature related to pediatric donation after circulatory determination of death. In addition to informing the development of pediatric-specific guidelines, this review serves to highlight several important knowledge gaps in this topic.

The difference in the attitude of Chinese and Japanese college students regarding deceased organ donation.

PubMed

Liu, S; Liu, C; Cao, X; Shang, B; Chen, A; Liu, B

2013-01-01

Under the influence of traditional oriental culture, the lack of organ donation is especially serious in China and Japan. The aim of this study was to compare Chinese and Japanese college students' attitudes and analyze contributing factors toward deceased donation. An anonymous, self-administered questionnaire comprising 15 questions was distributed to approximately 400 college students at Liaoning University, China, and Kyushu University, Japan. Statistical analysis used SPSS software. Japanese students' attitude towards deceased organ donation was more favorable than that of Chinese students (43.6% versus 35.9%, P = .001). Several factors contributed to positive responses by students from both countries: family perspective on organ donation and transplantation; decision to donate to family members; prior blood donation; living liver or kidney donation; possibility of needing a transplant; and willingness to receive a deceased or a living donor organ. More efforts must emphasize awareness and up-to-date knowledge regarding organ donation among citizens and should be undertaken by the Chinese and Japanese governments. Copyright © 2013 Elsevier Inc. All rights reserved.

Bereaved donor families' experiences of organ and tissue donation, and perceived influences on their decision making.

PubMed

Sque, Magi; Walker, Wendy; Long-Sutehall, Tracy; Morgan, Myfanwy; Randhawa, Gurch; Rodney, Amanda

2018-06-01

To elicit bereaved families' experiences of organ and tissue donation. A specific objective was to determine families' perceptions of how their experiences influenced donation decision-making. Retrospective, qualitative interviews were undertaken with 43 participants of 31 donor families to generate rich, informative data. Participant recruitment was via 10 National Health Service Trusts, representative of five regional organ donation services in the UK. Twelve families agreed to DBD, 18 agreed to DCD, 1 unknown. Participants' responses were contextualised using a temporal framework of 'The Past', which represented families' prior knowledge, experience, attitudes, beliefs, and intentions toward organ donation; 'The Present', which incorporated the moment in time when families experienced the potential for donation; and 'The Future', which corresponded to expectations and outcomes arising from the donation decision. Temporally interwoven experiences appeared to influence families' decisions to donate the organs of their deceased relative for transplantation. The influence of temporality on donation-decision making is worthy of consideration in the planning of future education, policy, practice, and research for improved rates of family consent to donation. Copyright © 2018 Elsevier Inc. All rights reserved.

US organ donation breakthrough collaborative increases organ donation.

PubMed

Shafer, Teresa J; Wagner, Dennis; Chessare, John; Schall, Marie W; McBride, Virginia; Zampiello, Francis A; Perdue, Jade; O'Connor, Kevin; Lin, Monica J-Y; Burdick, James

2008-01-01

More than 92000 Americans are on waiting lists for organ transplants, and an average of 17 of them die each day while waiting. The US Organ Donation Breakthrough Collaborative (ODBC), which began in 2003 at the request of the Secretary of the US Department of Health and Human Services, was a formal, concerted effort of the donation and transplantation community to bring about a major change to improve the organ donation system. The nationwide Collaborative was housed within a Health and Human Services agency, the Health Resources and Services Administration (HRSA) Division of Transplantation, and included participation of the organ procurement organizations (OPOs) throughout the United States and the American hospitals with the largest organ-donor potential. HRSA leaders used the Breakthrough Series Collaborative method, originally developed by the Institute for Healthcare Improvement, as the model for the intervention. Expert practitioners drawn from hospitals and OPOs that had already demonstrated their ability to achieve and sustain high organ donation rates were chosen as faculty for the collaborative and best practices were gleaned from their institutions. The number of organ donors in Collaborative hospitals increased 14.1% in the first year, a 70% greater increase than the 8.3% increase experienced by non-Collaborative hospitals. Moreover, the increased organ recovery continued into the post-Collaborative periods. Between October 2003 and September 2006, the number of total US organ donors increased 22.5%, an increase 4-fold greater than the 5.5% increase measured over the same number of years in the immediate pre-Collaborative period. The study did not involve a randomized design, but time-series analysis using statistical process control charts shows a highly significant discontinuity in the rate of increase in participating hospitals concurrent with the Collaborative program, and strongly suggests that the activities of the Collaborative were a major contributor to this increase. Given the stable nature of the historical increases over many years, the HRSA estimates that more than 4000 annual additional transplants have occurred in association and apparently as a result of these increases in organ donation.

Strategies for changing negative public attitudes toward organ donation in the People’s Republic of China

PubMed Central

Shumin, Xie; Woo, Stephanie Mu-Lian; Lei, Zhang

2014-01-01

In recent decades, the demand for organ transplantation has risen rapidly worldwide, due to an increased incidence of vital organ failure. However, the scarcity of organs appropriate for transplantation has led to an organ shortage crisis. This article retrospectively reviews strategies to change negative public attitudes toward organ donation in the People’s Republic of China. We strongly believe that efforts to publicize knowledge of organ donation, promote family discussions, train medical staff and students, establish incentive systems, and implement regulatory oversight may combat unfavorable Chinese public opinion toward organ donation and transplantation, thus potentially increasing the organ donation rate in the People’s Republic of China. PMID:24368880

Donation after cardiocirculatory death in Canada

PubMed Central

Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

2006-01-01

These recommendations are the result of a national, multidisciplinary, year-long process to discuss whether and how to proceed with organ donation after cardiocirculatory death (DCD) in Canada. A national forum was held in February 2005 to discuss and develop recommendations on the principles, procedures and practice related to DCD, including ethical and legal considerations. At the forum's conclusion, a strong majority of participants supported proceeding with DCD programs in Canada. The forum also recognized the need to formulate and emphasize core values to guide the development of programs and protocols based on the medical, ethical and legal framework established at this meeting. Although end-of-life care should routinely include the opportunity to donate organs and tissues, the duty of care toward dying patients and their families remains the dominant priority of health care teams. The complexity and profound implications of death are recognized and should be respected, along with differing personal, ethnocultural and religious perspectives on death and donation. Decisions around withdrawal of life-sustaining therapies, management of the dying process and the determination of death by cardiocirculatory criteria should be separate from and independent of donation and transplant processes. The recommendations in this report are intended to guide individual programs, regional health authorities and jurisdictions in the development of DCD protocols. Programs will develop based on local leadership and advance planning that includes education and engagement of stakeholders, mechanisms to assure safety and quality and public information. We recommend that programs begin with controlled DCD within the intensive care unit where (after a consensual decision to withdraw life-sustaining therapy) death is anticipated, but has not yet occurred, and unhurried consent discussions can be held. Uncontrolled donation (where death has occurred after unanticipated cardiac arrest) should only be considered after a controlled DCD program is well established. Although we recommend that programs commence with kidney donation, regional transplant expertise may guide the inclusion of other organs. The impact of DCD, including pre-and post-mortem interventions, on donor family experiences, organ availability, graft function and recipient survival should be carefully documented and studied. PMID:17124739

A televised entertainment-education drama to promote positive discussion about organ donation.

PubMed

Khalil, Georges E; Rintamaki, Lance S

2014-04-01

This article investigates pathways between the exposure to an entertainment-education (E-E) television drama called Three Rivers and positive discussion of organ donation among viewers of the drama in the United States. A cross-sectional survey was conducted using an online advertising for a period of one week. Survey participants included 1325 adults living in the United States, who had viewed the first episode of Three Rivers on television. Data were collected on recall of events in the storyline, perceived entertainment value, perceived accuracy of the presented health information, rejection of organ donation myths and positive discussion of organ donation and the storyline. Covariates were registration for organ donation, membership to the donation or transplant community and demographic variables. Results show that viewers with high recall of the storyline were more likely to reject myths about organ donation and engage in pro-donation discussions with others. Perceived entertainment value and perceived accuracy acted as mediators in such relationships. The insertion of accurate health information in television drama may be effective in promoting positive discussions about organ donation and myth rejection. Recall of events from the televised E-E drama Three Rivers, entertainment value and accuracy perception were associated with positive discussion.

Removing financial barriers to organ and bone marrow donation: the effect of leave and tax legislation in the U.S.

PubMed

Lacetera, Nicola; Macis, Mario; Stith, Sarah S

2014-01-01

Many U.S. states have passed legislation providing leave to organ and bone marrow donors and/or tax benefits for live and deceased organ and bone marrow donations and to employers of donors. We exploit cross-state variation in the timing of such legislation to analyze its impact on organ donations by living and deceased persons, on measures of the quality of the transplants, and on the number of bone marrow donations. We find that these provisions do not have a significant impact on the quantity of organs donated. The leave laws, however, do have a positive impact on bone marrow donations, and the effect increases with the size of the population of beneficiaries and with the generosity of the legislative provisions. Our results suggest that this legislation works for moderately invasive procedures such as bone marrow donation, but these incentives may be too low for organ donation, which is riskier and more burdensome. Copyright © 2013 Elsevier B.V. All rights reserved.

Attitudes toward live and postmortem kidney donation: a survey of Chinese medical students.

PubMed

Ge, Fangmin; Kaczmarczyk, Gabriele; Biller-Andorno, Nikola

2014-12-01

As the gap between supply and demand for donor organs is increasing, we sought to clarify the knowledge and attitudes regarding living-organ donation among Chinese medical students and analyze their incentives and influencing factors. Data were collected from Chinese medical students using a standardized questionnaire. Of 320 surveyed participants, 261 participants (81.6%) said they would consider donating their live kidney organ, and 262 participants (81.9%) were willing to donate posthumously. Although 177 participants (55.7%) confirmed current regulations on posthumous organ donation, only 85 participants (26.7%) could correctly identify the regulations on live organ donation in China. Gender differences were not significantly associated with willingness to donate a kidney, whereas religion and socioeconomic status of the respondents were significantly associated with willingness to donate a live or posthumous kidney. Among well-informed, young, healthy, and economically well-off Chinese male and female medical students, most were willing to be live kidney donors. Religion and socioeconomic status may affect the decision-making process for organ disposition.

Council of Europe Black Sea Area Project: International Cooperation for the Development of Activities Related to Donation and Transplantation of Organs in the Region.

PubMed

Arredondo, E; López-Fraga, M; Chatzixiros, E; Senemaud, B; Brezovsky, P; Carella, C; Ballesté, C; Aydin Mehmet, A; Tomadze, G; Codreanu, I; Sarkissian, A A; Simeonova, M; Nikonenko, A; Zota, V; Gómez, M P; Manyalich, M; Bolotinha, C; Franca, A; Costa, A N; Ott, M-O; Buchheit, K-H

2018-03-01

In 2011, the European Directorate for the Quality of Medicines & Healthcare of the Council of Europe launched a 3-year collaborative project to address the organ shortage and improve access to transplant health services in Council of Europe member states in the Black Sea area (Armenia, Azerbaijan, Bulgaria, Georgia, Moldova, Romania, Turkey, Ukraine, and the Russian Federation) through the development of safe and ethical donation and transplantation programs. Support the development of donation and transplantation programs through close interstate cooperation between national health organizations and relevant stakeholders. Several work packages (WP) were established: WP1, project coordination (European Directorate for the Quality of Medicines & Healthcare); WP2, development and implementation of an effective legislative and financial framework (Czech Republic and France); WP3, establishment of National Transplant Authorities (Italy and Portugal); and WP4, clinical practices (DTI Foundation). Data collection, surveys, and expert visits allowed for the collection of first-hand information from each participant country at national, regional, and hospital levels. Data analysis showed the positive impact of the project represented by a tendency to increase the total donation rates (per million people) in the participant countries (2011 vs 2013): Azerbaijan, +7.3; Armenia, -0.7; Georgia, +3.3; Bulgaria, +0.9; Moldova, +2.5; Ukraine:, +0.8; Romania, +2.3; and Turkey, +2.7. Increases in total donation rates are the result of a number of initiatives in the Black Sea area, including the stepwise implementation of legislative, organizational and institutional country-specific recommendations tailored by the CoE, efforts of the respective Ministries of Health in each country and synergism with other European projects in the region. These countries should invest further in implementing the recommendations that emerged from this project to improve their organ donation and transplantation programs and progress toward self-sufficiency. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychosocial barriers associated with organ donation in Mexico.

PubMed

Marván, Maria Luisa; Álvarez Del Río, Asunción; Jasso, Kristian; Santillán-Doherty, Patricio

2017-11-01

There is a severe shortage of organs for transplantation worldwide, and Mexico has one of the lowest organ donation rates. In this study, we explored the psychosocial barriers that prevent posthumous organ donation by Mexicans. We asked 218 adults who were not willing to be donors to complete the sentence "I don't want to donate my organs after death because organ donation is…" The data were analyzed using the Natural Semantic Networks Technique. The most important answers given by the participants were related to mistrust. Older participants and those with limited education gave more answers that reflect misconceptions about organ donation. Many participants acknowledged its benefits, even though they did not want to be donors, especially the youngest and those with a higher education. Mistrust and poor education are problems that urgently need to be addressed in order to increase acceptance of organ donation and transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Giving Your Last Gift: A Study of the Knowledge, Attitude and Information of Greek Students Regarding Organ Donation.

PubMed

Katsari, Vasiliki; Domeyer, Philip J; Sarafis, Pavlos; Souliotis, Kyriakos

2015-07-02

Organ donation rates in Greece are the lowest in the European Union. Studying and improving young students' awareness may increase organ donation rates. This study aimed to investigate young students' knowledge, attitude and information regarding organ donation and whether they are modified by putative predictors. A 62-item electronic questionnaire was sent to 1451 eligible students aged 18-30 years in 16 Greek public technical schools. Two composite scales (knowledge and attitude) were created. The multivariate statistical analysis included ordinal logistic and linear regression, as appropriate. Only 37.9% of the students knew the correct definition of organ donation, 40.3% knew which organs can be donated, 27.4% were informed about the new Greek legislation, and 83.1% acknowledged the need for better information. Although 60.5% would donate an organ after death, only 16.1% would become living donors. Although 83.1% of the students declared knowing what brain death means, 18.6% believe that a brain-dead person could fully recover and 32.3% are unsure about it. Being a health professional or a blood donor, the parent's educational level, the wish to donate all organs after death, the information from announcements or posters, the fear of organ removal after death without prior consent, the consent for autopsy, the wish for better information, and the misbelief that a brain-dead person could fully recover emerged as important predictors of the knowledge and attitude, regarding organ donation. An important lack of knowledge and misperceptions were noted regarding organ donation. Significant predictors were identified.

ICU Nurses' Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran.

PubMed

Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I

2015-01-01

Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.

[Patient's Experience with Living Donation: A Questionnaire-Based Survey of 144 Living Kidney Donors].

PubMed

Schieber, Katharina; Gaag, Sonja; Heller, Katharina; Erim, Yesim

2018-05-01

Living organ donation becomes more and more important as the number of patients needing organ transplantation is increasing. The University Hospital of Erlangen initiated a survey of living kidney donors to improve the process of living donation. The survey aimed to assess the donor's needs and experiences during the process of living kidney donation. From 2003 to 2014 n=199 living kidney donations were registered at the University Hospital of Erlangen. A total of n=144 living kidney donors (65.3% females, mean age M=58.7 years) participated in the study. In general, the majority of the living kidney donors were satisfied with the process of donation. Almost all of them (98%) confirmed to donate again, if it was possible. A large part of the living kidney donors denied any negative physical or psychological consequences of the donation. However, around 25% reported still physical problems for example wound healing, pain or long-term hypertension. Furthermore, a lack of pre- and post-operative psychological care or a regular medical follow-up care was reported. Thus, clinical practice needs to be further developed to meet the patient's needs. © Georg Thieme Verlag KG Stuttgart · New York.

In defense of a regulated system of compensation for living donation.

PubMed

Matas, Arthur J; Hippen, Benjamin; Satel, Sally

2008-08-01

The organ shortage is the major problem in kidney transplantation today. Despite aggressive organ procurement efforts, the supply of donated kidneys, living and deceased, has not matched the growing demand; as a consequence, more and more qualified candidates are suffering on dialysis and then dying before being transplanted. Herein, we provide justification for a regulated system of compensation for donation. The main argument in favor of compensation is simple-financial incentives will increase donation, so fewer transplant candidates will suffer and die while waiting. In addition, development of a regulated system of compensation is the most effective means of crippling the core economic support for transplant tourism. Because dialysis is so much more expensive than a transplant, compensated donation could be cost-neutral to the healthcare system. Importantly, opinion polls suggest that the public would support compensation. As uncompensated kidney donation is widely accepted, persuasive arguments against compensation must explain why such a system would be morally distinguishable from uncompensated donation. We suggest that the potential advantages of a regulated system of compensation for donation far outweigh any potential disadvantages. It is time to advocate for a change in the law so that trials can be done.

[Organ donation after active euthanasia in a patient with a neurodegenerative disease].

PubMed

van Dijk, Gert; Giezeman, Ariane; Ultee, Fred; Hamers, Raoul

2013-01-01

In countries where active euthanasia by a physician is allowed under law - Belgium and the Netherlands - physicians are sometimes confronted with patients who want to donate organs after active euthanasia has been performed. This combination of procedures has been reported in Belgium, and this article is the first description of such a case in the Netherlands. It concerns a patient with a neurodegenerative disease who donated organs after euthanasia. The combination of two complex and controversial procedures - active euthanasia and organ donation - raises important ethical, legal and practical issues. It is suggested that with a thorough preparation and a strict separation of both procedures, organ donation after active euthanasia can strengthen patient autonomy and increase the number of donated organs.

A mass mediated intervention on Hispanic live kidney donation.

PubMed

Alvaro, Eusebio M; Siegel, Jason T; Crano, William D; Dominick, Alexander

2010-06-01

This research examines the impact of a Spanish language mass media campaign on living organ donation attitudes and behavioral intentions among Spanish dominant Hispanics in Tucson, Arizona. Impact was assessed via a pretest/posttest control group quasiexperimental design with Tucson, Arizona, as the intervention community and Phoenix, Arizona, as the control. Preintervention focus groups provided qualitative data to guide intervention development, while telephone surveys in both communities provided quantitative data to assess campaign impact. Analyses reveal pretest/posttest differences in the intervention community such that posttest intentions regarding living organ donation behaviors increased from pretest. No such differences were observed in the control community. Subsequent analyses revealed differences between respondents in the intervention community exposed to the campaign vs. those in the same community not exposed to the campaign. Exposed respondents reported more positive living organ donation behavioral intentions than nonexposed respondents. Implications for research and practice are discussed.

Understanding the Role of Clergy in African American Organ and Tissue Donation Decision-Making

PubMed Central

Jacob Arriola, Kimberly R.; Perryman, Jennie P.; Doldren, Michelle A.; Warren, Carmen M.; Robinson, Dana H. Z.

2012-01-01

Objectives To describe and understand the attitudes, beliefs, and experiences towards organ and tissue donation among African American clergy in Atlanta, Georgia, USA. The secondary objective is to understand what messages clergy are providing to their parishioners relative to organ and tissue donation, and what their perceived role is in donation education. Design A qualitative study in which African American clergy (n = 26) participated in four focus groups. Results African American clergy, though generally supportive of organ and tissue donation in principle, have serious reservations about donation due to perceived inequalities in the donation and transplantation system. The clergy did not personally hold religious concerns about donation, but expressed that these concerns were a major barrier to donation among their parishioners. None of the clergy knew the written position that their religion took on donation; they acknowledged the need for more education for them and their parishioners on this topic. They also felt that as religious leaders, they could play an important role in promoting organ and tissue donation among African American parishioners. Conclusions African American clergy and religious leaders may play an important role towards improving willingness to donate among African American parishioners, but more education and advocacy is needed to prepare them for this role. PMID:17978944

[Knowledge, trust, and the decision to donate organs : A comparison of medical students and students of other disciplines in Germany].

PubMed

Terbonssen, T; Settmacher, U; Dirsch, O; Dahmen, U

2018-02-01

Following the organ transplant scandal in Germany in 2011, the willingness to donate organs postmortem decreased dramatically. This was explained by a loss of confidence in the German organ donation system. The aim of this study was to evaluate the relationship between knowledge, trust, and fear in respect to organ donation and the explicit willingness to potentially act as an organ donor by comparing medical students to students of other disciplines. We conducted a Facebook-based online survey (June-July 2013). The participating students were divided into two groups according to their discipline: medical students and other students. Based on questions covering different aspects of organ donation, a knowledge, trust, and fear score was established and calculated. The answers were related to an explicitly expressed decision to donate organs as expressed in a signed organ donor card. In total, 2484 participants took part in our survey. Of these, 1637 were students, 83.7% (N = 1370) of which were medical students and 16.3% (N = 267) other students. As expected, medical students reached a higher knowledge score regarding organ donation compared with other students (knowledge score 4.13 vs. 3.38; p < 0.001). They also demonstrated more confidence in organ donation, resulting in a higher confidence score (3.94 vs. 3.33; p < 0.001) and expressed less fear towards organ donation as indicated by the lower fear score (1.76 vs. 2.04; p < 0.01). Medical students declared their written willingness to donate organs more often than did other students (78.2% vs. 55.2%; p < 0.001). Entries on organ donation cards did not differ significantly between medical students and other students. Medical students possessing an organ donor card showed a higher knowledge and a higher trust score than did medical students without an organ donor card. In contrast, other students possessing an organ donor card showed a higher trust score but did not show a higher knowledge score. The higher level of knowledge and trust demonstrated by the medical students was associated with a higher rate of written decisions to donate organs. In contrast, the lower level of knowledge and trust observed in the non-medical students was associated with a lower rate of organ donor cards. Interestingly, in the group of non-medical students, the decision regarding organ donation was associated with a higher level of trust, but not with a higher level of knowledge. It would appear that knowledge, trust, and the decision to donate organs are closely related. In cases of a low level of knowledge, confidence is even more important. Therefore, organ donation campaigns should focus on increasing knowledge and fostering trust.

[Lack of donor organs as an argument for living donors?].

PubMed

Kirste, G

2010-09-01

In Germany more than 12,000 patients are presently waiting for an organ donation. Living donation makes sense for the long waiting time for a kidney, but it is not a permanent solution for the lack of organ donations. In the future topics which should be discussed are intensified public relations, a better family care and the allocation of rights and duties at the German coordinating agency. For all the prospects of success after a living donation the high standards of quality and security, which are targeted by the German donor organization in recipient protection, responsible evaluation of the expanded donor criteria and immunosuppressive therapy are all in favor of post-mortem organ donation. For all the phenomenal chance of success the priority of the post-mortem organ donation is regulated by law. The living donation remains an individual decision of the donor and the personal situation of life.

Identification of Strategies to Facilitate Organ Donation among African Americans using the Nominal Group Technique

PubMed Central

Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B.; Gaston, Robert; Segev, Dorry L.; Mannon, Elinor C.; Martin, Michelle Y.

2015-01-01

Background and objectives African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. Design, setting, participants, & measurements A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. Results In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants’ reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). Conclusions These data indicate a greater opposition to living donation compared with donation after one’s death among African Americans and suggest that improving knowledge about organ donation, particularly with regard to donor involvement and donation-related risks, may facilitate increases in organ donation. Existing educational campaigns may fall short of meeting information needs of African Americans. PMID:25635038

Identification of strategies to facilitate organ donation among African Americans using the nominal group technique.

PubMed

Locke, Jayme E; Qu, Haiyan; Shewchuk, Richard; Mannon, Roslyn B; Gaston, Robert; Segev, Dorry L; Mannon, Elinor C; Martin, Michelle Y

2015-02-06

African Americans are disproportionately affected by ESRD, but few receive a living donor kidney transplant. Surveys assessing attitudes toward donation have shown that African Americans are less likely to express a willingness to donate their own organs. Studies aimed at understanding factors that may facilitate the willingness of African Americans to become organ donors are needed. A novel formative research method was used (the nominal group technique) to identify and prioritize strategies for facilitating increases in organ donation among church-attending African Americans. Four nominal group technique panel interviews were convened (three community and one clergy). Each community panel represented a distinct local church; the clergy panel represented five distinct faith-based denominations. Before nominal group technique interviews, participants completed a questionnaire that assessed willingness to become a donor; 28 African-American adults (≥19 years old) participated in the study. In total, 66.7% of participants identified knowledge- or education-related strategies as most important strategies in facilitating willingness to become an organ donor, a view that was even more pronounced among clergy. Three of four nominal group technique panels rated a knowledge-based strategy as the most important and included strategies, such as information on donor involvement and donation-related risks; 29.6% of participants indicated that they disagreed with deceased donation, and 37% of participants disagreed with living donation. Community participants' reservations about becoming an organ donor were similar for living (38.1%) and deceased (33.4%) donation; in contrast, clergy participants were more likely to express reservations about living donation (33.3% versus 16.7%). These data indicate a greater opposition to living donation compared with donation after one's death among African Americans and suggest that improving knowledge about organ donation, particularly with regard to donor involvement and donation-related risks, may facilitate increases in organ donation. Existing educational campaigns may fall short of meeting information needs of African Americans. Copyright © 2015 by the American Society of Nephrology.

Evolution of deceased organ donation activity vs. efficiency over a 15 year period: an international comparison.

PubMed

Weiss, Julius; Elmer, Andreas; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Avsec, Danica; Costa, Alessandro Nanni; Haase-Kromwijk, Bernadette J J M; Laouabdia, Karim; Immer, Franz F

2018-04-19

The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. This is a retrospective analysis of 2001-2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the USA. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons. According to the DCI and of the countries included in the study, Spain, France, and the USA had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally. Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues.

Organ Donation After Circulatory Death: Ethical Issues and International Practices.

PubMed

Jericho, Barbara G

2018-05-21

Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs. Although there may be diversity among DCD programs in Europe, Australia, Israel, China, the United States, and Canada, addressing ethical considerations in these DCD programs is essential to respect donors and recipients during the altruistic and generous act of organ donation.

[Attitudes towards transplantation and organ donation in high school graduates of math gymnasium in Osijek].

PubMed

Lada, Zibar; Zvonimir, Popović; Nikola, Raguz Lucić; Vlasta, Orlić Karbić

2011-10-01

Testing attitudes and opinions ofgraduate students in Osijek towards organ donation and transplantation. Examinees and methods: The research included 99 students of math gymnasium in Osijek (54 males and 45 females, mean age 18 years). They fulfilled an anonymous questionnaire, consisted of 24 questions about transplantation, willingness to donate organs, consciousness of importance of donating organs and attitudes of religion towards organ donation. Statistical analysis was made by SPSS 16.0 computer program using Chi-square test. Most of the gymnasium students (80.8%) have already heard about organ donation, 76.8% of them have received information by television. 59.4% students know how a transplantation is being performed, but the majority (64.6%) of them don't know whom to address to receive additional information about organ donation. 27.3% students have discussed transplantation inside their families and 17.2% examinees know someone who signed the donor card. 55.6% examinees are convinced that transplantation procedure is safe and efficient. 41.4% thinks that family should give permission for explantation of a deceased patient's organs, while 33.3% consider it not necessary. Regarding the question whether examinees think that organ transplantation was a mutilation, 91.9% of them answered "no". Although 55.6% students believe that doctors would put the same effort in saving patients, independent whether they possessed donor card or not, there were 60.6% that thought it was possible to obtain organ in Croatia by illegal ways. Nevertheless, 79.8% students would receive organ from a deceased person, 64.6% would donate organs after their death. Observing ethical and religious attitudes, 92.9% are sure that organ donation is a humane gesture. 82.8% examinees were believers and 60.6% of them didn't know attitudes of their religion towards organ donation. Women have significantly more willingness to donate their organ to family member during their lives (97.8%), while 81.5% males would do the same, p=0.035. Lower percentage of atheists were found among women (6.7%) than in men (25.9%), p=0.011. 53.7% males consider their religion to be against organ donation, while only 17.8% females, p=0.046. High school graduates have mostly heard about organ transplantation (many of them by television) and the majority has positive attitude and are willing to donate theirs and to receive organs from another person. Such willingness and tendency towards organ donation should be taken with reserve, because it was relatively young population, without life experience in similar situations. Within their population, believers are predominating, and they often don't know whether their religion is pro organ donation or against it. Smaller proportion, but still the majority of the examinees, considers the transplantation to be a safe procedure. Women and men show differences regarding information, attitudes and willingness to make a sacrifice. Women are more willing to donate organs to a family member. Still, there is not enough discussion about transplantation inside each family. Rate of ignorance and lack of information about transplantation and organ donation, indicates a need for better representation of this topic in media, schools, religious institutions and inside family.

OPTN/SRTR 2012 Annual Data Report: deceased organ donation.

PubMed

Israni, A K; Zaun, D; Rosendale, J D; Snyder, J J; Kasiske, B L

2014-01-01

The status of deceased organ donation is assessed using several metrics, including donation/conversion rate (how often at least one organ is recovered for transplant from an eligible death), organ yield (ratio of observed/expected numbers of organs transplanted), and rate of organs discarded (number of organs discarded divided by the number of organs recovered for transplant). The 2012 donation/conversion rate was 72.5. eligible donors per 100 eligible deaths, slightly lower than the 2011 rate but higher than in previous years. The 2011-2012 yield ratio varied by donation service area from 0.91 (fewer organs transplanted per donor than expected) to 1.09 (more than expected), and also varied for specific organs. The mean number of organs transplanted per donor in 2012 was 3.02, lower than in 2011 and 2010; this number varied by donation service area from 2.04 to 3.76. The number of organs discarded is calculated by subtracting the number of organs transplanted from the number recovered for transplant; this number is used to calculate the discard rate. The discard rate in 2012 for all organs combined was 0.14 per recovered organ, slightly higher than in 2011 and 2011; it varied by donation service area and organ type. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Religion and organ donation: the views of UK faith leaders.

PubMed

Randhawa, Gurch; Brocklehurst, Anna; Pateman, Ruth; Kinsella, Suzannah; Parry, Vivienne

2012-09-01

This article reports the findings from the one-to-one interviews with the main UK faith and belief leaders which were commissioned by the Organ Donation Taskforce as part of its evidence gathering. Interviews were arranged with the main faith and belief organisations within the UK. Interviews covered a range of issues related to organ donation. Although some faith groups had some reservations regarding organ donation, interviews with these leaders demonstrated that none of these faith groups have reached a consensus against organ donation. The interviewees stated that the majority opinion in their faith or belief group is to permit organ donation, with some actively supporting it. Interviewees were keen to stress that there is a broad spectrum of opinion on organ transplantation within each faith and belief group and that consequently it is difficult to speak on behalf of an entire group. One complication mentioned by interviewees is that as organ transplantation is a relatively new medical procedure, there is no explicit reference to it in many original religious texts. Consequently, positions on the receipt and donation of organs are based on interpretation. It was felt that a much greater level of engagement is needed, as organ donation is currently not a priority for many faith and belief groups.

The Consequences of Vagueness in Consent to Organ Donation.

PubMed

Shaw, David M

2017-07-01

In this article I argue that vagueness concerning consent to post-mortem organ donation causes considerable harm in several ways. First, the information provided to most people registering as organ donors is very vague in terms of what is actually involved in donation. Second, the vagueness regarding consent to donation increases the distress of families of patients who are potential organ donors, both during and following the discussion about donation. Third, vagueness also increases the chances that the patient's intention to donate will not be fulfilled due to the family's distress. Fourth, the consequent reduction in the number of donated organs leads to avoidable deaths and increased suffering among potential recipients, and distresses them and their families. There are three strategies which could be used to reduce the harmful effects of this vagueness. First, recategorizing the reasons (commonly referred to as 'overrules' under the current system) given by families who refuse donation from registered donors would bring greater clarity to donation discussions. Second, people who wish to donate their organs should be encouraged to discuss their wishes in detail with their families, and to consider recording their wishes in other ways. Finally, the consent system for organ donation could be made more detailed, ensuring both that more information is provided to potential donors and that they have more flexibility in how their intentions are indicated; this last strategy, however, could have the disadvantage of discouraging some potential donors from registering. © 2016 John Wiley & Sons Ltd.

Portable device technology in organ donation: new "app" for procurement coordinators.

PubMed

Cavallin, M; Bertini, P; Lopane, P; Guarracino, F

2014-09-01

Portable devices are commonly used at bedside in everyday practice. Transplant procurement coordinators routinely have to deal with protocols and flow charts and need to assess the donor condition several times. In our experience, a great part of the organ procurement management work is provided by nurses "on call." We developed an application for iOS devices to facilitate their approach to relatives and procedures for organ donation. The application, which includes algorithms, tutorials, and simple calculators, has been designed by transplant procurement coordinators to speed up the process of organ donation and at the same time to be as accurate as possible for the process. It can be used alongside all of the procedures for procurement in the emergency room, intensive care unit, operating room, and morgue in both brainstem-dead and cadaver organ donors. The application could be effective in organ procurement management for everyday practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Micro-cultural customization of organ donation propagation messages.

PubMed

Dunkel, Anke; Nakamoto, Kent; Schulz, Peter J

2018-05-01

Organ transplantation is plagued by limited availability of organs. This study investigated the effect of messages promoting organ donation which were customized according to the language-defined micro-cultures in Switzerland. Community-, informative-, and emotional-oriented messages were carried by conventional flyers. A 3 × 3 between-subjects experiment was conducted with short- and long-term willingness to donate, long-term signing of organ donation card and long-term interpersonal communication on organ donation as outcome variables. The culturally customized interventions appeared to have no immediate effect and consequently no differential effect on willingness to donate organs and on signing a donor card. Among the Swiss Germans, of the three messages, the community-oriented one instigated less interpersonal communication. Findings are consistent with a mechanism in which the message does not have an immediate effect on willingness to donate organs but motivates further thought and related behaviors that lead to higher commitment and later increased willingness to donate. Targeting not only the message but also the objective that drives the messages must be considered. Campaigns should include elements that build on the unfolding commitment process to promote the follow-up actions that lead to greater willingness. Copyright © 2017 Elsevier B.V. All rights reserved.

Organ trafficking: global solutions for a global problem.

PubMed

Jafar, Tazeen H

2009-12-01

The organ trafficking market is on the rise worldwide. Numerous unfortunate stories of networks of brokers, physicians, and hospitals engaged in illegal trade have been featured in high-profile media. The profitable enterprises facilitating these unregulated services exploit the poor in underresourced countries and offer substandard medical care with unacceptable outcomes to the rich recipients. Despite efforts to boost altruistic organ donation and resolutions to curb transplant tourism, their implementation has been compromised. At the same time, the worldwide escalation in the number of patients with kidney failure coupled with a shortage in the supply of organs continues to fuel this trade. Thus, measures to enhance the donor pool in well-resourced countries to meet their own needs will act as a strong deterrent to the proliferation of transplant tourism in impoverished nations. Regulated schemes that include reimbursement for removing potential disincentives to organ donation and ensure the long-term safety of donors and their families are likely to increase living donations. Such socially responsible programs should be tested in both developed and developing countries for their own populations. It also is vital that developing countries establish a regulated, standardized, and ethical system of organ procurement; create awareness in physicians and the public; upgrade facilities and standardize medical care; and enforce legislation for transplantation. The World Health Organization, National Kidney Foundation, and international transplant and nephrology societies can have an instrumental role in facilitating initiatives in these critical areas. There should be clearly defined codes of conduct for health care facilities and professionals' roles in unregulated paid organ donations and transplants. Ultimately, physicians and transplant surgeons have the responsibility to ensure to the best of their ability that the organs they transplant were obtained upholding the highest standards of ethics.

National survey of Filipinos on acceptance of incentivized organ donation.

PubMed

Danguilan, R A; De Belen-Uriarte, R; Jorge, S L; Lesaca, R J; Amarillo, M L L; Ampil, R S; Ona, E T

2012-05-01

The increasing number of patients requiring transplantation has brought about a shortage of donor kidneys. Incentives can potentially improve organ donation. There is a need to know if the public can accept incentivized organ donation. To evaluate knowledge and opinions on organ donation and compensating the donor/donor family and to determine factors affecting consent. The third survey in 2009 covered 15 regions, 29 provinces, and 14 cities in the National Capital Region. There were 1500 respondents interviewed using a structured questionnaire. Analysis used Statistical Package for Social Science and chi-square. Of the respondents, 63% were females and 74% were married. Nearly half were between 26 and 45 years old. Fewer than 5% were unschooled. Monthly household income was less than USD $222.00 in 70% of respondents. A majority knew about donation from 2001 to 2009. Fewer than 20% knew about deceased donors. Those who wanted to become donors decreased. Sixty-five percent were willing to donate a brain-dead relative's organs. Respondents felt that kidney donors deserve a token of gratitude. Options included livelihood (32%), cash (31%), and educational assistance (26%). Sixty percent wanted the donor assistance termed a "token of gratitude." Consent for donation was positively correlated (P < .05) with higher education and monthly income. Awareness on organ transplantation and donation increased. Factors that promote organ donation are higher education and monthly income. A majority of Filipinos felt that the donor deserves a token of gratitude. Public acceptance of incentivized organ donation may be pursued. Strategies to improve the national advocacy campaign for deceased donation are needed. Copyright © 2012 Elsevier Inc. All rights reserved.

Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan

PubMed Central

Saleem, Taimur; Ishaque, Sidra; Habib, Nida; Hussain, Syedda Saadia; Jawed, Areeba; Khan, Aamir Ali; Ahmad, Muhammad Imran; Iftikhar, Mian Omer; Mughal, Hamza Pervez; Jehan, Imtiaz

2009-01-01

Background To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population in Pakistan. Methods Convenience sampling was used to generate a sample of 440; 408 interviews were successfully completed and used for analysis. Data collection was carried out via a face to face interview based on a pre-tested questionnaire in selected public areas of Karachi, Pakistan. Data was analyzed using SPSS v.15 and associations were tested using the Pearson's Chi square test. Multiple logistic regression was used to find independent predictors of knowledge status and motivation of organ donation. Results Knowledge about organ donation was significantly associated with education (p = 0.000) and socioeconomic status (p = 0.038). 70/198 (35.3%) people expressed a high motivation to donate. Allowance of organ donation in religion was significantly associated with the motivation to donate (p = 0.000). Multiple logistic regression analysis revealed that higher level of education and higher socioeconomic status were significant (p < 0.05) independent predictors of knowledge status of organ donation. For motivation, multiple logistic regression revealed that higher socioeconomic status, adequate knowledge score and belief that organ donation is allowed in religion were significant (p < 0.05) independent predictors. Television emerged as the major source of information. Only 3.5% had themselves donated an organ; with only one person being an actual kidney donor. Conclusion Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors and religious scholars. PMID:19534793

Police Officers' Knowledge and Attitudes Toward Brain Death and Organ Donation in Korea.

PubMed

Kim, H S; Yoo, Y S; Cho, O-H; Lee, C E; Choi, Y-H; Kim, H J; Park, J Y; Park, H S; Kwon, Y J

2018-05-01

Administrative processing by the police may affect the process involved in organ donation in the event of an accidental brain injury. The purpose of this study was to evaluate the knowledge and attitude of police toward brain-dead donors and organ donation. This was a descriptive research study using a 41-item questionnaire. As of July 19, 2017, 11 police stations in Seoul had collected questionnaires completed by 115 police officers. Data were analyzed using SAS (version 9.4) software. There were statistically significant differences in the scores on knowledge about brain death/donation according to religion (P = .022). Attitude was significantly positively correlated with the knowledge about brain-death organ donation (P = .029). It is necessary to understand and cooperate with the police when processing brain death organs from accidents. Education about organ donation can enhance the information and knowledge of the police and can also help to establish a positive attitude about organ donation. Copyright © 2018 Elsevier Inc. All rights reserved.

Facebook as a medium for promoting statement of intent for organ donation: 5-years of experience.

PubMed

Brzeziński, Michał; Klikowicz, Paweł

2015-03-12

The number of potential registered organ donors does not cover the actual demand in most developed countries. Therefore, methods increasing awareness and interest in organ donation, including modern tools of social marketing, are being researched worldwide. The aim of this paper is to present our 5-year experiences with a Facebook networking campaign - the Dawca.pl Club. The mission of the campaign is to raise awareness and educate Polish society on tissue, cell, and organ transplants, to increase public acceptance for transplants as a treatment method, and to increase the number of voluntary donors signing consents for organ donation. The project is based on the idea of creating a community promoting transplantation, focused around the Dawca.pl Club. At present the club has over 48,000 registered members - people who declared willingness to donate their organs after death. We present a description of members of this social networking service, the possibilities of using it to promote transplants and organ donation, and the efficacy of selected schemes for creating and publishing content on Facebook. The example of Dawca.pl shows that 2-way relations, spread over time, are required for social media to effectively engage and exert influence in a chosen sphere of public health and medicine. Unfortunately, at this time it is difficult to assess how such campaigns, apart from raising social awareness and acceptance, will affect the number of transplantations of organs from living and deceased donors.

Knowledge Attıtudes and Behavıors About Organ Donatıon Among Fırst- and Sıxth-class Medıcal Students: A Study From Turkey.

PubMed

Naçar, M; Çetinkaya, F; Baykan, Z; Elmalı, F

2015-01-01

The aim of this study is to determine the knowledge, attitude, and behaviors of Erciyes University School of Medicine students regarding organ donation. This descriptive study was conducted in 2014 on Erciyes University School of Medicine first- and sixth-grade students via questionnaire. It was to be conducted on all 490 students; in total, 464 students were enrolled-304 from first grade and 160 from sixth grade. Data were analyzed using descriptive statistics, χ(2) test, and binary logistic regression analysis. The mean age was 20.9 ± 2.8 years and it was found that 48.9% were male, 65.5% were in first grade; 50.0% of the students who participated in the study were considering donating their organs and this rate is 45.4% in the first grade and 58.8% at sixth grade. Those who donated their organs were 3.4% in the entire group and were 1.6% and 6.9% consequently in first and sixth grades. Those who are; at the sixth grade, female gender, those who feel themselves responsible for the donation of society, who think organ donation is appropriate in terms of religion and conversations within family about organ donations significantly want organ donation more statistically. However, grade and gender had no effect on wishing donating organs according to binary logistic regression analysis. The rate of feeling themselves responsible from the donation in society was 73.9% and finding organ donation appropriate in terms of religion was 75.6% and there wasn't significant difference between first and sixth grades. Although there are increases in many variables about this issue at sixth grade, students are unable to gain sufficient attitude and behavior about organ donation. Training can be planned during medical educations in terms of gaining attitudes and behaviors about the issue. Copyright © 2015 Elsevier Inc. All rights reserved.

Altruism and reward: motivational compatibility in deceased organ donation.

PubMed

Voo, Teck Chuan

2015-03-01

Acts of helping others are often based on mixed motivations. Based on this claim, it has been argued that the use of a financial reward to incentivize organ donation is compatible with promoting altruism in organ donation. In its report Human Bodies: Donation for Medicine and Research, the Nuffield Council on Bioethics uses this argument to justify its suggestion to pilot a funeral payment scheme to incentivize people to register for deceased organ donation in the UK. In this article, I cast a sceptical eye on the above Nuffield report's argument that its proposed funeral payment scheme would prompt deceased organ donations that remain altruistic (as defined by and valued the report). Specifically, I illustrate how this scheme may prompt various forms of mixed motivations which would not satisfy the report's definition of altruism. Insofar as the scheme produces an expectation of the reward, it stands diametrical to promoting an 'altruistic perspective'. My minimal goal in this article is to argue that altruism is not motivationally compatible with reward as an incentive for donation. My broader goal is to argue that if a financial reward is used to incentivize organ donation, then we should recognize that the donation system is no longer aiming to promote altruism. Rewarded donation would not be altruistic but it may be ethical given a persistent organ shortage situation. © 2014 John Wiley & Sons Ltd.

Organ donation and Islam-challenges and opportunities.

PubMed

Sharif, Adnan

2012-09-15

The issue of organ donation in Islam has been debated for decades, with most religious authorities sanctioning both living-organ and deceased-organ donation. However, disquiet among the Islamic community on the compatibility of organ donation with their faith remains, especially in relation to deceased-organ donation. This remains a topical, controversial, and challenging component of organ procurement at both local and international levels. In this article, I will explore Islamic arguments both for and against organ donation, in the context of both living-donor and deceased-donor models. By discussing both practical and philosophical perspectives, the aim is to facilitate discussion on how best to achieve consensus on this issue by driving the debate forward in an open and all-encompassing manner. Although every attempt should be made to achieve consensus among key Muslim opinion makers (individuals, authorities, and institutions), encouraging personalized decision making by intellectual effort should be the goal to achieve genuine informed consent.

[Blood donation in urban areas].

PubMed

Charpentier, F

2013-05-01

Medical and technical developments increase the difficulty to provide sufficient safe blood for all patients in developed countries and their sociodemographic and societal changes. Sufficient national blood supply remains a reached, however still actual, challenge. Tomorrow is prepared today: the management of blood donation programs both in line with these developments and with social marketing strategies is one of the keys to success. If the main components of this organization are well known (mobile blood drives in various appropriate environments, and permanent blood donation centers) their proportions in the whole process must evolve and their contents require adaptations, especially for whole blood donation in urban areas. We have to focus on the people's way of life changes related to increasing urbanization of the society and prominent position taken by very large cities. This requires targeting several goals: to draw the attention of the potential blood-giving candidate, to get into position to collect him when he will decide it, to give meaning and recognition to his "sacrifice" (give time rather than donate blood) and to give him desire and opportunity to come back and donate one more time. In this strategy, permanent blood centers in urban areas have significant potential for whole blood collection, highlighted by the decrease of apheresis technology requirements. This potential requires profound changes in their location, conception and organization. The concept of Maison Du Don (MDD) reflects these changes. Copyright © 2013. Published by Elsevier SAS.

Perceptions of organ donors and willingness to donate organs upon death: a test of the prototype/willingness model.

PubMed

Hyde, Melissa K; White, Katherine M

2014-01-01

Understanding people's organ donation decisions may narrow the gap between organ supply and demand. In two studies, participants who had not recorded their posthumous organ donation decision (Study 1, N = 210; Study 2, N = 307) completed items assessing prototype/willingness model (PWM; attitude, subjective norm, donor prototype favorability and similarity, willingness) constructs. Attitude, subjective norm, and prototype similarity predicted willingness to donate. Prototype favorability and a Prototype Favorability × Similarity interaction predicted willingness (Study 2). These findings provide support for the PWM in altruistic health contexts, highlighting the importance of people's perceptions about organ donors in their donation decisions.

Perceptions of Organ Donors and Willingness to Donate Organs Upon Death: A Test of the Prototype/Willingness Model.

PubMed

Hyde, Melissa K; White, Katherine M

2014-06-09

Understanding people's organ donation decisions may narrow the gap between organ supply and demand. In two studies, participants who had not recorded their posthumous organ donation decision (Study 1 N = 210; Study 2 N = 307) completed items assessing Prototype/Willingness Model (PWM) (attitude, subjective norm, donor prototype favorability and similarity, willingness) constructs. Attitude, subjective norm, and prototype similarity predicted willingness to donate. Prototype favorability and a prototype favorability x similarity interaction predicted willingness (Study 2). These findings provide support for the PWM in altruistic health contexts, highlighting the importance of people's perceptions about organ donors in their donation decisions.

ICU Nurses’ Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran

PubMed Central

Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.

2015-01-01

Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156

Attitudes Concerning Postmortem Organ Donation: A Multicenter Survey in Various German Cohorts.

PubMed

Uhlig, Constantin E; Böhringer, Daniel; Hirschfeld, Gerrit; Seitz, Berthold; Schmidt, Hartmut

2015-10-13

The aim of this study was to characterize postmortem organ donation attitudes in various German cohorts. Employees of 2 German cities and 2 German university hospitals, employees of a German automobile enterprise, and members of a German Medical Society were administered a questionnaire about postmortem organ and tissue donation attitudes. Demographic data and general attitudes were questioned and focused on: I) willingness to donate organs, II) holding a donor card, and III) having discussed the topic with the family. Of 5291 participants, 65.2% reported favoring postmortem organ donation. Missing negative experiences, the idea that donation is helpful, a non-medical professional environment, excellent general health, gender, agreement with the brain-death paradigm, and age significantly influenced the participants' attitudes. Participants were more likely to possess donor cards and had discussed more often with family members if they agreed with the brain-death paradigm and considered donation to be helpful. Males and older participants were the most likely to neglect donor cards, and Catholics, Protestants, and participants with poor health were the least likely to donate organs. Interest in receiving more information was expressed by 38.1% and 50.6% of participants refusing donation of all or of specific organs, respectively, and suggested the internet (60.0%) and family doctors (35.0%) as preferred sources of information. Public campaigns in Germany should focus on males and older people as regards donor cards, and females, younger, and religiously affiliated persons as regards the general willingness to donate organs postmortem.

Increasing organ donation in Hispanic Americans: the role of media and other community outreach efforts.

PubMed

Salim, Ali; Ley, Eric J; Berry, Cherisse; Schulman, Danielle; Navarro, Sonia; Zheng, Ling; Chan, Linda S

2014-01-01

The growing demand for organs continues to outpace supply. This gap is most pronounced in minority populations, who constitute more than 40% of the organ waiting list. Hispanic Americans are particularly less likely to donate compared with other minorities for reasons that remain poorly understood and difficult to change. To determine whether outreach interventions that target Hispanic Americans improve organ donation outcomes. Prospective before-after study of 4 southern California neighborhoods with a high percentage of Hispanic American residents. We conducted cross-sectional telephone surveys before and 2 years after outreach interventions. Respondents 18 years or older were drawn randomly from lists of Hispanic surnames. Awareness, perceptions, and beliefs regarding organ donation and intent to donate were measured and compared before and after interventions. Television and radio commercials about organ donation and educational programs at 5 high schools and 4 Catholic churches. Number of survey participants who specify intent to donate. A total of 402 preintervention and 654 postintervention individuals participated in the surveys. We observed a significant increase in awareness of and knowledge about organ donation and a significant increase in the intent to donate (17.7% vs 12.1%; adjusted odds ratio, 1.55 [95% CI, 1.06-2.26; P = .02]). Focused donor outreach programs sustain awareness and knowledge and can significantly improve intent to donate organs in the Hispanic American population. These programs should continue to be evaluated and implemented to influence donor registration.

Abandoning the dead donor rule? A national survey of public views on death and organ donation.

PubMed

Nair-Collins, Michael; Green, Sydney R; Sutin, Angelina R

2015-04-01

Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the 'dead donor rule', which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Do the myths still exist? Revisiting people's negative beliefs about organ donation upon death.

PubMed

Hyde, Melissa K; Wihardjo, Kylie R; White, Katherine M

2012-01-01

The prevalence of myths preventing people partial to donation in Australia from consenting is unknown. Respondents (N = 468: 381 donors, 26 non-donors, 61 undecided) were surveyed about their (negative) donation beliefs. Approximately 30% of donors were neutral or supported negative beliefs about organ allocation, especially donation to undesirable organ recipients and a black market organ trade. Confusion about brain death, lack of family and religious support, and discomfort with donation were negative beliefs endorsed by some respondents irrespective of donor preference. Proportionally, donors had greater trust in hospitals/doctors than other groups. Some myths still exist but may vary with donation preference.

Factors associated with positive attitudes toward organ donation in Arab Americans.

PubMed

Padela, Aasim I; Rasheed, Shoaib; Warren, Gareth J W; Choi, Hwajung; Mathur, Amit K

2011-01-01

The demand for transplantable organ continues to exceed supply, particularly in minority patient populations. We explored the factors influencing organ donation attitude within the Arab American community. Secondary data analysis from a face-to-face survey administered in late 2003 to 1016 adults from a representative population-based sample on Greater Detroit Arab Americans. Christian Arab Americans were more likely than Muslim Arab Americans, and women more than men, to believe organ donation after death was justifiable. Higher educational attainment and income, as well as greater acculturation into American society, were associated with greater odds of believing organ donation to be justified. Self-reported health status and level of psychological distress and health insurance status were not associated with beliefs about organ donation. A multifaceted approach toward increasing organ donation rates in this growing population requires targeted community-health care system collaborations involving religious and civic leaders using Arabic language and culturally sensitive media. Arab Americans represent a growing population about which little is known in regard to organ donation and transplantation. This population is not specifically captured within national and local transplantation databases, and little empiric work has assessed attitudes and barriers toward organ donation and transplantation within this community. Our work represents the first to use a representative population-based sample to explore the modifiable and non-modifiable characteristics of those who believe cadaveric organ donation to be justified. © 2010 John Wiley & Sons A/S.

A televised entertainment-education drama to promote positive discussion about organ donation

PubMed Central

Khalil, Georges E.; Rintamaki, Lance S.

2014-01-01

This article investigates pathways between the exposure to an entertainment-education (E-E) television drama called Three Rivers and positive discussion of organ donation among viewers of the drama in the United States. A cross-sectional survey was conducted using an online advertising for a period of one week. Survey participants included 1325 adults living in the United States, who had viewed the first episode of Three Rivers on television. Data were collected on recall of events in the storyline, perceived entertainment value, perceived accuracy of the presented health information, rejection of organ donation myths and positive discussion of organ donation and the storyline. Covariates were registration for organ donation, membership to the donation or transplant community and demographic variables. Results show that viewers with high recall of the storyline were more likely to reject myths about organ donation and engage in pro-donation discussions with others. Perceived entertainment value and perceived accuracy acted as mediators in such relationships. The insertion of accurate health information in television drama may be effective in promoting positive discussions about organ donation and myth rejection. Recall of events from the televised E-E drama Three Rivers, entertainment value and accuracy perception were associated with positive discussion. PMID:24399264

Determinants of Willingness to Become Organ Donors among Dialysis Patients' Family Members.

PubMed

Tumin, Makmor; Mohd Satar, Nurul Huda; Zakaria, Roza Hazli; Raja Ariffin, Raja Noriza; Soo-Kun, Lim; Kok-Peng, Ng; Tafran, Khaled

2015-09-04

This study explores the factors affecting the willingness of dialysis patients' family members to become involved in living and deceased organ donation. We utilize cross sectional data on 350 family members of dialysis patients collected through self-administered survey from June to October 2013. The factors affecting willingness to become deceased and living organ donors among respondents were identified by running logistic regressions. The findings reveal that ethnicity, education and role in family are significant factors explaining will­ingness for living donation, while ethnicity, knowledge of organ donation and donor age drive willingness for deceased donation. We also find that the reasons of respondents being unwilling to donate center on the lack of information and family objections for deceased donation, while being medically unfit, scared of surgery and family objections are the reasons for unwillingness to donate living organs. In light of our findings, educational efforts are suggested to decrease the reluctance to become in­volved in living and deceased donation.

Attitude and Impact Factors Toward Organ Transplantation and Donation Among Transplantation Nurses in China.

PubMed

Xie, J-F; Wang, C-Y; He, G-P; Ming, Y-Z; Wan, Q-Q; Liu, J; Gong, L-N; Liu, L-F

Health workers' awareness and knowledge of transplantation medicine can improve people's sensitivity and reduce their degree of opposition to donations. The medical literature contains numerous examples of attitudes toward organ transplantation and donation aimed at university students or medical staff members, but rarely for transplantation nurses. The purposes of the study were to investigate the attitudes toward organ transplantation and donation among transplantation nurses and to explore the impact factors. The study was conducted in 37 transplantation surgery wards in 22 hospitals using cross-sectional approach. SPSS (International Business Machines Corporation, Armonk, New York, USA) 7.0 software was used to analysis descriptive and inferential statistics for data. Five hundred thirty-six effective questionnaires were received and the effective rate was 89.33%. Nurses' mean age was 28.40 years with a mean service length of 6.54 years. Among these nurses, 66.6% and 78.0% were willing to accept organ transplantation surgery for themselves and their relatives, respectively. Of these nurses, 33.4% would donate their organs after death; whereas 39.9% were uncertain. Only 38.2% were willing to register in the national organ donation system. Of these nurses, 28.2% were willing to sign the organ donation consent forms when their relatives became potential organ donors, and 45.7% were uncertain. Eight independent variables that affected nurses' attitudes toward donating their organs from most to least significant were: ratio of nurse to bed, title, employment form, age, length of service, position, monthly income, and the highest educational degree earned. Pearson correlation analysis showed a significant correlation among nurses' attitudes toward organ transplantation, organ donation, and online registration. The attitude toward donation and transplantation in the hospitals was not too optimistic, and an improvement in the training regarding transplantation and donation among nurses in China is necessary. Nurses are an important group who generate opinion in the patient population, and their negative attitudes can have a significant negative impact on society's attitudes toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.

[Acceptance of post-mortem organ donation in Germany : Representative cross-sectional study].

PubMed

Tackmann, E; Dettmer, S

2018-02-01

The German post-mortem organ donation rate has dropped by one third since 2010. Furthermore, 958 patients died in 2015 in Germany while waiting for an organ. To decrease organ shortage, an amendment of the transplantation law was established in 2012. An information package including an organ donor card is sent to all German citizens via the postal service. A voluntary national transplantation register was introduced in 2016 to improve transparency in the organ donation process. The influence of several transplantation scandals starting in 2012 on organ donation rates is in question. Therefore, the objective of this article is to discuss approval and objections to post-mortem organ donation among the next of kin of potential donors and the general public in Germany. Binary logistic regression of data from the 2014 survey by the Federal Centre for Health Education on attitudes towards organ and tissue donation in Germany was conducted, aiming to identify influencing factors on the likelihood of organ donor card possession. Additionally, data of the German Organ Transplantation Foundation on post-mortem organ donations in Germany in 2014 were studied to highlight reasons for approval and objections by next of kin of potential and explanted post-mortem organ donors. Methods of documentation of the deceased's will according to data of the German Organ Transplantation Foundation were analyzed. Male gender and lack of knowledge about organ donation decrease the likelihood of having an organ donor card. Of the respondents in the survey of the Federal Centre for Health Education 71.0% would donate their own organs, whereas only one third possess an organ donor card. Health insurances and physicians are the most important providers of organ donor cards in Germany. An increase in the percentage of organ donor card possession following the amendment of the transplantation law could not be observed by 2016. Fear of organ trade and unjust organ allocation are the main reasons for rejecting organ donation among the general public. Previous transplantation scandals are a primary reason for a negative change in attitudes. Main reasons for objection among the next of kin of potential organ donors are known objections of the deceased and the lack of knowledge about the will of the deceased. In addition, only 58.1% of all explanted organ donors documented their will in written or verbal form. Education on organ donation can be a means to increase organ donation rates. The effects of the change in legislation and the establishment of the transplant register need to be evaluated. Further research regarding the influence of religion, especially among religious minorities, on organ donation rates in Germany needs to be conducted to identify possible obstacles. Moreover, the use of social networks to address potential organ donors has proven to increase registration numbers and could easily be implemented in Germany.

Ethical aspects of organ donation activities.

PubMed

Stephan, Antoine; Barbari, Antoine; Younan, Farida

2007-12-01

Renal transplant remains the treatment of choice for patients with end-stage renal disease. Human organs can be harvested from 2 main sources: living and deceased donors. Preference should be given to deceased-donor transplants since they represent the only source of organs for several nonrenal solid-organ transplants and the only modality where there is no risk to the donor. Unfortunately, even the most well-developed deceased-donor program (eg, the Spanish program) can barely cover 50% of its waiting list because the demand for deceased-donor organs far exceeds supply. The success of transplant surgery has created a waiting list dilemma. Despite all efforts, deceased-donor donation cannot meet current needs and therefore, living donation demands serious consideration. This is supported by the fact that the risk to live donors is minimal, graft survival is significantly better than that of deceased-donor kidneys regardless of HLA matching, and professional ethical philosophers have fewer difficulties with voluntary living donations than with the removal of an organ from a cadaver. This is especially true in our region. Living-related donation has always been acceptable ethically. It is, however, limited by the number of willing and qualified donors, the high incidence of familial renal diseases, and donor coercion (especially in our area). Living-unrelated donation increases the availability of donors, decreases the chances of coercion, and eliminates the problem of consanguinity. It raises, however, the ethical issues of commercialism, transplant tourism, and organ trafficking. The arguments for and against living-unrelated donation are innumerable. They have been the subject of several international forums and have raised endless discussions. We have set long ago a series of rules and regulations that are in close agreement with the recent Amsterdam and Kuwait resolutions. We have been continually modifying them over the last 15 years to try to implement our ideal, which is to protect the interest of the living donor and avoid commercialism.

National evaluation of healthcare provider attitudes toward organ donation after cardiac death.

PubMed

Mandell, M Susan; Zamudio, Stacy; Seem, Debbie; McGaw, Lin J; Wood, Geri; Liehr, Patricia; Ethier, Angela; D'Alessandro, Anthony M

2006-12-01

Organ donation after cardiac death will save lives by increasing the number of transplantable organs. But many healthcare providers are reluctant to participate when the withdrawal of intensive care leads to organ donation. Prior surveys indicate ethical concerns as a barrier to the practice of organ donation after cardiac death, but the specific issues that characterize these concerns are unknown. We thus aimed to identify what barriers healthcare providers perceive. We conducted a qualitative analysis of focus group transcripts to identify issues of broad importance. Healthcare setting. Participants included 141 healthcare providers representing critical care and perioperative nurses, transplant surgeons, medical examiners, organ procurement personnel, neurosurgeons, and neurologists. Collection and analysis of information regarding healthcare providers' attitudes and beliefs. All focus groups agreed that increased organ availability is a benefit but questioned the quality of organs recovered. Study participants identified a lack of standards for patient prognostication and cardiopulmonary death and a failure to prevent a conflict between patient and donor interests as obstacles to acceptance of organ donation after cardiac death. They questioned the practices and motives of colleagues who participate in organ donation after cardiac death, apprehensive that real or perceived impropriety would affect public perception. Healthcare providers are uncomfortable at the clinical juncture where end-of-life care and organ donation interface. Our findings are consistent with theories that care providers are hesitant to perform medical tasks that they consider to be outside the focus of their practice, especially when there is potential conflict of interest. This conflict appears to impose moral distress on healthcare providers and limits acceptance of organ donation after cardiac death. Future research is warranted to examine the effect of standardized procedures on reducing moral distress. The hypothesis generated by this qualitative study is that use of neutral third parties to broach the subject of organ donation may improve acceptance of organ donation after cardiac death.

Teenagers in Rural Areas Faced With Organ Donation and Transplantation.

PubMed

Febrero, B; Almela, J; Ríos, A; Ros, I; Pérez-Sánchez, B; Martínez-Alarcón, L; Ruiz-Carreño, P; Ferreras, D; Ramírez, P; Parrilla, P

2018-03-01

In rural areas it is common to find unfavorable attitudes toward organ donation, and therefore it is important to find out the attitude and profile of new generations for improving predisposition to organ donation in these areas. Our objective was to analyze the attitude toward organ donation and the related variables of teenagers in a rural area. Students in the final year of compulsory education (mostly 15-16 years of age) were selected from secondary schools in a rural area in southeastern Spain (n = 319; population density <300 inhabitants/km 2 ). The instrument of measurement used was a validated psychosocial questionnaire. Completion was anonymous and self-administered. Descriptive statistical analysis, Student t test, χ 2 test, and multivariate analysis were employed. There was a completion rate of 96% (n = 306). Overall, 65% (n = 200) were in favor of donating their organs, 30% (n = 90) were undecided, and 5% (n = 16) were against. Attitude toward the donation of one's own organs was related with sex (P = .015), previous experience of organ donation or transplantation (P = .046), comment on the topic of organ donation within the family (P = .003; odds ratio 2.155), knowing one's mother's opinion about the matter (P = .021), knowing the correct concept of brain death (P = .012; odds ratio 2.076), and religion (P = .014). A favorable attitude of teenagers in rural areas toward organ donation is slightly higher than in the adult population and is determined by many psychosocial variables, above all family discussion about organ donation and transplantation and correct knowledge of the brain death concept. Copyright © 2017 Elsevier Inc. All rights reserved.

Gender disparity in organ donation.

PubMed

Steinman, Judith L

2006-12-01

Organ donation is affected by legal, cultural, religious, and racial factors, as well as by health considerations. Although organs in and of themselves are gender neutral and can be exchanged between the sexes, women account for up to two thirds of all organ donations. There are no clear reasons why women are more willing to undergo the risks of surgery than are men, nor is this gender disparity mirrored in the demand for donated organs. More men than women are recipients, and women are less likely to complete the necessary steps to receive donated organs. Internationally, ethical concern has been focused on possible human rights violations in the harvesting of organs from prisoners and, in poor countries, on the trafficking of organs from girls and women who are expected to financially help their families by selling their organs.

[Life lessons of eight families donating organs of deceased family members].

PubMed

Avilés R, Lissette; Rivera M, M Soledad; Catoni S, María Isabel

2014-06-01

Most organ donors are already death. Therefore family members become an essential link in the final decision for organ donation. To get acquainted about the life lessons of people who accepted donating an organ of a deceased family member. Qualitative research, in depth interviews to eight families that accepted donating an organ of a deceased family member. The interviews were analyzed using the method proposed by Streubert et al and modified by Rivera. The life lessons are described in six comprehensive categories. The painful experience changed towards the feeling that the loved one remains alive. This sensation generated a sense of pride in family members and sensitized them towards the painful experience of other people. Therefore, a desire to help and improve as humans beings was awakened. A compassionate approach towards families donating organs with improve organ donation and humanize the process.

The notion of gift-giving and organ donation.

PubMed

Gerrand, Nicole

1994-04-01

The analogy between gift-giving and organ donation was first suggested at the beginning of the transplantation era, when policy makers and legislators were promoting voluntary organ donation as the preferred procurement procedure. It was believed that the practice of gift-giving had some features which were also thought to be necessary to ensure that an organ procurement procedure would be morally acceptable, namely voluntarism and altruism. Twenty-five years later, the analogy between gift-giving and organ donation is still being made in the literature and used in organ donation awareness campaigns. In this paper I want to challenge this analogy. By examining a range of circumstances in which gift-giving occurs, I argue that the significant differences between the various types of gift-giving and organ donation makes any analogy between the two very general and superficial, and I suggest that a more appropriate analogy can be found elsewhere.

[Living donors for kidney transplantation: ethical and legal challenges].

PubMed

Mamzer-Bruneel, Marie-France; Fournier, Catherine; Legendre, Christophe

2010-05-01

Living donor kidney transplantation has developed very heterogeneously worldwide despite excellent results and without taking into account the context of global organ shortage. Such a heterogeneity highlights persistent ethical issues, whereas organ trafficking is emerging as an organized transplant tourism reinforcing the need for strong national legal frameworks. Despite its powerful regulation system, which ensures standardization, transparency and accountability of support for donation, France remains reluctant to enlarge the circle of legal donors, whereas it would be the first step to give a greater role to living organ donation.

Design, implementation, and evaluation of a knowledge translation intervention to increase organ donation after cardiocirculatory death in Canada: a study protocol.

PubMed

Squires, Janet E; Grimshaw, Jeremy M; Taljaard, Monica; Linklater, Stefanie; Chassé, Michaël; Shemie, Sam D; Knoll, Gregory A

2014-06-20

A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders' beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level.

Design, implementation, and evaluation of a knowledge translation intervention to increase organ donation after cardiocirculatory death in Canada: a study protocol

PubMed Central

2014-01-01

Background A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. Methods We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders’ beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. Discussion We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level. PMID:24950719

Impact of a National Controlled Donation After Circulatory Death (DCD) Program on Organ Donation in the United Kingdom: A 10-Year Study.

PubMed

Hodgson, R; Young, A L; Attia, M A; Lodge, J P A

2017-12-01

Organ transplantation is the most successful treatment for some forms of organ failure, yet a lack of organs means many die on the waiting list. In the United Kingdom, the Organ Donation Taskforce was set up to identify barriers to organ donation and in 2008 released its first report (Organ Donation Taskforce Report; ODTR). This study assesses the success since the ODTR and examines the impact of the United Kingdom's controlled donation after circulatory death (DCD) program and the controversies surrounding it. There were 12 864 intended donation after brain death (DBD) or DCD donors from April 2004 to March 2014. When the 5 years preceding the ODTR was compared to the 5 years following, intended DCD donors increased 292% (1187 to 4652), and intended DBD donors increased 11% (3327 to 3698). Organs retrieved per intended DBD donor remained static (3.30 to 3.26), whereas there was a decrease in DCD (1.54 to 0.99) due to a large rise in donors who did not proceed to donation (325 to 2464). The majority of DCD donors who proceeded did so within 30 min from time of withdrawal. Our study suggests further work on converting eligible referrals to organ donation and exploring methods of converting DCD to DBD donors. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Knowledge and ethical perception regarding organ donation among medical students

PubMed Central

2013-01-01

Background To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan. Methods Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20. Results A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students’ opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P=0.000). Conclusion Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic. PMID:24070261

Factors associated with (un)willingness to be an organ donor: importance of public exposure and knowledge.

PubMed

Haustein, Silke V; Sellers, Marty T

2004-04-01

Transplantation is increasingly limited by the supply of donor organs. Identifying subgroups that do not support organ donation will allow targeted efforts to increase organ donation. A total of 185 non-acutely ill outpatients visiting a community physician's office voluntarily completed a survey designed to capture views and general knowledge/misconceptions about cadaveric organ donation/transplantation. Of 185 patients, 86 were willing to donate, 42 were unwilling, and 57 were unsure. Willingness to donate was significantly associated with: having discussed the topic with family; having known a cadaveric organ donor; age 55 yr; having graduated high school; recognizing the organ shortage as the primary problem in transplantation; having received a post-high school degree; having seen public information within 30 d; and having a family member in health care (all p

Modified mandated choice for organ procurement

PubMed Central

Chouhan, P; Draper, H

2003-01-01

Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. PMID:12796435

Cardiac transplantation. Organ procurement to patient discharge.

PubMed

Rudolphi, D M; Nagy, K M; Verne, D J

1987-01-01

The care of the cardiac transplant patient is complex, yet rewarding. During the hospital stay, the patients, families, and nurses develop close-knit relationships that last after discharge. The cardiac transplant patients at Hershey Medical Center have formed a support group. To promote organ donation, they wear T-shirts, hats, and coats with the logo, "I got my heart at HMC," (Hershey Medical Center). This not only increases awareness of the need for organ donation, but also gives Hershey Medical Center recognition for its cardiac transplantation program.

Attitude and willingness of high school students toward organ donation.

PubMed

Afshar, Reza; Sanavi, Suzan; Rajabi, Mohammad-Reza

2012-09-01

Public awareness of organ donation fundamentally affects the organ transplantation programs. This study was performed to assess the attitude and willingness of high school adolescents regarding organ donation. The study population consisted of 416 high school girls who were studying in four grades of three educational courses. Data were collected by a questionnaire and included demographic variables and attitude and willingness, which were assessed based on the Likert scale. The SPSS v.16 was used for data analysis. The mean age of the study subjects was 16.26 ± 1.06 years, 31% studied in grade-1, 27% in grade-2 (25% natural sciences, 27% mathematics and 48% humanities), 26% in grade-3 (30% natural sciences, 34% mathematics and 36% humanities) and 16% in pre-university stage (32% natural sciences, 42% mathematics and 26% humanities). The students had a highly positive attitude toward organ donation (mean score 4.2 ± 0.54). The greatest willingness for organ donation was concerning the kidney (88%) and heart (84%), followed by the liver (83.4%), pancreas (79.6%), cornea (67.8%) and skin (51%). Willingness for deceased as well as living organ donation was indicated by 92% and 47%, respectively, of the participants. Organ donation was considered acceptable only to relatives by 5% of the participants when the donors were deceased donors and by 16% of the participants when the donors were living donors; donation to all needy persons from deceased donors was accepted by 87% of the participants and from living donors by 31%. The purpose of donation was stated as lending help to others by 89% and progression of science by 40.2% of the participants. Willingness for organ donation from a deceased relative was declared by 63% of the students. There was significant positive correlation between willingness for organ donation and attitude (P <0.001). In addition, attitude and willingness had positive correlation with educational levels, age and educational courses. Our study suggests that Iranian adolescents have a great attitude and willingness toward organ donation, which reflects favorable knowledge of transplantation. Further research on public awareness in both genders and various age ranges is needed.

Imagining the Impact of Different Consent Systems on Organ Donation: The Decisions of Next of Kin

ERIC Educational Resources Information Center

Coppen, Remco; Friele, Roland D.; Gevers, Sjef K. M.; Van Der Zee, Jouke

2010-01-01

Next of kin play an important role in organ donation. The aim of this study was to assess the extent to which explicitness of consent to organ donation by the deceased impacts the likelihood that next of kin will agree to organ donation of the deceased by using hypothetical cases. Results indicate that that people say they are more willing to…

Transcendental Spirituality and Acquaintance With the Activities of the Domestic National Transplant Center as Factors Shaping Attitudes Toward Organ Donation.

PubMed

Melnikov, Semyon; Ashkenazi, Tamar; Amara, Muhammad; Peles Bortz, Anat

2017-06-01

Organ donation has been shown to be perceived as inappropriate by religiously observant individuals. The impact of spirituality level on attitudes toward organ donation has not been broadly explored. To explore the contribution of ethnicity, spirituality, level of religious observance, and acquaintance with the activities of the Israel National Transplant Center (INTC) to forming attitudes toward organ donation among Jews and Muslim Arabs in Israel. A descriptive cross-sectional survey. Three hundred five (65.2%) Jewish and 163 (34.8%) Muslim Arab respondents living in Israel. Jewish respondents had more positive attitudes toward organ donation than Muslim Arabs. Muslim Arabs had a higher mean spirituality score than Jews. Gender, age, ethnicity, level of religious observance, education, 4 spirituality dimensions, and acquaintance with the activities of the INTC explained 41.5% of the variance in attitudes to organ donation. Transcendental spirituality, acquaintance with the activities of the INTC, and level of religious observance had the highest contribution to explaining attitudes to organ donation, while gender and age had a low contribution. Ethnicity, education, and the 3 other spirituality dimensions were not found to have a significant contribution. A multifaceted approach to improving attitudes toward organ donation among Jews and Muslim Arabs in Israel is important.

Gifts of giving: the role of empathy and perceived benefits to others and self in young adults' decisions to become organ donors.

PubMed

Cohen, Elizabeth L; Hoffner, Cynthia

2013-01-01

Trait empathy and self-interest exert a strong influence on different prosocial behaviors, but their role in the promotion of organ donation registration is unclear. A survey examined how perceived benefits of organ donation for others and the self affect people's willingness to register as donors. Perceived other-benefits did not predict registration. Those with lower risk and greater self-benefit perceptions were more willing to donate. Empathic concern predicted donation willingness and moderated the effect of other-benefit perceptions, such that other-benefit perceptions predicted donation willingness among those with greater empathic concern. Applications of these findings to organ donation promotion are discussed.

Involvement of Religious Factors on the Attitude Toward Organs Donation Among the Ecuadorian Population Resident in Spain.

PubMed

Rios, A; Lopez-Navas, A; Iniesta, A; Mikla, M; Martinez-Alarcón, L; Ramis, G; Ramirez, P; Parrilla, P

2015-11-01

The attitude toward cadaveric organ donation is modulated by different factors, such as religious beliefs. This study sought to analyze the attitude of nationals of Ecuador resident in Spain regarding deceased organ donation depending on their religious beliefs. A sample of Ecuadorian population resident in Spain (n = 461) stratified by age and sex was selected. We used a validated questionnaire of psychosocial aspects (PCID-DTO Rios), which is self-administered and anonymous. The χ(2) test, Student t test, and logistic regression analysis were used to analyze data. Of the 461 survey respondents, 86% (n = 395) were Catholic, 7% (n = 31) were believers of other faiths, and 7% (n = 35) declared themselves agnostic or atheist. A significant association between the religious beliefs and attitude toward organ donation among those tested can be objectified: 61% of Catholics (n = 241), 42% of believers in non-Catholic doctrines (n = 13), and 49% of atheists/agnostics (n = 17) were in favor of donation (P = .05). Among religious people, 77% of respondents believed their religion was favorable toward donation and 35%, although in favor of organ cadaveric donation, consider their religion contrary to donation (P < .001). The attitude toward cadaveric organ donation among the Ecuadorian population resident in Spain is influenced by religious beliefs and considers what their religion says regarding organ donation. Copyright © 2015 Elsevier Inc. All rights reserved.

Knowledge, attitudes, and practices of Palestinian people relating to organ donation in 2016: a cross-sectional study.

PubMed

Abukhaizaran, Nidal; Hashem, Mohammed; Hroub, Osama; Belkebir, Souad; Demyati, Khaled

2018-02-21

Organ transplantation is the treatment of choice for organ failure, but organs are scarce and their availability is affected by relational ties, religious beliefs, cultural influences, body integrity, medical mistrust, and other factors. This aim of this study was to assess the knowledge, attitudes, and practices of Palestinian population with respect to organ donation. In this cross-sectional study, we used a validated questionnaire delivered by land telephone to collect data on the knowledge, attitudes, and practices relating to organ donation in the general population of the West Bank. Stratified sampling and simple random sampling were applied using data obtained from the Palestinian Telecommunication Group in 2016. Stata version 20 was used for statistical analysis, and a p value less than 0·05 was considered significant. Ethics approval was obtained from the Institutional Review Board of An-Najah National University, and all participants gave verbal informed consent. The questionnaire was completed by 385 (68%) of 565 people approached (mean age 42 years [SD 14·13]). 266 (69%) respondents were married, 311 (80%) were employed, and 375 (97%) were Muslim. 136 (35%) respondents were university students or post-graduates. Half of participants lived in urban areas. Local religious clergy were reported as being the source of general information by 150 (40%) participants. 273 (71%) respondents had adequate knowledge about organ donation, TV being the main source of information for 207 (60%) participants. 70 (26%) respondents would consider donation only after death, and 342 (67%) respondents would only consider donating to a close family member, whereas 341 (100%) respondents believed that their organ could be misused and 219 (64%) believed organ donation carries a health risk. 135 (49%) respondents preferred to donate to a recipient of the same religion. 266 (78%) individuals believed that organ donation should be promoted in the occupied Palestinian territory, although 188 (55%) reported organ donation to be culturally unacceptable. Religious beliefs and fears of complications were the main obstacles to organ donation. An adequate level of knowledge was associated with the female sex (p=0·008), level of education (p=0·046), monthly income (p=0·041), and marital status (p=0·012), whereas a positive attitude to organ donation was associated with religious score (p=0·015), marital status (p=0·031), and knowledge score (p=0·003). A high level of knowledge was associated with employment and the perception of organ donation as permitted in religion, whereas a positive attitude was associated with single marital status, high level of knowledge, and residence in cities. Despite adequate knowledge and positive attitudes towards organ donation, a comprehensive study is necessary to fully understand the local characteristics that influence organ donation by Palestinians and to better inform decision makers and future policies. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Body donation versus organ donation].

PubMed

Reis, Ria

2010-01-01

There appears to be a discrepancy between the oversupply of donated bodies 'for science' in anatomical institutions in the Netherlands and the shortage of donated organs. However, organ donation is not as straightforward as it seems, mainly because of its strict conditions, e.g. with respect to age and the required hospital setting of the dying. Since Dutch body donors are mainly elderly men, their attitudes to their body, death and science should be explored from a generational perspective.

Legal and ethical aspects of organ donation and transplantation

PubMed Central

Shroff, Sunil

2009-01-01

The legislation called the Transplantation of Human Organ Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. Broadly, the act accepted brain death as a form of death and made the sale of organs a punishable offence. With the acceptance of brain death, it became possible to not only undertake kidney transplantations but also start other solid organ transplants like liver, heart, lungs, and pancreas. Despite the THO legislation, organ commerce and kidney scandals are regularly reported in the Indian media. In most instances, the implementation of the law has been flawed and more often than once its provisions have been abused. Parallel to the living related and unrelated donation program, the deceased donation program has slowly evolved in a few states. In approximately one-third of all liver transplants, the organs have come from the deceased donor program as have all the hearts and pancreas transplants. In these states, a few hospitals along with committed NGOs have kept the momentum of the deceased donor program. The MOHAN Foundation (NGO based in Tamil Nadu and Andhra Pradesh) has facilitated 400 of the 1,300 deceased organ transplants performed in the country over the last 14 years. To overcome organ shortage, developed countries are re-looking at the ethics of unrelated programs and there seems to be a move towards making this an acceptable legal alternative. The supply of deceased donors in these countries has peaked and there has been no further increase over the last few years. India is currently having a deceased donation rate of 0.05 to 0.08 per million population. We need to find a solution on how we can utilize the potentially large pool of trauma-related brain deaths for organ donation. This year in the state of Tamil Nadu, the Government has passed seven special orders. These orders are expected to streamline the activity of deceased donors and help increase their numbers. Recently, on July 30, 2008, the Government brought in a few new amendments as a Gazette with the purpose of putting a stop to organ commerce. The ethics of commerce in organ donation and transplant tourism has been widely criticized by international bodies. The legal and ethical principles that we follow universally with organ donation and transplantation are also important for the future as these may be used to resolve our conflicts related to emerging sciences such as cloning, tissue engineering, and stem cells. PMID:19881131

On harm thresholds and living organ donation: must the living donor benefit, on balance, from his donation?

PubMed

Williams, Nicola Jane

2018-03-01

For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: (1) The living donor provides valid consent to donation. (2) Living donation produces an overall positive balance of harm-benefit for donors and recipients which cannot be obtained in a less harmful manner. (3) Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view-termed here 'The Donor Benefit Standard'-directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants 'The Donor Benefit Standard' should ultimately be rejected.

Willingness toward organ and body donation among anatomy professors and students in Mexico.

PubMed

Quiroga-Garza, Alejandro; Reyes-Hernández, Cynthia Guadalupe; Zarate-Garza, Pablo Patricio; Esparza-Hernández, Claudia Nallely; Gutierrez-de la O, Jorge; de la Fuente-Villarreal, David; Elizondo-Omaña, Rodrigo Enrique; Guzman-Lopez, Santos

2017-11-01

Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students, medical student teaching assistants, medical students involved in research, and anatomy professors. A cross-sectional, prospective study was designed in which the questionnaire was distributed among first-year human anatomy students before undertaking cadaver dissection at the beginning of the semester, and then again after a commemoration service at the end of the course. The questionnaire items included demographic data, as well as questions designed to characterize participants' attitudes regarding body/organ donation from strangers, family members, and whether participants would consider such practices with their own bodies. Out of a total of 517 students enrolled in the Human Anatomy course in the Medical School at the Universidad Autónoma de Nuevo León, Mexico during January to June 2016, 95% responded to the first (491) and second (490) surveys. Participants' opinions on their own organ donation was similar before and after exposure to cadaver dissection, with between 87% and 81% in favor of such practices, and only 3% against it, in both surveys. Participants' willingness to donate their own bodies, as well as those of family members, increased, while reluctance regarding such practices decreased by half (P < 0.0001 and P < 0.05). Professors had the highest rates of positive opinions regarding their own body donation (74.9%), with 18.8% undecided. Low opposition toward organ and body donation remains prevalent among both anatomists and physicians in training in Mexico. Anat Sci Educ 10: 589-597. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

The role of women in the donation consent decision: building on previous research.

PubMed

Dodd-McCue, Diane; Tartaglia, Alexander; Cowherd, Robin

2007-09-01

Recently published findings emphasize the dominant role of women in the donation discussion. With some noteworthy exceptions, the empirical literature on gender and donation, and the role of gender in healthcare decisions as well as donation, is limited. To provide preliminary information needed to begin theoretical or framework development and to initiate more rigorous research on the role of gender in donation discussions. This exploratory study is a descriptive qualitative retrospective study using focus group methodology. Two focus groups were conducted in 2 major cities in the organ procurement organization's service area. Participants were women who were involved in the donation discussion within the past 5 years; 6 participated in 1 session, 8 in the other. The focus group discussions highlight the role of women in the donation process relative to information needs, information usage, and the ensuring dynamics of the donation discussion. Compared to men, women tend to seek more information and reframe this information for others. Because women are frequently central in family communication networks, they serve as a communication conduit for other family members and may influence others. Involving key women decision makers in the early stages of the donation discussion and providing information elaboration build on women's central placement and role in family communication network processes. The significance of women's central placement may carry cultural implications, particularly for racial or ethnic groups with strong matriarchal or extended kinship structures.

Deterrents to Organ Donation: A Multivariate Analysis of 766 Survey Respondents.

PubMed

Sellers, Marty T; McGinnis, H Scott; Alperin, Melissa; Sweeney, John F; Dodson, Thomas F

2018-04-01

Although successful on many fronts, solid organ transplantation fails patients who die on waitlists. Too few organ donors beget this failure. Dispelling misperceptions associated with donation and transplantation would expectedly increase donation and decrease waitlist mortality; recipients would also receive transplants earlier in their disease process, leading to better post-transplantation outcomes. Survey responses to 7 questions pertaining to organ donation and transplantation were analyzed to determine their association with willingness to donate. Subgroup analyses according to race, residence status (rural vs nonrural), and education level were performed. There were 766 respondents; 84.6% were willing to be a donor, 76.2% were female, 79.7% were Caucasian, and 16.5% were African-American. Having concerns about getting inadequate medical care if registered as a donor was the strongest independent predictor of willingness to donate overall (odds ratio 0.21; 95% CI 0.13 to 0.36) and in each subgroup; African Americans were more likely than Caucasians to have this concern (20.2% vs 9.5%; p < 0.001). Race (odds ratio 0.41; 95% CI 0.22 to 0.75 for African Americans) and age were also predictive overall, but less so. Willingness to donate a family member's organs depended on whether a discussion about donation had hypothetically occurred: 61.0% would donate if there had been no discussion; 95.2% would donate if the family member had said "yes" to donation; and 11.0% would donate if the family member had said "no" (p < 0.001). If there was no prior discussion, having concerns about getting less-aggressive medical care predicted willingness to donate a family member's organs (odds ratio 0.40; 95% CI 0.25 to 0.65). The strongest deterrent of willingness to donate one's own or a family member's organs is a misperception that should be correctable. Race and age are less predictive. Efforts to dispel misperceptions and increase donation remain desperately needed to improve waitlist mortality and post-transplantation outcomes. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Living organ donation: the effect of message frame on an altruistic behaviour.

PubMed

McGregor, Lesley M; Ferguson, Eamonn; O'Carroll, Ronan E

2012-09-01

This experimental study investigates the impact of message frame and risk perceptions upon willingness to consider living organ donation. A 2 (gain vs. loss) by 2 (liver vs. kidney) by 2 (involved vs. not involved) between-group study was conducted. Eighty-seven participants completed a questionnaire after reading a vignette designed to invite participants to consider living kidney or liver donation. Within a gain frame scenario, willingness to donate was significantly higher when the risk of donating was lower. The results have important implications for the generalizability of framing theories and the promotion of living organ donation.

Current Status of Organ Donation.

PubMed

Tuttle-Newhall, J E Betsy; Schnitzler, Mark

2015-01-01

Organ and tissue donation are options at the end of a patient's life. Physicians and surgeons should have no direct role to play in the solicitation of organ donation and consent for organ recovery from the family of either a brain dead patient or a neurologically devastated patient. Certainly organ and tissue donation, and transplant procedures are life-saving and life-changing for many patients with organ failure and life-altering conditions. Due in part to the disparity between supply and demand for these resources, the potential exists for ethical tensions between the caring physician and surgeon team's advocacy for their patient, and the family at the end of the patient's life, and the process of organ donation. In this article, we will discuss the evolution of the legislative landscape for organ donation in the past decade, the concept of first person consent and its implications, the process of recovery and finally concerns regarding issues of conflict of interest regarding the handling and processing of the donor gift.

Financial incentives to improve organ donation: what is the opinion of the Vaud French-speaking population?

PubMed

Bosisio, Francesca; Santiago, Marie; Benaroyo, Lazare

2011-12-09

With the increase of the organ shortage, several authors assume that financial incentives would improve organ donation rates and fill the unbalance between the demand and the organs available for transplant medicine. This line of argument has been criticised with people arguing that an exchange of money for organs would violate the legal and the ethical principle of gratuity, decrease voluntarism and increase the body parts commodification phenomena. Switzerland is often highlighted as having under-average organ donation rates compared to other European countries. In this paper we investigate the opinions of the Vaud French-speaking population concerning direct, indirect and non financial incentives in order to assess their opinions and anticipate the further debate. As part of a broad survey about the organ donation decision-making process, questions about incentives for both living and deceased organ donation were addressed to Vaud inhabitants and physicians. The data collected showed that respondents were opposed to rewarding both living and deceased organ donation. The analysis of positive answers showed that indirect and non financial incentives were the most likely choice to acknowledge the donor's act. People in critical financial situations preferred direct financial incentives. These results showed that altruism and gratuity were key-values in the organ donation and transplantation social perceptions of the respondents. Thus, we assume that introducing financial incentives could tarnish the image of transplant medicine. Nevertheless, further studies are needed to evaluate if their introduction would improve the organ donation rates or decrease voluntarism.

A Systematic Literature Review and Research Agenda for Organ Donation Decision Communication.

PubMed

Knox, Kathy; Parkinson, Joy; Pang, Bo; Fujihira, Haruka; David, Patricia; Rundle-Thiele, Sharyn

2017-09-01

This study systematically located and appraised peer-reviewed evidence for the efficacy of strategies to increase organ donation decision communication among adults including an assessment of study quality to guide future research in this field. There is little room to move in strengthening unanimously positive public attitudes toward organ donation. Consequently, researchers have called for a focus on organ donation decision communication to understand modifiable factors to increase organ donation rates. Multiple databases were searched during September 2015, and 44 studies were selected for inclusion. Data concerning participants, design, and outcomes were extracted. Studies were rated for quality and levels of evidence. Although not amenable to meta-analysis, the literature indicates that approximately 50% of adults who are willing to become an organ donor have discussed this decision with family. The majority of research was conducted in a Western context with an overrepresentation of students. Strategies to increase communication include education, motivation, input from lived experience, efforts to address salient audience beliefs, and scheduled reminders or prompts. Intentions and willingness to discuss organ donation were consistently positively related to discussion behavior; however, formative research and experimental studies testing theoretically driven interventions were scarce. There is mixed evidence for the role of demographic and attitudinal characteristics in the success of organ donation communication interventions. Additional theoretically based research is recommended to establish boundary conditions and validate strategies to increase organ donation decision communication among adults.

Influence of religious and spiritual values on the willingness of Chinese-Americans to donate organs for transplantation.

PubMed

Lam, W A; McCullough, L B

2000-10-01

The rate of organ donation among minority groups in the United States, including Chinese-Americans, is very low. There is currently very little data in the biomedical literature that builds on qualitative research to quantify the attitudes of Chinese Americans toward organ donation. The present study quantitatively assesses the religious and cultural reasons that Chinese-Americans appear to be less willing to donate their organs than other populations. It also seeks to determine whether Confucian, Buddhist, or Daoist ideals are a significant factor in their overall reluctance to donate organs among respondents in this sample. A questionnaire distributed to Chinese American adults asked about general feelings toward organ donation and Buddhist, Confucian, Christian, Daoist, and other spiritual objections. The results suggest that Chinese-Americans are indeed influenced by Confucian values, and to a lesser extent, Buddhist, Daoist, and other spiritual beliefs, that associate an intact body with respect for ancestors or nature. Another significant finding is that the subjects were most willing to donate their organs after their deaths, to close relatives, and then in descending order, distant relatives, people from their home country, and strangers. This 'negotiable' willingness has enormous implications for clinicians, who may be able to increase organ donation rates among Chinese-Americans by, first, recognizing their diverse spiritual beliefs, and, second, offering a variety of possibilities for the organ procurement and allocation.

Organ donation among Malaysian Muslims: the role of mosques.

PubMed

Tumin, Makmor; Raja Ariffin, Raja Noriza; Mohd Satar, NurulHuda; Abdullah, Nawi; Wan Md Adnan, Wan Ahmad Hafiz; Ismail, Ahmad Zuhdi; Che Soh, Mazlan

2015-04-13

Malaysia, a country of Muslim majority, is suffering from a severe organ shortage due to the lack of donors. Mosques are the main gateways into the Muslim community. Hence, it is imperative to explore their role in facilitating organ donation. A self-administered survey was conducted between October and December 2013. We distributed 700 pilot-tested questionnaires to 82 mosques in Kuala Lumpur and its suburbs. The respondents were stratified into 2 groups: the mosque committees and the Muslim Jama'ah (individuals who come regularly to mosque for prayer). Data collected from a survey on 653 Malaysian Muslims reveals that the main factors that hamper organ donation-related activities at the mosques in Malaysia are the lack of experts and financial resources. The level of autonomy of the mosque is also another main issue. The respondents believe that talks and dialogues are the best methods for organ donation campaigns at the mosques. Conclusions We argue that if the mosques are to play a role in imparting knowledge on organ donation, there should be ample opportunity for the mosque committee to choose the content of religious talks held in their community. The mosques in Malaysia are not sufficiently facilitated to channel the information on organ donation to the Muslim community. Providing financial support and expert campaigners are expected to increase organ donation-related activities at the mosques and subsequently could increase awareness regarding organ donations among Malaysian Muslims.

Satisfaction with the organ donation process of brain dead donors' families in Korea.

PubMed

Kim, H S; Yoo, Y S; Cho, O H

2014-12-01

The purpose of this study was to investigate the satisfaction of the families of brain dead donors with regard to donation processes as well as their emotions after the donation. A cross-sectional survey study was performed that included 45 families of brain-dead donors in 1 hospital-based organ procurement organization (HOPO) in Korea between February 2007 and April 2011. Donor willingness and desire in life was the most frequent reason organs were donated (34.5%), followed by the advice of family members or friends (31.0%). Satisfaction with the organ donation processes was 4.04 of 6 points. In each category, the satisfaction with the decision of donation was the highest (4.96 points) and the satisfaction with the procedure of donation was the lowest (3.07 points); of each question, the satisfaction of "information and help on funeral arrangements was enough" and "the process of preparing the relevant documents was cumbersome" was the lowest. "Missing" the dead person and "pride" were the most common emotions experienced after organ donation (69.0% and 62.1%, respectively), followed by "grief," "family coherence," and "guilt." Religious practices were observed to be most helpful for psychological stress relief after donation, followed by spending time with family and friends. Moreover, 24.1% responded that they had not yet overcome their suffering. Because donors' own willingness is the most common reason that families choose donation, it is necessary to remind the public of the importance of organ donation through education and public relations using mass communication approaches. Additionally, because the families felt grief and guilt as well as missing their loved ones and pride regarding their dead loved ones after organ donation, continuous and systematic supports are needed to promote their psychological stability. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Knowledge and Attitude Regarding Organ Donation among Relatives of Patients Referred to the Emergency Department.

PubMed

Pouraghaei, Mahboob; Tagizadieh, Mohammad; Tagizadieh, Ali; Moharamzadeh, Payman; Esfahanian, Samaneh; Shahsavari Nia, Kavous

2015-01-01

Organ donation is one of the surviving procedures, which can increase the life expectancy of end-stage patients. Inappropriate beliefs and attitude of individuals to organ donation, their poor knowledge, and the socio-economic level are one of the most important barriers for organ donation. Therefore, here knowledge and attitude levels among relatives of trauma patients regarding organ donation were evaluated. This cross-sectional study was done on relatives of trauma patients referred to the emergency department of Sina Hospital, Tabriz, Iran, through 2013 to 2014. The questionnaire included parts of demographic data and socio-economic situations as well as status of knowledge and attitude regarding organ donation. A score between 0-7 was belonged to each person based on his/her level of knowledge. Attitude level had a score between 0-12. Chi- square, Fisher, and Mann-Whitney U test were performed to assess the relation between demographic variables and the level of knowledge and attitude. P<0.05 was considered as a significant level. 79 persons (57.1% male) with the mean age of 31.3±11.3 years were evaluated. 57 (73.1%) of subjects agreed with organ transplant. The main causes of disagreement among relatives regarding organ donation were dissatisfaction of the donor's relatives (25%) and religious issues (15%). 49 (62.02%) studied people had inappropriate attitude and 27 (34.2%) ones had good knowledge. male gender (OR=5.87; 95%CI: 3.32-8.42; p=0.001) and self-employed job (OR=7.78; 95%CI: 4.64-10.92; p=0.001) are independent factors associated with poor knowledge about organ donation. Self-employed job (OR=3.86; 95%CI: 1.41-6.11; p=0.009) and poor knowledge (OR=15.3; 95%CI: 9.03-21.57; p<0.001) were related to inappropriate attitude toward organ donation. The present study showed that 73.1% of participants agreed with organ donation. The major causes of disagreements were dissatisfaction of other relatives and religious beliefs. 62.0% of the studied people had positive view regarding organ donation and 34.2% of them well informed about. The most important causative factors for poor knowledge in this context were male gender and self-employed occupation. In addition, poor knowledge and self-employed job were two factors associated with inappropriate attitude toward organ donation.

Attitude of the Saudi community towards heart donation, transplantation, and artificial hearts.

PubMed

AlHabeeb, Waleed; AlAyoubi, Fakhr; Tash, Adel; AlAhmari, Leenah; AlHabib, Khalid F

2017-07-01

To understand the attitudes of the Saudi population towards heart donation and transplantation. Methods: A survey using a questionnaire addressing attitudes towards organ transplantation and donation was conducted across 18 cities in Saudi Arabia between September 2015 and March 2016.  Results: A total of 1250 respondents participated in the survey. Of these, approximately 91% agree with the concept of organ transplantation but approximately 17% do not agree with the concept of heart transplantation; 42.4% of whom reject heart transplants for religious reasons. Only 43.6% of respondents expressed a willingness to donate their heart and approximately 58% would consent to the donation of a relative's organ after death. A total of 59.7% of respondents believe that organ donation is regulated and 31.8% fear that the doctors will not try hard enough to save their lives if they consent to organ donation. Approximately 77% believe the heart is removed while the donor is alive; although, the same proportion of respondents thought they knew what brain death meant. Conclusion: In general, the Saudi population seem to accept the concept of transplantation and are willing to donate, but still hold some reservations towards heart donation.

The Latin American population in Spain and organ donation. Attitude toward deceased organ donation and organ donation rates.

PubMed

Ríos, Antonio; López-Navas, Ana I; Navalón, Juan C; Martínez-Alarcón, Laura; Ayala-García, Marco A; Sebastián-Ruiz, María J; Moya-Faz, Francisco; Garrido, Gregorio; Ramirez, Pablo; Parrilla, Pascual

2015-04-01

The Latin American (LA) population has similarities with the Spanish population which makes its integration into Spanish society easier. to analyze the attitude toward organ donation among Latin American citizens residing in Spain, to determine the psychosocial variables which affect this attitude, and to examine the correlation between donation rates of LA citizens in Spain and in their countries of origin. A random sample of LA residents in Spain was taken and stratified according to the respondent's nationality (n = 1.314), in the year 2010. Attitude was assessed using a validated questionnaire (PCID-DTO Dr Rios). The survey was self-administered and completed anonymously. Student's t-test, the χ(2) test, and logistic regression analysis. There was a 94% completion rate (n = 1.237). Attitude toward donation was favorable in 60% of cases (n = 745), 12% (n = 145) were against, and 28% (n = 347) were undecided. The following variables were associated with attitude toward donation: sex (P = 0.038), level of formal education (P < 0.001), country of origin (P = 0.002), attitude toward the donation of a family member's organs (P < 0.001), having discussed donation with the family (P < 0.001), carrying out prosocial activities (P = 0.025), attitude toward cremation of the body (P < 0.001), attitude toward burial of the body (P < 0.001), attitude toward having an autopsy carried out (P < 0.001), previous experience of the organ donation and transplantation process (P < 0.001), fear of mutilation after donation (P < 0.001), knowledge that the Church has a positive attitude toward organ donation and transplantation (P < 0.001), knowledge of one's partner's attitude toward organ donation (P < 0.001), and a belief that one might need a transplant in the future (P < 0.001). The donation rates in this population group in Spain are higher than those recorded in their countries of origin (55.76 vs. <10 pmp; P < 0.001). The attitude toward organ donation among LA citizens residing in Spain is slightly worse than that reported in the native Spanish population and is determined by many psychosocial factors. The donation rates of LA citizens in Spain are higher than those in their countries of origin. © 2015 Steunstichting ESOT.

[Attitude towards organ and tissue donation in Europe : Prerequisite for osteochondral allograft treatment].

PubMed

Schmidt, S; Schulte, A; Schwarz, S; Hofmann, N; Tietz, S; Boergel, M; Sixt, S U

2017-11-01

The biggest obstacle to overcome for routine treatment of various pathologies with fresh osteochondral allograft is the availability of tissue for transplantation. Large fresh osteochondral allografts are usually harvested from organ donors, but in contrast to organs, tissues can be procured after cardiac arrest. Medical staff as well the general public are much less aware of the possibilities and requirements of tissue donation compared to organ donation. This review aims to highlight the current situation of organ and tissue donation in Europe and to raise this much needed awareness. For this research, PubMed database was scanned using the terms "tissue/organ donation", "bone donation/transplantation", "cartilage transplantation/allografts" and "osteochrondral allografts". Relatives of potential donors are often not approached because physicians and nurses do not feel sufficiently prepared for this task and, thus, are reluctant to address this topic. Different options could alleviate the pressure medical staff is feeling. Furthermore, there are different factors influencing consent that can be addressed to increase donation rates. Currently, a lot of potential concerning musculoskeletal tissue grafts remains unused. Most importantly, families should be encouraged to speak about their potenzial will to donate and educational programs should be established to increase trust in organ and tissue donation and the allocation system and to increase knowledge about the importance of transplantation medicine. But joined efforts of different parts of the medical systems and different organizations involved in tissue transplantation should improve the situation for patients waiting for much needed transplants.

Campaigning for Organ Donation at Mosques.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L

2016-09-01

There is a trend of recruiting faith leaders at mosques to overcome religious barriers to organ donation, and to increase donor registration among Muslims. Commentators have suggested that Muslims are not given enough information about organ donation in religious sermons or lectures delivered at mosques. Corrective actions have been recommended, such as funding campaigns to promote organ donation, and increasing the availability of organ donation information at mosques. These actions are recommended despite published literature expressing safety concerns (i.e., do no harm) in living and end-of-life organ donation. Living donors require life-long medical follow-up and treatment for complications that can appear years later. Scientific and medical controversies persist regarding the international guidelines for death determination in end-of-life donation. The medical criteria of death lack validation and can harm donors if surgical procurement is performed without general anesthesia and before biological death. In the moral code of Islam, the prevention of harm holds precedence over beneficence. Moral precepts described in the Quran encourage Muslims to be beneficent, but also to seek knowledge prior to making practical decisions. However, the Quran also contains passages that demand honesty and truthfulness when providing information to those who are seeking knowledge. Currently, information is limited to that which encourages donor registration. Campaigning for organ donation to congregations in mosques should adhere to the moral code of complete, rather than selective, disclosure of information. We recommend as a minimal standard the disclosure of risks, uncertainties, and controversies associated with the organ donation process.

Community Preferences for the Allocation & Donation of Organs--the PAraDOx Study.

PubMed

Howard, Kirsten; Jan, Stephen; Rose, John; Chadban, Steven; Allen, Richard D M; Irving, Michelle; Tong, Allison; Wong, Germaine; Craig, Jonathan C; Cass, Alan

2011-05-25

Transplantation is the treatment of choice for people with severe organ failure. However, demand substantially exceeds supply of suitable organs; consequently many people wait months, or years to receive an organ. Reasons for the chronic shortage of deceased organ donations are unclear; there appears to be no lack of 'in principle' public support for organ donation. The PAraDOx Study examines community preferences for organ donation policy in Australia. The aims are to 1) determine which factors influence decisions by individuals to offer their organs for donation and 2) determine the criteria by which the community deems the allocation of donor organs to be fair and equitable. Qualitative and quantitative methods will be used to assess community preferences for organ donation and allocation.Focus group participants from the general community, aged between 18-80, will be purposively sampled to ensure a variety of cultural backgrounds and views on organ donation. Each focus group will include a ranking exercise using a modified nominal group technique. Focus groups of organ recipients, their families, and individuals on a transplant waiting list will also be conducted.Using the qualitative work, a discrete choice study will be designed to quantitatively assess community preferences. Discrete choice methods are based on the premise that goods and services can be described in terms of a number of separate attributes. Respondents are presented with a series of choices where levels of attributes are varied, and a mathematical function is estimated to describe numerically the value respondents attach to different options. Two community surveys will be conducted in approximately 1000 respondents each to assess community preferences for organ donation and allocation. A mixed logit model will be used; model results will be expressed as parameter estimates (β) and the odds of choosing one option over an alternative. Trade-offs between attributes will also be calculated. By providing a better understanding of current community preferences in relation to organ donation and allocation, the PAraDOx study will highlight options for firstly, increasing the rate of organ donation and secondly, allow for more transparent and equitable policies in relation to organ allocation.

Organ donation, awareness, attitudes and beliefs among post graduate medical students.

PubMed

Bapat, Usha; Kedlaya, Prashanth G

2010-01-01

Organ transplantation is the most preferred treatment modality for patients with end-stage organ disease. There is an inadequate supply of cadaver organs commensurate with need. Health-care professionals are the critical link in augmenting public awareness about organ donation. Their attitudes and beliefs can influence the public opinion. This study aims at understanding the awareness, attitudes, and beliefs among the medical postgraduate students. A total of 123 post-graduates of a medical college hospital in South India participated in the study. A specially de-signed questionnaire was used in assessment. Data were statistically analyzed using SPSS Windows version 10.0. The mean age of the postgraduate students was 28.32 + or - 3.5 years, 54% were males, 62% belonged to Christian religion, 69% were single, 77% were from nuclear families, 87% had urban background, and 54% were from upper socioeconomic strata. About 97% said they were aware of organ donation through media, 23 understood the concept of "cadaver" as "brain-death" and 93% were able to distinguish between brain-death and persistent vegetative state. Eighty-nine percent wished to donate their organs, 77% did not believe in body disfigurement and 87% did not believe in rebirth without the donated organs, if they pledged their organs. Sixty-nine percent were willing to donate the organs of their family members. Eighty percent were willing to receive organs from family and cadaver, 40% were willing to donate a child's organs, 95% did not believe that organ donation is against their religion, 87% disagreed with the notion that doctors would not impart adequate care if they were pledged organ donors and 79% agreed that doctors would not declare death prematurely, if they had pledged their organs during life. There was a statistically significant correlation between attitudes, beliefs and demographics. In conclusion, the concept of brain-death was clearly understood by only a small number of medical postgraduate students. They however, had positive attitudes and beliefs towards organ donation.

Knowledge and willingness toward living organ donation: a survey of three universities in Changsha, Hunan Province, China.

PubMed

Zhang, L; Li, Y; Zhou, J; Miao, X; Wang, G; Li, D; Nielson, K; Long, Y; Li, J

2007-06-01

This study was conducted to clarify the knowledge and attitudes of Chinese university students regarding living organ donation and analyze the determinants impacting their decisions. A questionnaire was delivered to college students chosen by random assignment. The data was analyzed by Statistics Package for Social Science (SPSS) software. Of 434 participants, 49.8% indicated they would be willing to be living organ donors, 58.4% believed living organ donation could ease the organ shortage, 48.2% thought that the recovery rate of recipients of living organ donors transplants was equal to or even better than deceased donation, 62.4% designated relatives as their most probable recipients, 48.0% argued that partial compensation was an effective method to increase live organ donation, and 53.7% wished to donate through transplantation centers. According to univariate analysis, attitudes regarding the value of life, relationship between body integrity and health as well as body integrity and conventional culture were factors that impacted on an individual's decision. Students' knowledge of the value of living organ transplantation and their economic background were considered to be determinants of individual willingness. Furthermore, the operation's impact on quality of life and postoperative complications were additional concerns. Multivariate analysis indicated that other factors influencing students' willingness to donate included attitudes toward the relationship between body integrity and health, beliefs regarding body integrity and conventional culture, value of living donor organ transplantation, economic background of students, and anxiety about the impact on postoperative complications. Numerous students were willing to participate in living organ donation. At the same time, social education and advertisements for living organ donation were far from adequate, having little or no influence on the decision-making process.

Organ Donation After Euthanasia: A Dutch Practical Manual.

PubMed

Bollen, J; de Jongh, W; Hagenaars, J; van Dijk, G; Ten Hoopen, R; Ysebaert, D; Ijzermans, J; van Heurn, E; van Mook, W

2016-07-01

Many physicians and patients do not realize that it is legally and medically possible to donate organs after euthanasia. The combination of euthanasia and organ donation is not a common practice, often limited by the patient's underlying pathology, but nevertheless has been performed >40 times in Belgium and the Netherlands since 2005. In anticipation of patients' requests for organ donation after euthanasia and contributing to awareness of the possibility of this combination among general practitioners and medical specialists, the Maastricht University Medical Center and the Erasmus University Medical Center Rotterdam have developed a multidisciplinary practical manual in which the organizational steps regarding this combined procedure are described and explained. This practical manual lists the various criteria to fulfill and the rules and regulations the different stakeholders involved need to comply with to meet all due diligence requirements. Although an ethicist was involved in writing this paper, this report is not specifically meant to comprehensively address the ethical issues surrounding the topic. This paper is focused on the operational aspects of the protocol. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

[Healthcare professionals' perceptions of Islamic beliefs and traditions as barriers to organ donation and transplantation in Algeria].

PubMed

Laidouni, Nouhad; Briones-Vozmediano, Érica; Garrido Clemente, Pilar; Gil González, Diana

The aim of this study is to explore healthcare professionals' perception of the influence of Islamic beliefs and traditions concerning organ donation and transplants in Algeria. Exploratory qualitative study using individual semi-structured interviews of 17 healthcare professionals (9 men, 8 women) of different specialties in a University hospital in Algiers (Algeria). Qualitative content analysis of transcripts was performed using the computer software ATLAS.ti 5. Healthcare professionals believe that religious beliefs do not affect living donation but say they have a negative impact on donation of cadaveric organs due to the existence of myths derived from the Islamic religion and lack of knowledge of the Algerian population about the positioning of religious leaders in relation to organ donation and transplantation. There is confusion among the Algerian population on the position of Islam around organ donation and transplantation, mainly to the detriment of the rate of cadaveric donation. Collaboration between the health sector and religious leaders to raise public awareness could improve the willingness of the population to donate organs after death. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Donation FAQs (Bone and Tissue Allografts)

MedlinePlus

... about organ, tissue and eye donation in your state, visit www.donatelife.net . Is there a difference between tissue and organ donation? In order for a person to become an organ donor (kidney, heart, liver, lung), blood and oxygen must flow through the organs until the time of recovery ...

76 FR 1185 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... public knowledge, attitudes, and behaviors related to organ donation. With a constantly growing deficit... attitudes and perceptions about, and perceived impediments to, organ donation. Two national surveys using... attitudes about living donation, presumed consent, and financial incentives for donation. Demographic...

Public awareness survey about organ donation and transplantation.

PubMed

Mohamed, E; Guella, A

2013-01-01

This survey was conducted to assess the public perception on organ donation and transplantation. A random sample of the population attending the outpatient clinics in Dhahran Military Hospital, Saudi Arabia, from December 1, 2011, to January 31, 2012, answered a questionnaire related to the above aim. From 582 subjects who answered the questionnaire, 85 were excluded for incoherent answers. From the remaining 497, 77.7% were males and 22.3% females with the age ranging from 18 to 65 years, and the majority was at a secondary or university level of education. More than 90% were aware organ transplantation and donation. From a religious point of view, 68.6% considered it legal to donate organs versus 26.2%. Those who disagreed with the concept of donation believed that one kidney is not enough to survive (50%), and that the remaining kidney may be affected (25.8%), whereas 15.2% expressed fear of the operation. Kidney transplantation was the preferred treatment for 73.2% of respondents and 12.75% were in favor of dialysis. Regarding financial incentive, 14.5% asked for reward from the government, 3.4% believed that the reward should come from the donor, and the majority (82.1%) stated that organ donation should be for the sake of God. Finally, there was a 61.2% willingness of respondents to donate relatives' organs after brain death. The level of awareness about donation and transplantation in our population was found to be satisfactory. Religion was not a bar for organ donation; moreover, financial incentive was not found to be a positive stimulus toward donation because the majority was willing to donate for the sake of God. Copyright © 2013 Elsevier Inc. All rights reserved.

Influences of general and traditional Chinese beliefs on the decision to donate blood among employer-organized and volunteer donors in Beijing, China.

PubMed

Tison, Geoffrey H; Liu, Changli; Ren, Furong; Nelson, Kenrad; Shan, Hua

2007-10-01

For the past several decades, Chinese blood centers have relied on blood donations from employer-organized donors (blood donors who donate blood in groups with coworkers as prearranged by the employer and the local blood center). Recently the government has decided to phase out employer-organized donors and transition to the use of only volunteer donors (blood donors who donate individually independent of employers). Evaluating the beliefs and attitudes of employer-organized and volunteer donors is critical to maintain an adequate blood supply after this transition. The study population consisted of 431 volunteer donors and 527 employer-organized donors who completed a structured questionnaire in July 2005. Employer-organized donors tended to be older, male, and married, with higher education and higher income compared to volunteer donors. Volunteer donors were more often motivated by altruism (p < 0.001) and more likely to donate larger volumes (400 mL vs. 200 mL) of blood (volunteer 70.5% vs. employer-organized 7%; p < 0.001). Employer-organized donors were more inhibited by factors related to traditional Chinese beliefs, such as the belief that blood donation affects life energy "Qi" (volunteer 3.1% vs. employer-organized 12.7%; p < 0.001), and requested more time off from work after donating. Employer-organized donors also express a greater concern about contracting disease from donating blood. To recruit voluntary donors effectively in China and other countries with traditional cultures, efforts need to counteract traditional beliefs and perceptions of risk that discourage donation by emphasizing the benefits, safety mechanisms, physiology, and epidemiology of blood donation. In China, there is a rich opportunity to convert prior employer-organized donors into volunteer donors, and the institution of a confidential predonation screening system may help to facilitate truthful risk factor disclosure.

Identifying Opinion Leaders to Promote Organ Donation on Social Media: Network Study.

PubMed

Shi, Jingyuan; Salmon, Charles T

2018-01-09

In the recent years, social networking sites (SNSs, also called social media) have been adopted in organ donation campaigns, and recruiting opinion leaders for such campaigns has been found effective in promoting behavioral changes. The aim of this paper was to focus on the dissemination of organ donation tweets on Weibo, the Chinese equivalent of Twitter, and to examine the opinion leadership in the retweet network of popular organ donation messages using social network analysis. It also aimed to investigate how personal and social attributes contribute to a user's opinion leadership on the topic of organ donation. All messages about organ donation posted on Weibo from January 1, 2015 to December 31, 2015 were extracted using Python Web crawler. A retweet network with 505,047 nodes and 545,312 edges of the popular messages (n=206) was constructed and analyzed. The local and global opinion leaderships were measured using network metrics, and the roles of personal attributes, professional knowledge, and social positions in obtaining the opinion leadership were examined using general linear model. The findings revealed that personal attributes, professional knowledge, and social positions predicted individual's local opinion leadership in the retweet network of popular organ donation messages. Alternatively, personal attributes and social positions, but not professional knowledge, were significantly associated with global opinion leadership. The findings of this study indicate that health campaign designers may recruit peer leaders in SNS organ donation promotions to facilitate information sharing among the target audience. Users who are unverified, active, well connected, and experienced with information and communications technology (ICT) will accelerate the sharing of organ donation messages in the global environment. Medical professionals such as organ transplant surgeons who can wield a great amount of influence on their direct connections could also effectively participate in promoting organ donation on social media. ©Jingyuan Shi, Charles T Salmon. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.01.2018.

Identifying Opinion Leaders to Promote Organ Donation on Social Media: Network Study

PubMed Central

Salmon, Charles T

2018-01-01

Background In the recent years, social networking sites (SNSs, also called social media) have been adopted in organ donation campaigns, and recruiting opinion leaders for such campaigns has been found effective in promoting behavioral changes. Objective The aim of this paper was to focus on the dissemination of organ donation tweets on Weibo, the Chinese equivalent of Twitter, and to examine the opinion leadership in the retweet network of popular organ donation messages using social network analysis. It also aimed to investigate how personal and social attributes contribute to a user’s opinion leadership on the topic of organ donation. Methods All messages about organ donation posted on Weibo from January 1, 2015 to December 31, 2015 were extracted using Python Web crawler. A retweet network with 505,047 nodes and 545,312 edges of the popular messages (n=206) was constructed and analyzed. The local and global opinion leaderships were measured using network metrics, and the roles of personal attributes, professional knowledge, and social positions in obtaining the opinion leadership were examined using general linear model. Results The findings revealed that personal attributes, professional knowledge, and social positions predicted individual’s local opinion leadership in the retweet network of popular organ donation messages. Alternatively, personal attributes and social positions, but not professional knowledge, were significantly associated with global opinion leadership. Conclusions The findings of this study indicate that health campaign designers may recruit peer leaders in SNS organ donation promotions to facilitate information sharing among the target audience. Users who are unverified, active, well connected, and experienced with information and communications technology (ICT) will accelerate the sharing of organ donation messages in the global environment. Medical professionals such as organ transplant surgeons who can wield a great amount of influence on their direct connections could also effectively participate in promoting organ donation on social media. PMID:29317384

[Donation protocol following controlled cardiac death (Maastricht type III donation). First experience].

PubMed

Rubio-Muñoz, J J; Pérez-Redondo, M; Alcántara-Carmona, S; Lipperheide-Vallhonrat, I; Fernández-Simón, I; Valdivia-de la Fuente, M; Villanueva-Fernández, H; Balandín-Moreno, B; Ortega-López, A; Romera-Ortega, M A; Galdos-Anuncibay, P

2014-03-01

To present our experience with the implementation of a donation protocol following controlled cardiac death (Maastricht type III donation). A retrospective descriptive and observational study was made. Intensive Care Unit of a third-level university hospital. Eight patients in an irreversible state, in which withdrawal of all life support had been agreed, were evaluated as potential donors. Application of the adopted protocol. Clinical data of donors, evaluation of a donation protocol following cardiac death, warm ischemia times, and short-term outcome of the recipients. Eight patients were evaluated. In one case donation was not possible because no cardiac arrest developed in the 120 minutes after extubation. The 7 remaining patients were effective kidney donors. Warm ischemia times were less than 23 minutes in all cases. Although 7 of the 14 recipients suffered delayed graft function, all of them achieved good renal function. Donation after cardiac death in patients in an overwhelming and irreversible state represents a potential source of donors not previously considered in this country. The prior development of a consensus-based protocol can help increase the number of organs in combination with those obtained after brain death. In our experience, the results of kidney transplants obtained from donors after cardiac death are good, and the success of these types of protocols could be extended to other organs such as the liver and lungs. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Organ donation after assisted death: Is it more or less ethically-problematic than donation after circulatory death?

PubMed

Kirby, Jeffrey

2016-12-01

A provocative question has emerged since the Supreme Court of Canada's decision on assisted dying: Should Canadians who request, and are granted, an assisted death be considered a legitimate source of transplantable organs? A related question is addressed in this paper: is controlled organ donation after assisted death (cDAD) more or less ethically-problematic than standard, controlled organ donation after circulatory determination of death (cDCDD)? Controversial, ethics-related dimensions of cDCD that are of relevance to this research question are explored, and morally-relevant distinctions between cDAD and cDCD are identified. In addition, a set of morally-relevant advantages of one practice over the other is uncovered, and a few potential, theoretical issues specifically related to cDAD practice are articulated. Despite these concerns, the analysis suggests a counterintuitive conclusion: cDAD is, overall, less ethically-problematic than cDCDD. The former practice better respects the autonomy interests of the potential donor, and a claim regarding irreversibility of cessation of the donor's circulatory function in the cDAD context can be supported. Further, with cDAD, there is no possibility that the donor will have negative sensory experiences during organ procurement surgery. Although the development of appropriate policy-decision and regulatory approaches in this domain will be complex and challenging, the comparative ethical analysis of these two organ donation practices has the potential to constructively inform the deliberations of relevant stakeholders, resource persons and decision makers.

[Results of an internet-based survey amongst members of the German Ophthalmological Society concerning postmortem cornea donation].

PubMed

Uhlig, C E; Promesberger, J; Hirschfeld, G; Koch, R; Reinhard, T; Seitz, B

2012-12-01

Analysis of willingness for postmortem cornea donation by professionals in ophthalmology and their motives in favor of or against donation. 3887 members of the German Ophthalmological Society received an anonymous questionnaire concerning sociodemographic background, physical health, experiences with organ explantation and their former engagement and motives concerning organ and cornea donation. 722 of the questionnaires were partially and 533 completely answered with an average willingness for cornea donation of 79.4%. Significant parameters for cornea donation were gender, former experience with organ explantation, ophthalmological health and fear of false diagnosis of brain death, worse medical treatment or organ commercialization. Of the participants 53.9% suggested the internet as a favorite source of information in this matter. The factors which had a significant impact on cornea donation in this survey seem to be mainly a result of insufficient information. Detailed information regarding this topic should preferentially be presented on internet pages of professional societies and could probably increase donation approval of DOG members.

A Strategic Planning Tool for Increasing African American Blood Donation.

PubMed

Singleton, Ashley; Spratling, Regena

2018-05-01

Historically, African Americans (AAs) have been underrepresented as blood donors. Having a lack of racially diverse blood donors contributes to transfusion complications, particularly in patients with sickle cell disease, who are both disproportionately AA and the recipients of frequent transfusions. Increasing AA blood donation is a complex public health issue. This review article serves to fill a gap in translating research regarding known hindrances and facilitators of AA blood donation to improve real-world donation practice and ultimately, patient outcomes. We incorporate findings from a literature review to develop a tool that blood centers, provider organizations, and patient advocacy groups can use to aid strategic planning efforts aimed at increasing AA blood donation.

Religious aspects of organ transplantation.

PubMed

Bruzzone, P

2008-05-01

No religion formally forbid donation or receipt of organs or is against transplantation from living or deceased donors. Only some orthodox jews may have religious objections to "opting in." However, transplantation from deceased donors may be discouraged by Native Americans, Roma Gypsies, Confucians, Shintoists, and some Orthodox rabbis. Some South Asia Muslim ulemas (scholars) and muftis (jurists) oppose donation from human living and deceased donors because the human body is an "amanat" (trusteeship) from God and must not be desecrated following death, but they encourage xenotransplantation research. No religion formally obliges one to donate or refuse organs. No religion formally obliges one to consider cadaveric organs "a societal resource" or considers organ donation "a religious duty" (except some rabbis and isolated Muslim and Christian scholars) No religion has a formal position on "bonus points," which is priority on the waiting list. Living organ donation is strongly encouraged only between jesus christians (15 of 28 jesus christians worldwide have donated a kidney). No religion forbid this practice. Directed organ donation to people of the same religion has been proposed only by some Orthodox Jews and some Islamic Ulemas/Muftis. Only some Muslim Ulemas/Muftis and some Asian religions may prefer living donation over cadaveric donation. No religion prefers cadaveric over living donation. No religion formally forbid non-heart-beating donors (nhbd) cadaveric donation or cross-over donation. Due to the sacrad of human life, the Catholic Church is against donation from anencephalic donors or after active euthanasia. No religion formally forbid xenotransplantation. Addressing the participants of the First International Congress of the Society for Organ Sharing in 1991, Pope John Paul II said "There are many questions of an ethical, legal and social nature which need to be more deeply investigated. There are even shameful abuses which call for determined action on the part of medical association and donor societies, and especially of competent legislative bodies" and later on "In effect, the human body is always a personal body, the body of a person. The body cannot be treated as a merely physical or biological entity, nor can its organs and tissues ever be used as item for sale or exchange". Addressing the participants at the XVIII International Congress of the Transplantation Society in 2000, Pope John Paul II said "Accordingly, any procedure which tends to commercialize human organs or to consider them as items of exchange or trade must be considered morally unacceptable, because to use the body as an object is to violate the dignity of the human person" and later on added "The criteria for assigning donated organs should in no way be discriminatory (i.e. based on age, sex, race, religion, social standing, etc.) or utilitarian (i.e. based on work capacity, social usefulness, etc.)." To conclude, according to the Catechism of the Catholic Church Compendium signed by Pope Benedict XVI on june 28, 2005, 476. Are allowed transplantation and organ donation, before and after death? Organ transplantation is morally acceptable with the consent of the donor and without excessive risks for him/her. For the noble act of organ donation after death, the real death of the donor must be fully ascertained.

Can education alter attitudes, behaviour and knowledge about organ donation? A pretest-post-test study.

PubMed

McGlade, Donal; Pierscionek, Barbara

2013-12-30

The emergence of evidence suggests that student nurses commonly exhibit concerns about their lack of knowledge of organ donation and transplantation. Formal training about organ donation has been shown to positively influence attitude, encourage communication and registration behaviours and improve knowledge about donor eligibility and brain death. The focus of this study was to determine the attitude and behaviour of student nurses and to assess their level of knowledge about organ donation after a programme of study. A quantitative questionnaire was completed before and after participation in a programme of study using a pretest-post-test design. Participants were recruited from a University based in Northern Ireland during the period from February to April 2011. 100 preregistration nurses (female : male=96 : 4) aged 18-50 years (mean (SD) 24.3 (6.0) years) were recruited. Participants' knowledge improved over the programme of study with regard to the suitability of organs that can be donated after death, methods available to register organ donation intentions, organ donation laws, concept of brain death and the likelihood of recovery after brain death. Changes in attitude postintervention were also observed in relation to participants' willingness to accept an informed system of consent and with regard to participants' actual discussion behaviour. The results provide support for the introduction of a programme that helps inform student nurses about important aspects of organ donation.

THE INFLUENCE OF INFORMATION AND RELIGION ON ORGAN DONATION, AS SEEN BY SCHOOL TEACHERS IN BOSNIA AND HERZEGOVINA.

PubMed

Sadic, Sahmir; Sadic, Jasna; Krupic, Rasim; Fatahi, Nabi; Krupic, Ferid

2016-10-01

Transplantation of organs is the treatment of choice for severe organ failure worldwide. The aims of the present study were to determine the influence of religion on attitudes towards organ donation among staff at schools in Tuzla. In the Tuzla region there are 42 schools and 1580 school staff. A total of 21 schools were selected randomly, which were stratified by geographical location. 499 employees were invited to participate in the study, and 475 agreed to participate. According to the definition of their attitude towards religion the subjects were divided into three groups: non-religious, only religious and practical believers. None of the subjects possesses a donor card. To the question whether the subjects support the idea of organ transplantation, most replied that they support the idea of donating organs both during life and after death. Regarding this question there is a significant difference between the groups (p = 0.0063). To the question whether they are prepared to donate an organ of a deceased family member, most replied that they would consent to donating an organ, whilst a significant number also replied that they were not sure. The results show that there is no significant difference between the replies given by the groups (p = 0.7694). To the question regarding to whom they were prepared to donate an organ, most said they were prepared to donate one to a member of their family, then to a close relative, whilst the least would donate to a stranger. The results show that there is a significant difference between the groups (p = 0.0002). In order to reduce the wide disparity between the need and organ donation amongst other things a more active relationship is necessary between health workers, religious officials and school staff.

Historical development and current status of organ procurement from death-row prisoners in China.

PubMed

Allison, Kirk C; Caplan, Arthur; Shapiro, Michael E; Els, Charl; Paul, Norbert W; Li, Huige

2015-12-03

In December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners. In the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to "voluntarily donate" organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards. Organ sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with "consent" are now simply labelled as "voluntarily donations from citizens". The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain.

How does the general public view posthumous organ donation? A meta-synthesis of the qualitative literature

PubMed Central

2011-01-01

Background Many individuals are unwilling to become posthumous organ donors, resulting in a disparity between the supply and demand for organ transplants. A meta-synthesis of the qualitative literature was therefore conducted to determine how the general public views posthumous organ donation. Methods Three online databases (PubMed, PsycINFO, Scopus) were searched for articles published between January 1990 and May 2008 using the following search terms: organ donation, qualitative, interview. Eligibility criteria were: examination of beliefs about posthumous organ donation; utilization of a qualitative research design; and publication in an English peer-reviewed journal. Exclusion criteria were examining how health professionals or family members of organ donors viewed posthumous organ donation. Grounded theory was used to identify the beliefs emerging from this literature. Thematically-related beliefs were then grouped to form themes. Results 27 articles from 24 studies met the inclusion criteria and were reviewed. The major themes identified were: religion, death, altruism, personal relevance, the body, the family, medical professionals, and transplant recipients. An altruistic motivation to help others emerged as the most commonly identified motivator for becoming an organ donor, although feeling a sense of solidarity with the broader community and believing that donated organs are put to good use may be important preconditions for the emergence of this motivation. The two most commonly identified barriers were the need to maintain bodily integrity to safeguard progression into the afterlife and the unethical recovery of organs by medical professionals. The influence of stakeholder groups on willingness to become an organ donor was also found to vary by the level of control that each stakeholder group exerted over the donation recovery process and their perceived conflict of interest in wanting organ donation to proceed. Conclusions These findings afford insights into how individuals perceive posthumous organ donation. PMID:21988839

Organ donation in Muslim countries: the case of Malaysia.

PubMed

Tumin, Makmor; Noh, Abdillah; Mohd Satar, Nurulhuda; Chin-Sieng, Chong; Soo-Kun, Lim; Abdullah, Nawi; Kok-Peng, Ng

2013-12-09

The aim of this paper is to look into the factors influencing Malaysian Muslims' decision to become deceased organ donors in Malaysia. We approached 900 Malaysian Muslims and 779 participated in our survey, conducted in Kuala Lumpur and its suburb. We examined their willingness to become donors and the willing donors were asked why they did not pledge to become donors. Non-donors were asked why they refuse to become donors. The survey found the main reason for Malaysian Muslims not pledging their organs was due to their lack of information on organ donation and/or their lack of confidence in the government's ability to properly administer organ donation procedures. Another interesting finding is that religion is not a main deterrent to organ donation. The survey suggests that Malaysia can explore many ways to encourage organ donation without having to resort to the highly controversial financial incentive option. A key to Malaysia's success or failure to increase organ donation rate lies in its ability to persuade its Muslim population (its largest population) to donate organs. This can be done by adopting a segmented, focused, and highly localized form of public education and by leveraging on existing networks involving local religious and community leaders as well as government and non-governmental institutions.

Contribution of the ethics committee of the French Intensive Care Society to describing a scenario for implementing organ donation after Maastricht type III cardiocirculatory death in France

PubMed Central

2012-01-01

French law allows organ donation after death due to cardiocirculatory arrest. In the Maastricht classification, type III non-heart-beating donors are those who experience cardiocirculatory arrest after the withdrawal of life-sustaining treatments. French authorities in charge of regulating organ donation (Agence de la Biomédecine, ABM) are considering organ collection from Maastricht type III donors. We describe a scenario for Maastricht type III organ donation that fully complies with the ethical norms governing care to dying patients. That organ donation may occur after death should have no impact on the care given to the patient and family. The dead-donor rule must be followed scrupulously: the organ retrieval procedure must neither cause nor hasten death. The decision to withdraw life-sustaining treatments, withdrawal modalities, and care provided to the patient and family must adhere strictly to the requirements set forth in patient-rights legislation (the 2005 Léonetti law in France) and should not be influenced in any way by the possibility of organ donation. A major ethical issue regarding the family is how best to transition from discussing treatment-withdrawal decisions to discussing possible organ retrieval for donation should the patient die rapidly after treatment withdrawal. Close cooperation between the healthcare team and the organ retrieval team is crucial to minimize the distress of family members during this transition. Modalities for implementing Maastricht type III organ donation are discussed here, including the best location for withdrawing life-sustaining treatments (operating room or intensive care unit). PMID:22747673

Breakdown in the organ donation process and its effect on organ availability.

PubMed

Razdan, Manik; Degenholtz, Howard B; Kahn, Jeremy M; Driessen, Julia

2015-01-01

Background. This study examines the effect of breakdown in the organ donation process on the availability of transplantable organs. A process breakdown is defined as a deviation from the organ donation protocol that may jeopardize organ recovery. Methods. A retrospective analysis of donation-eligible decedents was conducted using data from an independent organ procurement organization. Adjusted effect of process breakdown on organs transplanted from an eligible decedent was examined using multivariable zero-inflated Poisson regression. Results. An eligible decedent is four times more likely to become an organ donor when there is no process breakdown (adjusted OR: 4.01; 95% CI: 1.6838, 9.6414; P < 0.01) even after controlling for the decedent's age, gender, race, and whether or not a decedent had joined the state donor registry. However once the eligible decedent becomes a donor, whether or not there was a process breakdown does not affect the number of transplantable organs yielded. Overall, for every process breakdown occurring in the care of an eligible decedent, one less organ is available for transplant. Decedent's age is a strong predictor of likelihood of donation and the number of organs transplanted from a donor. Conclusion. Eliminating breakdowns in the donation process can potentially increase the number of organs available for transplant but some organs will still be lost.

Philosophy of organ donation: Review of ethical facets.

PubMed

Dalal, Aparna R

2015-06-24

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization's Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

The Blood Donation Ambivalence Survey: measuring conflicting attitudes about giving blood.

PubMed

Fox, K R; Himawan, L K; France, C R

2017-05-18

This study was designed to develop and conduct initial validation testing for a novel measure of ambivalence about donating blood. Previous studies of living organ, bone marrow and stem cell donors have identified donation-related ambivalence as a predictor of decisions about donation and post-donation outcomes. Ambivalence about blood donation has not received the same attention. In Study 1, a sample of young adults (N = 396) were administered test items of ambivalence, and exploratory (EFA) and confirmatory factor analyses (CFA) were performed to identify the Blood Donation Ambivalence Survey. In Study 2, a separate sample of young adults (N = 241) completed the Blood Donation Ambivalence Survey in addition to questionnaires assessing known predictors of blood donation. Exploratory and confirmatory factor analyses indicated a two-factor structure reflecting commitment to donating blood and indecision about giving blood. The commitment subscale was positively related to known predictors of increased donation behaviour (e.g. donation intention, self-efficacy), whereas the indecision subscale was positively related to known predictors of decreased donation behaviour (e.g. donation anxiety, negative affect). Furthermore, a history of blood donation was associated with greater commitment and less indecision. The present findings provide strong initial support for the reliability and validity of a novel measure of blood donor ambivalence. © 2017 British Blood Transfusion Society.

Promoting organ donation to Hispanics: the role of the media and medicine.

PubMed

Frates, Janice; Bohrer, Gloria Garcia; Thomas, David

2006-01-01

This study assesses the impact of a paid media advertising campaign employing Spanish language, culturally sensitive television and radio spots airing on major Hispanic stations in southern California. An advertising tracking study with a baseline and three postintervention telephone surveys was conducted from 2001 through 2003 among 500 randomly selected self-identified, primarily Spanish language dominant adult Hispanics. Measures of organ donation attitudes and behaviors (decision and declared intent to donate organs) improved significantly (P < .05) in 2001 and 2002, then leveled off or declined in 2003. Among the reasons given for not making a decision to donate was fear that medical personnel might withhold care from identified organ donors, suggesting lack of knowledge and distrust of the health care system. Few respondents talked to health care professionals or contacted the organ procurement agency for information either before or after the campaign. Findings from this study indicate a need for ongoing public education in the Hispanic community about organ transplantation and donation. Health professionals need to become more engaged in encouraging Hispanic patients to learn about organ transplantation and donation, and to inform their families that they have made the personal decision to donate.

Evolution of a Statewide Organ Donation, Recovery and Allocation Program: “A Louisiana Perspective”

PubMed Central

Jacobbi, Louise M.; McBride, Virginia

1999-01-01

This article reviews the evolution, growth, and impact of a structured organ recovery program on transplantation in Louisiana and discusses the clinical, social, and financial factors that influence the acceptance of organ transplantation as a viable treatment option for organ failure which once led inexorably to death. The rising number of organ donations and the formulation of strategies to increase these numbers to meet the growing need are examined. Enactment and enforcement of state and federal legislation making organ donation and transplantation available and safer have led to advances in organ donation, procurement, informed consent, and organ preservation, a technology that makes the use of cadaveric organs possible and durable. PMID:21845115

Evaluation of an educational, theater-based intervention on attitudes toward organ donation in Risaralda, Colombia

PubMed Central

Buitrago, Juliana; Gómez, Sandra; Guerra, Alvaro; Lucumí, Leidy; Romero, César

2013-01-01

Introduction: The shortage of organs for transplantation is a worldwide problem and the main cause is the refusal of family members to donate. Consent to donate is influenced by many factors and educational interventions are strongly recommended. Objective: To evaluate the impact of an educational, theaterbased strategy on the attitudes toward organ donation. Methods: This study employed an intervention using theater as the central tool. The impact of this intervention on the intention to donate was assessed through a controlled, prospective, nonrandomized designed study. The sample consisted of 1,038 people. All the participants answered a survey that asked about sex, age and intent to donate. Afterward, one portion of the sample was exposed to the play, The Gift of Life, and a subsequent discussion forum that was guided by experts. The same survey was administered again after the intervention. Results: Before the intervention, donation attitudes were positive in 68.3% of the responses, negative in 6.8% and uncertain in 24.9%. Females showed a greater intent to donate while age had no apparent influence on the donation decision. Those exposed to the intervention were found to be more likely to donate and show a favorable change in attitude toward donation than those who were not exposed to the intervention. Conclusion: An educational intervention using theater is an effective tool to generate a short-term change in the intent to donate. Educational strategies should be employed to increase the rates of organ donation. PMID:24892320

Spanish experience as a leading country: what kind of measures were taken?

PubMed

Matesanz, Rafael; Domínguez-Gil, Beatriz; Coll, Elisabeth; de la Rosa, Gloria; Marazuela, Rosario

2011-04-01

A recent call for self-sufficiency in transplantation issued by the WHO faces variable worldwide activity, in which Spain occupies a privileged position, with deceased donation rates of 33-35per million population (pmp) and 85 transplants pmp. An evaluation of current challenges, including a decrease in deaths because of traffic accidents and cerebrovascular diseases, and a diversity of cultures in Spain, has been followed by a comprehensive strategy to increase organ availability. Actions include an earlier referral of possible donors to the transplant coordination teams, a benchmarking project to identify critical success factors in donation after brain death, new family approach and care methods, and the development of additional training courses aimed at specific groups of professionals, supported by their corresponding societies. Consensus documents to improve knowledge about safety limits for organ donation have been developed to minimize inappropriate discarding of organs. Use of organs from expanded criteria donors under an 'old for old' allocation policy has resulted from adaptation to the progressive decline of optimal organs. National strategic plans to deal better with organ shortage, while respecting solid ethical standards, are essential, as reflected in the WHO Guiding Principles and the Istanbul Declaration on Organ Trafficking and Transplant tourism. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

COMmunication with Families regarding ORgan and Tissue donation after death in intensive care (COMFORT): protocol for an intervention study.

PubMed

Potter, Julie E; Herkes, Robert G; Perry, Lin; Elliott, Rosalind M; Aneman, Anders; Brieva, Jorge L; Cavazzoni, Elena; Cheng, Andrew T H; O'Leary, Michael J; Seppelt, Ian M; Gebski, Val

2017-01-17

Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation. This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia. The control condition is pre-intervention usual practice for at least six months before each site implements the intervention. The COMFORT intervention consists of six elements: family conversations regarding offers for organ donation to be led by a "designated requester"; family offers for donation are deferred to the designated requester; the offer of donation is separated from the end-of-life discussion that death is inevitable; it takes place within a structured family donation conversation using a "balanced" approach. Designated requesters may be intensivists, critical care nurses or social workers prepared by attending the three-day national "Family Donation Conversation" workshops, and the half-day NSW Simulation Program. The design is pre-post intervention to compare rates of family consent for organ donation six months before and under the intervention. Each ICU crosses from using the control to intervention condition after the site initiation visit. The primary endpoint is the consent rate for deceased organ donation calculated from 140 eligible next of kin families. Secondary endpoints are health professionals' adherence rates to core elements of the intervention; identification of predictors of family donation decision; and the proportion of families who regret their final donation decision at 90 days. The pragmatic design of this study may identify 'what works' in usual clinical settings when requesting organ donation in critical care areas, both in terms of changes in practice healthcare professionals are willing and able to adopt, and the effect this may have on desired outcomes. The findings of this study will be indicative of the potential benefits of the intervention and be relevant and transferrable to clinical settings in other states and countries. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000815763 (24 July 2013). ClinicalTrials.gov: NCT01922310 (14 August 2013) (retrospectively registered).

Experience of nurses in the process of donation of organs and tissues for transplant.

PubMed

de Moraes, Edvaldo Leal; dos Santos, Marcelo José; Merighi, Miriam Aparecida Barbosa; Massarollo, Maria Cristina Komatsu Braga

2014-01-01

to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo. the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives. knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.

Philosophy of organ donation: Review of ethical facets

PubMed Central

Dalal, Aparna R

2015-01-01

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail. PMID:26131406

Clinicians' Perception and Experience of Organ Donation From Brain-Dead Patients.

PubMed

Kentish-Barnes, Nancy; Duranteau, Jacques; Montlahuc, Claire; Charpentier, Julien; Martin-Lefevre, Laurent; Joseph, Liliane; Lefrant, Jean-Yves; Fieux, Fabienne; Renault, Anne; Thuong, Marie; Chevret, Sylvie; Azoulay, Elie

2017-09-01

ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician's perceptions and experience of organ donation. Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression. Physicians and nurses. Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32-0.53; p < 0.001), more often potential organ donors (odds ratio, 1.92; 95% CI, 1.56-2.35; p < 0.001), less likely to describe inconsistency (odds ratio, 0.43; 95% CI, 0.23-0.8) or complexity (odds ratio, 0.55; 95% CI, 0.45-0.67) of their feelings versus their professional activity, less likely to report that organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55-0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37-2.14; p < 0.001). Professionals who felt organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34-2.54; p < 0.001), less often physicians (odds ratio, 0.58; 95% CI, 0.44-0.77; p < 0.001), more likely to describe shift from curative care to organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52-2.21; p < 0.001), care of relatives of brain-dead patients as complex (odds ratio, 1.59; 95% CI, 1.32-1.93; p < 0.001), and inconsistency and complexity of personal feelings about organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92-5.53; p < 0.001), and more likely to have little experience with caring for potential organ donors (odds ratio, 1.49; 95% CI, 1.09-2.04). Significant differences exist among ICU clinician's perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation.

A Family's Life-Giving, Simple Decision.

ERIC Educational Resources Information Center

Green, Reg

2002-01-01

A father describes the far-reaching effects of his donating his young son's organs after he was killed during a botched robbery while vacationing in Italy, discussing the need to promote the importance of organ donation, particularly among young people. A sidebar lists organizations that can provide information on organ and tissue donations. (SM)

Review paper: Organ transplants: ethical, social, and religious issues in a multicultural society.

PubMed

Robson, Noor Zurani Md Haris; Razack, Azad Hassan; Dublin, Norman

2010-07-01

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.

Influencing relatives to respect donor autonomy: Should we nudge families to consent to organ donation?

PubMed

Sharif, Adnan; Moorlock, Greg

2018-03-01

Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next-of-kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited understanding of why families refuse permission into successful strategies targeting consent in the setting of deceased organ donation, primarily because our interventions fail to target underlying cognitive obstacles. Novel interventions to overcome these hurdles, incorporating an understanding of cognitive psychology and behavioral change therapy, may be beneficial. One potential intervention is to use the concept of nudge theory, where decision-making is influenced by encouraging positive reinforcement and indirect suggestion. Purposefully nudging families to given consent for organ donation by understanding, and then overcoming, their inherent cognitive biases is novel but also controversial. This article explores the roles of relatives in decisions about organ donation, how nudge theory translates to organ donation and discusses the arguments for and against its application. © 2018 John Wiley & Sons Ltd.

Increasing organ donation after cardiac death in trauma patients.

PubMed

Joseph, Bellal; Khalil, Mazhar; Pandit, Viraj; Orouji Jokar, Tahereh; Cheaito, Ali; Kulvatunyou, Narong; Tang, Andrew; O'Keeffe, Terence; Vercruysse, Gary; Green, Donald J; Friese, Randall S; Rhee, Peter

2015-09-01

Organ donation after cardiac death (DCD) is not optimal but still remains a valuable source of organ donation in trauma donors. The aim of this study was to assess national trends in DCD from trauma patients. A 12-year (2002 to 2013) retrospective analysis of the United Network for Organ Sharing database was performed. Outcome measures were the following: proportion of DCD donors over the years and number and type of solid organs donated. DCD resulted in procurement of 16,248 solid organs from 8,724 donors. The number of organs donated per donor remained unchanged over the study period (P = .1). DCD increased significantly from 3.1% in 2002 to 14.6% in 2013 (P = .001). There was a significant increase in the proportion of kidney (2002: 3.4% vs 2013: 16.3%, P = .001) and liver (2002: 1.6% vs 2013: 5%, P = .041) donation among DCD donors over the study period. DCD from trauma donors provides a significant source of solid organs. The proportion of DCD donors increased significantly over the last 12 years. Copyright © 2015 Elsevier Inc. All rights reserved.

Attitudes of intensive care and emergency physicians in Australia with regard to the organ donation process: A qualitative analysis.

PubMed

Macvean, Emily; Yuen, Eva Yn; Tooley, Gregory; Gardiner, Heather M; Knight, Tess

2018-04-01

Specialized hospital physicians have direct capacity to impact Australia's sub-optimal organ donation rates because of their responsibility to identify and facilitate donation opportunities. Australian physicians' attitudes toward this responsibility are examined. A total of 12 intensive care unit and three emergency department physicians were interviewed using a constructionist grounded theory and situational analysis approach. A major theme emerged, related to physicians' conflicts of interest in maintaining patients'/next-of-kin's best interests and a sense of duty-of-care in this context. Two sub-themes related to this main theme were identified as follows: (1) discussions about organ donation and who is best to carry these out and (2) determining whether organ donation is part of end-of-life care; including the avoidance of non-therapeutic ventilation; and some reluctance to follow clinical triggers in the emergency department. Overall, participants indicated strong support for organ donation but would not consider it part of end-of-life care, representing a major obstacle to the support of potential donation opportunities. Findings have implications for physician education and training. Continued efforts are needed to integrate the potential for organ donation into end-of-life care within intensive care units and emergency departments.

Knowledge and Attitude Regarding Organ Donation among Relatives of Patients Referred to the Emergency Department

PubMed Central

Pouraghaei, Mahboob; Tagizadieh, Mohammad; Tagizadieh, Ali; Moharamzadeh, Payman; Esfahanian, Samaneh; Shahsavari Nia, Kavous

2015-01-01

Introduction: Organ donation is one of the surviving procedures, which can increase the life expectancy of end-stage patients. Inappropriate beliefs and attitude of individuals to organ donation, their poor knowledge, and the socio-economic level are one of the most important barriers for organ donation. Therefore, here knowledge and attitude levels among relatives of trauma patients regarding organ donation were evaluated. Methods: This cross-sectional study was done on relatives of trauma patients referred to the emergency department of Sina Hospital, Tabriz, Iran, through 2013 to 2014. The questionnaire included parts of demographic data and socio-economic situations as well as status of knowledge and attitude regarding organ donation. A score between 0-7 was belonged to each person based on his/her level of knowledge. Attitude level had a score between 0-12. Chi- square, Fisher, and Mann–Whitney U test were performed to assess the relation between demographic variables and the level of knowledge and attitude. P<0.05 was considered as a significant level. Results: 79 persons (57.1% male) with the mean age of 31.3±11.3 years were evaluated. 57 (73.1%) of subjects agreed with organ transplant. The main causes of disagreement among relatives regarding organ donation were dissatisfaction of the donor's relatives (25%) and religious issues (15%). 49 (62.02%) studied people had inappropriate attitude and 27 (34.2%) ones had good knowledge. male gender (OR=5.87; 95%CI: 3.32-8.42; p=0.001) and self-employed job (OR=7.78; 95%CI: 4.64-10.92; p=0.001) are independent factors associated with poor knowledge about organ donation. Self-employed job (OR=3.86; 95%CI: 1.41-6.11; p=0.009) and poor knowledge (OR=15.3; 95%CI: 9.03-21.57; p<0.001) were related to inappropriate attitude toward organ donation. Conclusion: The present study showed that 73.1% of participants agreed with organ donation. The major causes of disagreements were dissatisfaction of other relatives and religious beliefs. 62.0% of the studied people had positive view regarding organ donation and 34.2% of them well informed about. The most important causative factors for poor knowledge in this context were male gender and self-employed occupation. In addition, poor knowledge and self-employed job were two factors associated with inappropriate attitude toward organ donation. PMID:26512367

Just love in live organ donation.

PubMed

Zeiler, Kristin

2009-08-01

Emotionally-related live organ donation is different from almost all other medical treatments in that a family member or, in some countries, a friend contributes with an organ or parts of an organ to the recipient. Furthermore, there is a long-acknowledged but not well-understood gender-imbalance in emotionally-related live kidney donation. This article argues for the benefit of the concept of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The concept of just love is helpful in the analysis of these live organ donations even if no statistical gender-imbalance prevails. It is particularly helpful, however, in the analysis of the gender-imbalance in live kidney donations if these donations are seen as a specific kind of care-work, if care-work is experienced as a labour one should perform out of love and if women still experience stronger pressures to engage in care-work than do men. The aim of the article is to present arguments for the need of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The aim is also to elaborate two criteria that need to be met in order for love to qualify as just and to highlight certain clinical implications.

Delayed Referral Results in Missed Opportunities for Organ Donation After Circulatory Death.

PubMed

Krmpotic, Kristina; Payne, Clare; Isenor, Cynthia; Dhanani, Sonny

2017-06-01

Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario. Retrospective cohort study. Provincial organ procurement organization. Patients who died in designated donation hospitals within the province of Ontario, Canada between April 1, 2013, and March 31, 2015. None. Of 1,407 patient deaths following planned withdrawal of life-sustaining therapy, 54.0% (n = 760) were medically suitable for donation after circulatory death. In 438 cases where next of kin was approached, consent rates reached 47.5%. A total of 119 patients became actual organ donors. Only 66.2% (n = 503) of suitable patients were appropriately referred, resulting in 251 missed potential donors whose next of kin could not be approached regarding organ donation because referral occurred after initiation of withdrawal of life-sustaining therapy or not at all. The number of medically suitable patients who die within 2 hours of planned withdrawal of life-sustaining therapy is nearly six times higher than the number of actual organ donors, with the greatest loss of potential due to delayed referral until at the time of or after planned withdrawal of life-sustaining therapy. Intensive care teams are not meeting their ethical responsibility to recognize impending death and appropriately refer potential organ donors to the local organ procurement organization. In cases where patients had previously registered their consent decision, they were denied a healthcare right.

Asking the difficult questions: message strategies used by organ procurement coordinators in requesting familial consent to organ donation.

PubMed

Anker, Ashley E; Feeley, Thomas Hugh

2011-07-01

The present study provides an in-depth examination of the messages used by organ procurement coordinators (OPCs) in shaping familial requests for organ donation. OPCs (N = 102), recruited from a national sample of 16 organ procurement organizations, participated in a structured interview designed to uncover the communication strategies used in obtaining familial consent for donation. Analysis of interviews indicates OPCs' messages cover 4 domain areas. Specifically, OPCs report use of messages intended to (a) provide education, (b) discuss the benefits to donation, (c) learn about potential donor families, and (d) persuade families to engage in donation. Within the 4 domain areas, OPCs report use of 15 specific messages (e.g., "positively framing the donor," "social proof," "discuss the benefit of donation to grieving") in requesting consent. The present study provides a detailed examination of strategies and offers recommendations for using message strategies to explore the effectiveness of the consent process from the perspective of OPCs in approaching donor families.

Impact of an Educational Intervention on Increasing the Knowledge and Changing the Attitude and Beliefs towards Organ Donation among Medical Students.

PubMed

Ramadurg, Umesh Yamanappa; Gupta, Akash

2014-05-01

Organ transplantation saves thousands of lives worldwide. Organ transplantation is a boon to the medical profession, as it helps in saving the lives of many diseased people. Globally, the prevalence of knowledge on organ donation was found to range from 60% to 85%, on using different knowledge variables. Knowledge, attitude and actions are interrelated and previous studies have shown that culture and religion were important external influences which affected the decision making process. So, students require further information on the organ donation process and they need opportunities to examine their own beliefs and attitudes, which can be addressed through educational interventions. Purpose of the study was to investigate the knowledge, attitude and belief on/towards organ donation and the impact of an educational intervention on them. An educational interventional study with pre structured questions being administered to study subjects. In the present study, a total of 70 students consented to participate and all the 70 attended the pre-test and post-test after the classroom teaching. Among the 70 participants, 35(50%) were males and 35(50%) were females. A majority of the subjects were Hindus 64(91.4%) and only 3(4.30%) were Muslims. Sixty seven (95.7%) of the students had heard of the term, 'organ donation'. Most common reason given by the participants for organ donation was that it was done to save someone's life [61 (87.11%)]. Among the 70 study subjects, only 19(27.10%) knew about the organs that could be donated, whose number increased to 56(80%) after providing the educational intervention. The difference which was observed in their knowledge before and after providing the educational intervention was found to be statistically significant (t= 39.315, p< 0.0000). The awareness of the legislation regarding organ donation was poor. Thiry one(444.3%) subjects were unaware about the existence of laws which were related to organ donation and its process. The study emphasizes the need of an intervention which incorporates the knowledge, motivational messages, facts and figures, to bring necessary changes in the perceptions and intentions of the students regarding organ donations.

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences

PubMed Central

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-01-01

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death. PMID:19772617

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences.

PubMed

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-09-22

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death.

[Attitude and opinion of medical students about organ donation and transplantation].

PubMed

Galvao, Flavio H F; Caires, Renato A; Azevedo-Neto, Raimundo S; Mory, Eduardo K; Figueira, Estela R R; Otsuzi, Thiago S; Bacchella, Telesforo; Machado, Marcel C C

2007-01-01

We analyzed the opinion and understanding of medical students about organ donation and transplantation. 347 students voluntarily completed a questionnaire with 17 queries concerning organ donation and transplantation. They were analyzed to identify general tendencies and divided into five groups, according to their year of study (first through sixth year), to assess differences among the years. Students of the fifth and sixth years were placed in the same group. Results were analyzed by the Chi-square test. The intention to become a post mortem or living donor was of 89% and 90% respectively; however, only 62% were aware of living donation risks. 70% of the 347 students admitted regular or little knowledge of the subject, 90.2% considered organ transplantation an important issue for a medical graduation program, 76.9% considered informed/expressed consent the best organ donation criterion and 64.3% of them chose severity of patient disease as the best allocation condition. As students progressed in their studies their understanding about transplantation improved. Students of the fourth, fifth and sixth year manifested a negative attitude about organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners. This data show the great interest and positive attitude of medical students toward organ donation and transplantation, despite the fact that most of them admitted having insufficient knowledge on the subject. A negative attitude by students of the fourth, fifth and sixth year on organ donation to alcohol addicts, non donors, drug users, law offenders and foreigners was also observed.

Can education alter attitudes, behaviour and knowledge about organ donation? A pretest–post-test study

PubMed Central

McGlade, Donal; Pierscionek, Barbara

2013-01-01

Objective The emergence of evidence suggests that student nurses commonly exhibit concerns about their lack of knowledge of organ donation and transplantation. Formal training about organ donation has been shown to positively influence attitude, encourage communication and registration behaviours and improve knowledge about donor eligibility and brain death. The focus of this study was to determine the attitude and behaviour of student nurses and to assess their level of knowledge about organ donation after a programme of study. Design A quantitative questionnaire was completed before and after participation in a programme of study using a pretest–post-test design. Setting Participants were recruited from a University based in Northern Ireland during the period from February to April 2011. Participants 100 preregistration nurses (female : male=96 : 4) aged 18–50 years (mean (SD) 24.3 (6.0) years) were recruited. Results Participants’ knowledge improved over the programme of study with regard to the suitability of organs that can be donated after death, methods available to register organ donation intentions, organ donation laws, concept of brain death and the likelihood of recovery after brain death. Changes in attitude postintervention were also observed in relation to participants’ willingness to accept an informed system of consent and with regard to participants’ actual discussion behaviour. Conclusions The results provide support for the introduction of a programme that helps inform student nurses about important aspects of organ donation. PMID:24381257

Immunosuppressants

MedlinePlus

... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z ... Exchange Programs Knowing Your Immunosuppressive (anti-rejection) Medications Organ and Tissue Donation The National Kidney Foundation (NKF) is the largest, ...

[Changes in the transplantation world--from altruism to a utilitarian approach].

PubMed

Mor, Eytan

2006-10-01

The lack of organs for transplantation is a worldwide problem that has created a moral conflict between the traditional altruistic basis of organ donation and alternative solutions based on utilitarian grounds. Survival of grafts achieved in recent decades after unrelated living-donor kidney transplantation between spouses is longer than with deceased donor transplantation. This experience justified the extension of kidney donation beyond the traditional close family relationships including: anonymous donors and paired exchange programs. However, unrelated donation of kidneys within altruistic norms could not provide an ultimate solution for the lack of organs for transplantation. On the other hand, globalization and development of advanced medical technology in developing countries that do not provide transplantation for all their citizens, created an opportunity for a worldwide flourish of transplant tourism as an alternative solution for transplant candidates. Transplant tourism functions according to market laws and is profit-driven, as opposed to the legal organ exchange programs in Europe and the U.S.A., which are non-profit and patient-oriented. The transition from trade in kidneys from unrelated living-donors to the use of other organs (heart, lung and liver) from death penalty prisoners in China was only a matter of deciding where to lay the moral border when justifying the act for the sake of life-saving. Considering the inability of current legal altruistic transplantation practice to supply the growing need for organs, healthcare authorities and professional transplantation organizations have to tackle the donor crisis by designing legally acceptable utilitarian solutions. For instance, through the formation of international organ exchange programs under formal agreements or, in the case of kidney transplantation, through the establishment of a regulated compensated donation system.

"Are You In or Are You Out?!" Moral Appeals to the Public in Organ Donation Poster Campaigns: A Multimodal and Ethical Analysis.

PubMed

Hansen, Solveig L; Eisner, Marthe I; Pfaller, Larissa; Schicktanz, Silke

2018-08-01

Organ transplantation is a well-established practice in modern medicine. However, many countries, especially those with an opt-in regulation, face the problem of low donation numbers. Respective public campaigns attempt to increase the number of donors by swaying public opinion with the use of carefully selected bits of information. Germany serves as a case study for an opt-in country investing approximately €7.5 million/year in the distribution of respective campaigns. To address diverse populations, large-scale posters in various public spaces still display a multitude of moral messages for organ donation. We developed a detailed multimodal approach for the analysis of health communication by focusing exemplarily on such organ donation poster campaigns as a common mean since the 1990s. In all, we identified 13 campaigns with 83 posters from 1996 to 2016. Here, we focus on both the textual and visual elements of such material to analyze how morally relevant principles and virtues are interwoven. Six categories of moral appeals were identified in the complete sample: altruism, being a decisive person, family responsibility, minimizing suffering, social conformity, and complete reciprocity. Overall, visual items were used to create a variety of social, moral, and epistemic claims with respect to organ donation. Our analysis reveals critical aspects highlighting the potential conflicts that arise from the ambiguity and wrong information of some messages as well as the risk of inappropriate blaming driven by these campaigns.

Female College Students' Perceptions of Organ Donation

ERIC Educational Resources Information Center

Boland, Kathleen; Baker, Kerrie

2010-01-01

The current process of organ donation in the U.S. relies on the premise of altruism or voluntary consent. Yet, human organs available for donation and transplant do not meet current demands. The literature has suggested that college students, who represent a large group of potential healthy organ donors, often are not part of donor pools. Before…

An Empirical Exploration of Selected Policy Options in Organ Donation.

ERIC Educational Resources Information Center

Klenow, Daniel J.; Youngs, George A., Jr.

1995-01-01

Presents findings from a mail survey of 414 persons regarding organ transplantation and donation policy issues. Gauged three measures of support for organ donation: donor card commitment, required request of next-of-kin support, and weak presumed consent support. High levels of support exist for organ donor cards and the next-of-kin law. Little…

25 CFR 900.98 - Who takes title to excess BIA or IHS property donated to an Indian tribe or tribal organization?

Code of Federal Regulations, 2012 CFR

2012-04-01

... an Indian tribe or tribal organization? 900.98 Section 900.98 Indians BUREAU OF INDIAN AFFAIRS... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures Bia and... or tribal organization? The Indian tribe or tribal organization takes title to donated excess BIA or...

25 CFR 900.98 - Who takes title to excess BIA or IHS property donated to an Indian tribe or tribal organization?

Code of Federal Regulations, 2011 CFR

2011-04-01

... an Indian tribe or tribal organization? 900.98 Section 900.98 Indians BUREAU OF INDIAN AFFAIRS... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures Bia and... or tribal organization? The Indian tribe or tribal organization takes title to donated excess BIA or...

25 CFR 900.98 - Who takes title to excess BIA or IHS property donated to an Indian tribe or tribal organization?

Code of Federal Regulations, 2010 CFR

2010-04-01

... an Indian tribe or tribal organization? 900.98 Section 900.98 Indians BUREAU OF INDIAN AFFAIRS... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures Bia and... or tribal organization? The Indian tribe or tribal organization takes title to donated excess BIA or...

25 CFR 900.98 - Who takes title to excess BIA or IHS property donated to an Indian tribe or tribal organization?

Code of Federal Regulations, 2013 CFR

2013-04-01

... an Indian tribe or tribal organization? 900.98 Section 900.98 Indians BUREAU OF INDIAN AFFAIRS... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures Bia and... or tribal organization? The Indian tribe or tribal organization takes title to donated excess BIA or...

Organ donation in adults: a critical care perspective.

PubMed

Citerio, Giuseppe; Cypel, Marcelo; Dobb, Geoff J; Dominguez-Gil, Beatriz; Frontera, Jennifer A; Greer, David M; Manara, Alex R; Shemie, Sam D; Smith, Martin; Valenza, Franco; Wijdicks, Eelco F M

2016-03-01

The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

Contribution of the ethics committee of the French society of intensive care medicine to a scenario for the implementation of organ donation after Maastricht III-type cardiac death in France.

PubMed

Graftieaux, J-P; Bollaert, P-E; Haddad, L; Kentish-Barnes, N; Nitenberg, G; Robert, R; Villers, D; Dreyfuss, D

2014-02-01

French law allows organ donation after death due to cardiocirculatory arrest. In the Maastricht classification, type III non-heart-beating donors are those who experience cardiocirculatory arrest after the withdrawal of life-sustaining treatments. French authorities in charge of regulating organ donation (Agence de la Biomédecine, ABM) are considering organ collection from Maastricht type III donors. We describe a scenario for Maastricht type III organ donation that fully complies with the ethical norms governing care to dying patients. That organ donation may occur after death should have no impact on the care given to the patient and family. The dead-donor rule must be followed scrupulously: the organ retrieval procedure must neither cause nor hasten death. The decision to withdraw life-sustaining treatments, withdrawal modalities, and care provided to the patient and family must adhere strictly to the requirements set forth in patient-rights legislation (the 2005 Léonetti law in France) and should not be influenced in any way by the possibility of organ donation. A major ethical issue regarding the family is how best to transition from discussing treatment-withdrawal decisions to discussing possible organ retrieval for donation should the patient die rapidly after treatment withdrawal. Close cooperation between the healthcare team and the organ retrieval team is crucial to minimize the distress of family members during this transition. Modalities for implementing Maastricht type III organ donation are discussed here, including the best location for withdrawing life-sustaining treatments (operating room or intensive care unit). Copyright © 2014. Published by Elsevier SAS.

Organ Donation From Deceased Donors: A Proactive Detection Program in Saudi Arabia.

PubMed

Shaheen, Faissal A M; Souqiyyeh, Muhammad Ziad; Attar, Besher; Ibrahim, Amal; Alsayyari, Abdulla

2015-11-01

Several challenging obstacles remain to increasing the number of organ donations from deceased patients in a hospital setting. These include medical, administrative, and ethical issues. Possible medical obstacles include the failure of early recognition of possible donors and inadequate care of potential and actual donors. To maximize the use of donated organs, proper care of the donors and expedited donor consent cannot be overemphasized. The care rendered to patients should ensure appropriate perfusion and nutrition of the organs, with meticulous follow-up until organ recovery. For example, patients involved in accidents are presumed to be healthy, but many have no available medical history on file. At the time of organ recovery, unexpected infections or malignancies can be minimized by raising the index of suspicion of the presence of serious conditions in donors, especially in donors with unknown medical history. A careful physical examination and an appropriate and aggressive laboratory investigation may disclose the cause of suspected clinical conditions in these potential donors. Individuals who work in intensive care units are the main group of health care providers directly involved in the process of organ donation. Appointing a donor coordinator in each intensive care unit could improve all aspects of organ donation. Such coordination could harmonize efforts toward the goals mentioned above and surmount the obstacles encountered during deceased-donor organ donation. Here, we describe the preliminary results of the Proactive Detection Program, a collaboration between the Saudi Center for Organ Transplantation (the national organ donation and transplant supervising center) and intensive care units of donating hospitals. With its success in Saudi Arabia, it is hoped that it will be widely adopted in other regions.

Holy month of Ramadan and increase in organ donation willingness.

PubMed

Najafizadeh, Katayoun; Ghorbani, Fariba; Hamidinia, Sajjad; Emamhadi, Mohammad Ali; Moinfar, Mohammad Ali; Ghobadi, Omid; Assari, Shervin

2010-05-01

Organ shortage is the most significant factor in restricting the activities of transplantation systems. We herein report the positive impact of Muslims' holy month of Ramadan on willingness to donate organs in Iran. Data were derived from the database of Donation Willingness Registries, affiliated to the organ procurement unit of Masih Daneshvari Hospital during March 2007 till March 2008. The number of applications for organ donation was compared between Ramadan and its previous month, and the socio-economic characteristics of the applicants were compared between those who applied in Ramadan and those who did so in the previous month. In addition, the mean number of daily applications was compared between Ramadan and the other months of the same year. A total of 11528 applications for organ donation cards were registered for the Ramadan of 2007 as opposed to 4538 applications in the previous month, showing an increasing rate of 154%. The mean number of daily applications was significantly higher in Ramadan than that of the other months of the same year (P < 0.001). There was also a significant difference in terms of the socio-economic characteristics between the applicants in Ramadan and those in the previous month. The increase in organ donation willingness in Ramadan may be the result of the propagation of altruism by the mass media and religious organizations. Ramadan seems to provide a great opportunity to promote organ donation across the Muslim world.

Factors Affecting the Decision to Grant Consent for Organ Donation: A Survey of Adults in England.

PubMed

Webb, Gwilym; Phillips, Neil; Reddiford, Sarah; Neuberger, James

2015-07-01

Solid organ transplantation reduces both morbidity and mortality. Donation rates have increased by more than 60% in the last 6 years in the United Kingdom, largely through improved identification and management of potential donors. However, the next of kin (NoK) decline to consent in 43% of cases-the second highest rate in Europe. We aimed to define factors that influence decisions to consent for organ donation. This is an online survey of 1549 adult residents of England with results weighted to national demographics. Eighty percent would consider donating some or all of their organs. Religion, age, and ethnicity influenced this support. Concerns over body integrity, religion, and effects on the quality of care received reduce support. Only 48% recognized that NoK consent would be sought before any donation. Previous discussion and Organ Donor Register (ODR) enrollment both correlate with NoK consent: 87% would consent after discussion and ODR enrollment, 79% would consent after discussion alone, 55% would consent with ODR registration alone, and 29% would consent without either. Reported misconceptions inhibiting consent included a perceived inability to deregister from the ODR and that individuals were too old to donate. Those who did not wish to donate their own organs were more likely to overrule others' expressed wishes to donate. To ensure that organ donation occurs wherever appropriate, attention should focus primarily on determining an individual's wishes before death, ensuring that any misconceptions are corrected before a decision is made, promotion of ODR enrollment, and challenging those NoK who wish to overrule others' wishes.

A liver for a kidney: Ethics of trans-organ paired exchange.

PubMed

Samstein, Benjamin; de Melo-Martin, Inmaculada; Kapur, Sandip; Ratner, Lloyd; Emond, Jean

2018-05-01

Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to the donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with a liver recipient to donate a kidney. This article explores some of the ethical concerns that trans-organ exchange might encounter including unbalanced donor risks, the validity of informed consent, and effects on deceased organ donation. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands.

PubMed

Bollen, Jan; Ten Hoopen, Rankie; Ysebaert, Dirk; van Mook, Walther; van Heurn, Ernst

2016-08-01

Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Challenges of Organ Donation: Potential Donors for Transplantation in an Area of Brazil's Northeast.

PubMed

Marinho, B B O; Santos, A T F; Figueredo, A S; Cortez, L S A B; Viana, M C A; Santos, G M; Brito, J W S; Rebouças, V C F; Braga-Neto, P

2018-04-01

New strategies to manage the pool of potential donors are needed to increase organ donation rates. The purpose of the study was to identify the main causes of lack of organ donation and to identify the sociodemographic and clinical profiles of potential organ donors in an area of northeastern Brazil. We conducted a cross-sectional, retrospective, observational study between November 2015 and January 2017. A total of 150 potential donors were included in the sample. The main cause of death among potential donors was hemorrhagic stroke (35.3%). Hypertension was the most prevalent comorbidity (25.6%). Family member's refusal was cited as the most common reason for not performing organ donation (49.4%). Among the causes of family member's refusal, the most prevalent was declaration of non-consent in life (23%), followed by family disagreement (20.3%). There is clearly a need for public educational efforts with regard to organ donation. Educational advertising campaigns can help improve the authorization rate of organ donation. Copyright © 2018 Elsevier Inc. All rights reserved.

Factors That Affect the Attitudes of the Bolivian Population in Spain With Regard to Organ Donation for Transplant.

PubMed

Ríos, A; López-Navas, A I; Sánchez, Á; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcó, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

The Bolivian population is an emerging Latin American immigrant group in Spain, several of whom have been transplanted or are awaiting transplant. We aimed to assess attitudes toward organ donation among Bolivians currently residing in Spain. The population screened was born in Bolivia but living in Spain, stratified by gender and age. The appraisal tool used was a questionnaire that assesses attitudes toward organ donation for transplant ("PCID-DTO Ríos"). Support from immigration associations in Spain was needed for advice on locations of potential respondents. Survey participation was anonymized and the questionnaire was self-administered. Verbal consent was obtained before participation. There were 206 respondents: 49% (n = 101) in favor of donating their organs after death; 21% (n = 44) against donation; and 30% (n = 61) undecided. Their attitudes were found to be associated with level of education (P = .008), previous experience with donation and transplant (P = .011), concern regarding mutilation after donation (P = .002), knowing the attitude of their religion toward transplant (P = .001), the opinion of their partner (P < .001), and the possibility of needing a future transplant (P = .050). In the multivariate study, the main factor was having a partner in favor of organ donation (odds ratio = 16.129; P = .003). Attitudes toward organ donation among Bolivians residing in Spain are far more negative compared with rest of the Spanish population, due to various factors. Copyright © 2017 Elsevier Inc. All rights reserved.

Training of health care students and professionals: a pivotal element in the process of optimal organ donation awareness and professionalization.

PubMed

Paez, G; Valero, R; Manyalich, M

2009-01-01

Successes in organ donation and transplantation programs are directly evidence-based education. Transplant Procurement Management (TPM) is an international educational project on organ donation and transplantation. Our purpose was to evaluate the TPM educational project. We compared the data of 17 years of experience, strategies, and methods. We retrospectively performed a descriptive analysis of all educational activities developed between 1991 and 2008. We identified 7 crucial points. (1) In 1991, TPM was started under the auspices of the University of Barcelona (UB) and the National Spanish Transplant Organization (ONT; national training, face-to-face). (2) In 1994, TPM became international (international advanced training and country-based). (3) Since 1997 in Italy and 2006 in France, national training courses were organized adapting the same methodologies as the advanced international TPM courses. TPM also implemented short (1-3 days) introductory courses worldwide. (4) In 2002, the e-learning platform program was launched to facilitate the education of professionals. (5) In 2005, an international master's degree was created at UB under the Life-Long Learning Institute (IL3). (6) In 2006, the courses were expanded to include pregraduate health science faculties with the International Project on Education and Research in Donation at University of Barcelona (PIERDUB). (7) In 2007, the European-funded European Training Program on Organ Donation (ETPOD) project was started. Currently, TPM offers face-to-face, e-learning, and blended international courses. As of 2008, TPM has trained 6498 professionals in 89 countries on 5 continents. TPM has impacted positively on the various essential levels in the process of organ donation and transplantation, with lifelong follow-up and an international network through the capacity to adapt to specific country needs as well as continuous quality improvement thanks to the collaboration of expert teachers and consultants.

Deceased Organ Donation Registration and Familial Consent among Chinese and South Asians in Ontario, Canada

PubMed Central

Li, Alvin Ho-ting; McArthur, Eric; Maclean, Janet; Isenor, Cynthia; Prakash, Versha; Kim, S. Joseph; Knoll, Greg; Shah, Baiju; Garg, Amit X.

2015-01-01

Objective For various reasons, people of Chinese (China, Hong Kong or Taiwan) and South Asian (Indian subcontinent) ancestry (the two largest ethnic minority groups in Ontario, Canada) may be less likely to register for deceased organ donation than the general public, and their families may be less likely to consent for deceased organ donation at the time of death. Methods We conducted two population-based studies: (1) a cross-sectional study of deceased organ donor registration as of May 2013, and (2) a cohort study of the steps in proceeding with deceased organ donation for patients who died in hospital from October 2008 to December 2012. Results A total of 49 938 of 559 714 Chinese individuals (8.9%) and 47 774 of 374 291 South Asians (12.8%) were registered for deceased organ donation, proportions lower than the general public (2 676 260 of 10 548 249 (25.4%). Among the 168 703 Ontarians who died in a hospital, the families of 33 of 81 Chinese (40.1%; 95% CI: 30.7%-51.6%) and 39 of 72 South Asian individuals (54.2%; 95% CI: 42.7-65.2%) consented for deceased organ donation, proportions lower than the general public (68.3%; 95% CI: 66.4%-70.0%). Conclusions In Ontario, Canada Chinese and South Asian individuals are less likely to register and their families are less likely to consent to deceased organ donation compared to the remaining general public. There is an opportunity to build support for organ and tissue donation in these two large ethnic communities in Canada. PMID:26230320

[New conditions for organ donation in France].

PubMed

Antoine, Corinne; Maroudy, Daniel

2016-09-01

The procurement of organs from donors after circulatory death is a reliable technique which gives satisfactory posttransplant results and also represents a potential source of additional organs. In order to meet the growing need for organ donations, the 'anticipated organ donation approach' procedure is currently receiving renewed interest with new conditions for its implementation in France. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Understanding bereavement, grief, and mourning: implications for donation and transplant professionals.

PubMed

Corr, Charles A; Coolican, Margaret B

2010-06-01

This article surveys recent literature on bereavement, grief, and mourning. It offers a review of the state of the art of current understandings of those topics to assist professionals who work in the field of organ and tissue donation and transplantation. The article's goal is to provide well-developed and up-to-date education and knowledge about bereavement, grief, and mourning to supplement the natural skills and experience of donation and transplant professionals in their work with bereaved persons.

Practical Considerations in Donation After Circulatory Determination of Death in Switzerland.

PubMed

Dalle Ave, Anne L; Shaw, David M; Elger, Bernice

2017-09-01

Faced with similar issues of organ scarcity to its neighbors, Switzerland has developed donation after circulatory determination of death (DCDD) as a way to expand the organ pool since 1985. Here, we analyze the history, practical considerations, and ethical issues relating to the Swiss donation after circulatory death programs. In Switzerland, determination of death for DCDD requires a stand-off period of 10 minutes. This time between cardiac arrest and the declaration of death is mandated in the guidelines of the Swiss Academy of Medical Sciences. As in other DCDD programs, safeguards are put to avoid physicians denying lifesaving treatment to savable patients because of being influenced by receivers' interest. An additional recommendation could be made: Recipients should be transparently informed of the worse graft outcomes with DCDD programs and given the possibility to refuse such organs.

"Why throw away something useful?": Attitudes and opinions of people treated for bipolar disorder and their relatives on organ and tissue donation.

PubMed

Padoan, Carolina S; Garcia, Lucas F; Rodrigues, Aline A; Patusco, Lucas M; Atz, Mariana V; Kapczinski, Flavio; Goldim, José R; Magalhães, Pedro V S

2017-03-01

In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.

Using Standardized Patients to Educate Medical Students about Organ Donation

ERIC Educational Resources Information Center

Feeley, Thomas Hugh; Anker, Ashley E.; Soriano, Rainier; Friedman, Erica

2010-01-01

Medical students at Mount Sinai School of Medicine participated in an intervention designed to promote knowledge and improved communication skills related to cadaveric organ donation. The intervention required students to interact with a standardized patient for approximately 10 minutes and respond to questions posed about organ donation in a…

Tax policy as a lifeline: encouraging blood and organ donation through tax credits.

PubMed

Clamon, Joseph B

2008-01-01

This article, the second concerning the organ donation crisis, proposes the use of tax policy to encourage blood and organ donation. After critiquing the ethical and logistical problems posed by other commercial and non-commercial solutions, the author demonstrates how tax credits can be used as an effective and ethical solution to address the shortage of donors. The author also offers two model statutes that provide guidance as to how a nonrefundable tax credit for blood and organ donation might operate in the tax code.

Three proposals to increase Australia's organ supply.

PubMed

Isdale, William; Savulescu, Julian

2015-01-01

In 2008 the Australian Government introduced a national reform agenda to increase organ and tissue donation. Australia continues to perform poorly by international standards on measures of organ procurement, however. This paper outlines three proposals to improve donation rates and considers the empirical evidence available for each. A number of ethical objections frequently given to resist such proposals are also addressed. Firstly, it is recommended that Australia implement an 'opt-out' system of organ donation. Secondly, the existing veto rules should be changed to better protect the wishes of those who wish to donate. Finally, a numer of incentives should be offered to increase donation rates; these could include incentives of financial value, but also non-financial incentives such as prioritisation for the receipt of organs for previous donors.

Family perspectives on organ and tissue donation for transplantation: a principlist analysis.

PubMed

Dos Santos, Marcelo José; Feito, Lydia

2017-01-01

The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. This study aims to analyze the family interview process with a focus on principlist bioethics. This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: "Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not." For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others.

PubMed

Zeiler, Kristin

2014-10-01

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty's philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors' relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine.

[The Organ Transplantation Law].

PubMed

Yuzawa, Kenji; Takahara, Shiro

2010-12-01

The old Organ Transplantation Law was issued in 1997 and had never been revised for 12 years. Brain dead donors had to leave written consent to donate their own organs as well as their family consent. The organ donation from children under 15 years old was prohibited. The majority of the patients in need of organ transplantation died of organ shortages in Japan. Many patients especially children had to travel abroad to receive organs. The amendment bill for the Organ Transplantation Law was passed in the House of Councilors on July 13, 2009. The new Organ Transplantation Law permit organ donation from brain dead donors who had not refused to donate their organs, as long as there is family consent. Children under 15 years old can become donors. This article explains the old and the new Organ Transplantation Laws and the course of the amendment.

Use of standardized patients to teach medical students about living organ donation.

PubMed

Bramstedt, Katrina A; Moolla, Ariff; Rehfield, Patricia L

2012-03-01

Educators routinely use standardized patients to teach medical students a variety of clinical concepts. Standardized patients have also been used to teach students about medical ethics and deceased organ donation. Not reported before, however, is the use of standardized patients to educate medical students about the ethical issues in living organ donation. It seems important to fill this gap because in the United States, roughly 45% of organ donors are living donors, and these patients will visit physicians throughout their lifespan, not just with the occurrence of donation. This article reports an experience teaching concepts in living donation and transplant ethics to second-year osteopathic medicine students using a standardized patient and supplementary instructional materials (eg, film, panel discussion, reading list). Specifically, a transplant ethics module was created that included an actor portraying a living donor candidate who had a number of case variables pertaining to medical and psychosocial matters. Instructional themes included informed consent, altruism, patient selection criteria, organ vending, and post-donation support systems.

Where do human organs come from? Trends of generalized and restricted altruism in organ donations.

PubMed

Boas, Hagai

2011-11-01

The supply of human organs for transplantation is undergoing a dramatic transformation. Using data from 30 countries for the years 1995-2007, this paper suggests that organ supply today is more dependent on direct donations than on the collective organ pool. This trend is analyzed by studying different modes of altruism: "generalized altruism" relates to the procurement of organs through a one-for-all collectivized system of donations whereas "restricted altruism" relates to one-to-one donations with organs considered personal gifts. The data suggest that transplants are becoming less and less social goods and more and more personal gifts. This trend is documented and discussed in light of the linkage that social scientists hypothesize between altruism and social solidarity. Whereas altruism is conceived as generating social solidarity, the rise in direct organ donations restricts the effect of altruism to one-to-one interactions rather than one-for-all giving. Copyright © 2011 Elsevier Ltd. All rights reserved.

Grief Symptoms in Relatives who Experienced Organ Donation Request in the ICU.

PubMed

Kentish-Barnes, Nancy; Chevret, Sylvie; Cheisson, Gaëlle; Joseph, Liliane; Martin-Lefèvre, Laurent; Si Larbi, Anne Gaelle; Viquesnel, Gérald; Marqué, Sophie; Donati, Stéphane; Charpentier, Julien; Pichon, Nicolas; Zuber, Benjamin; Lesieur, Olivier; Ouendo, Martial; Renault, Anne; Le Maguet, Pascale; Kandelman, Stanislas; Thuong, Marie; Floccard, Bernard; Mezher, Chaouki; Galon, Marion; Duranteau, Jacques; Azoulay, Elie

2018-03-19

In the case of organ donation, the family is highly involved in the decision process. To assess experience of organ donation process and grief symptoms in relatives of brain dead patients who discussed organ donation in the ICU. Multicentre cross-sectional study in 28 ICUs in France. Participating subjects were relatives of brain dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at 3 time points: at 1 month to complete a questionnaire describing their experience of organ donation process; At 3 months to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; At 9 months, to complete the IES-R and the Inventory of Complicated Grief. 202 relatives of 202 patients were included, of whom 158 consented and 44 refused organ donation. Interviews were conducted at 1, 3 and 9 months for 157, 137 and 117 relatives respectively. Experience was significantly more burdensome for relatives of non-donors. However there were no significant differences in grief symptoms measured at 3 and 9 months between the 2 groups. Understanding of brain death was associated with grief symptoms with higher prevalence of complicated grief symptoms in relatives who did not understand (75% vs 46.1%, p=0.026). Experience of the organ donation process varies between relatives of donor vs non-donor patients with relatives of non-donors experiencing lower quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element for relatives.

Altruism or solidarity? The motives for organ donation and two proposals.

PubMed

Saunders, Ben

2012-09-01

Proposals for increasing organ donation are often rejected as incompatible with altruistic motivation on the part of donors. This paper questions, on conceptual grounds, whether most organ donors really are altruistic. If we distinguish between altruism and solidarity--a more restricted form of other-concern, limited to members of a particular group--then most organ donors exhibit solidarity, rather than altruism. If organ donation really must be altruistic, then we have reasons to worry about the motives of existing donors. However, I argue that altruism is not necessary, because organ donation supplies important goods, whatever the motivation, and we can reject certain dubious motivations, such as financial profit, without insisting on altruism. Once solidaristic donation is accepted, certain reforms for increasing donation rates seem permissible. This paper considers two proposals. Firstly, it has been suggested that registered donors should receive priority for transplants. While this proposal appears based on a solidaristic norm of reciprocity, it is argued that such a scheme would be undesirable, since non-donors may contribute to society in other ways. The second proposal is that donors should be able to direct their organs towards recipients that they feel solidarity with. This is often held to be inconsistent with altruistic motivation, but most donation is not entirely undirected in the first place (for instance, donor organs usually go to co-nationals). While allowing directed donation would create a number of practical problems, such as preventing discrimination, there appears to be no reason in principle to reject it. © 2012 Blackwell Publishing Ltd.

Altruism in organ donation: an unnecessary requirement?

PubMed Central

Moorlock, Greg; Ives, Jonathan; Draper, Heather

2014-01-01

Altruism has long been taken to be the guiding principle of ethical organ donation in the UK, and has been used as justification for rejecting or allowing certain types of donation. We argue that, despite this prominent role, altruism has been poorly defined in policy and position documents, and used confusingly and inconsistently. Looking at how the term has been used over recent years allows us to define ‘organ donation altruism’, and comparing this with accounts in the philosophical literature highlights its theoretical shortcomings. The recent report from the Nuffield Council on Bioethics reaffirmed the importance of altruism in organ donation, and offered a clearer definition. This definition is, however, more permissive than that of altruism previously seen in UK policy, and as a result allows some donations that previously have been considered unacceptable. We argue that while altruistic motivation may be desirable, it is not necessary. PMID:23538329

Altruism, gift giving and reciprocity in organ donation: a review of cultural perspectives and challenges of the concepts.

PubMed

Sharp, C; Randhawa, G

2014-10-01

Living and deceased organ donation are couched in altruism and gift discourse and this article reviews explores cultural views towards these concepts. Altruism and egoism theories and gift and reciprocity theories are outlined from a social exchange theory perspective to highlight the key differences between altruism and the gift and the wider implications of reciprocation. The notion of altruism as a selfless act without expectation or want for repayment juxtaposed with the Maussian gift where there are the obligations to give, receive and reciprocate. Lay perspectives of altruism and the gift in organ donation are outlined and illustrate that there are differences in motivations to donate in different programmes of living donation and for families who decide to donate their relative's organs. These motivations reflect cultural views of altruism and the gift and perceptions of the body and death. Copyright © 2014 Elsevier Inc. All rights reserved.

The self-protective altruist: terror management and the ambivalent nature of prosocial behavior.

PubMed

Hirschberger, Gilad; Ein-Dor, Tsachi; Almakias, Shaul

2008-05-01

Three studies examined the hypothesis that mortality salience (MS) will increase prosocial behaviors when the prosocial cause promotes terror management processes. However, when the prosocial cause interferes with these processes, MS will reduce prosocial behavior. In Study 1, following a MS procedure, participants indicated their willingness to donate money to charity or to donate to an organ donation organization. In Study 2, a research assistant randomly distributed fliers with reminders of death or back pain, and another research assistant solicited participants' assistance from either a charitable fund booth or an organ donation booth. Study 3 examined the impact of MS on helping a wheelchair-bound confederate or a walking confederate. The results indicated that MS increased charitable donations and increased help to a walking confederate. However, MS significantly decreased organ donation card signings and decreased help to a wheelchair-bound confederate. The discussion examines the tension between personal fear and worldview validation.

An examination of three theoretical models to explain the organ donation attitude--registration discrepancy among mature adults.

PubMed

Quick, Brian L; Anker, Ashley E; Feeley, Thomas Hugh; Morgan, Susan E

2016-01-01

An inconsistency in the research indicates positive attitudes toward organ donation do not map reliably onto organ donor registrations. Various models have sought to explain this inconsistency and the current analysis formally compared three models: the Bystander Intervention Model (BIM), the Organ Donor Model (ODM), and Vested Interest Theory (VIT). Mature (N = 688) adults between the ages of 50 to 64 years completed surveys related to organ donation. Results revealed that VIT accounted for the most variance in organ donation registrations followed by the BIM and ODM. The discussion emphasizes the importance of employing theories to explain a phenomenon as well as the practical implications of the findings.

3 CFR 8491 - Proclamation 8491 of April 1, 2010. National Donate Life Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... of circumstances through organ, tissue, stem cell, and blood donation. During National Donate Life... groups, and private organizations to join forces to boost the number of organ, tissue, blood, and stem cell donors throughout our Nation. IN WITNESS WHEREOF, I have hereunto set my hand this first day of...

[Marketing role of corneal graft tissue donation to an eye bank and donors' socioeconomic profile].

PubMed

Farias, Roberta Jansen de Mello; Sousa, Luciene Barbosa de

2008-01-01

Penetrating keratoplasty has been the leading and the most successful type of transplant in the world, however corneal deficiency is a commom problem usually presented to corneal surgeons. Impact evaluation of the number of corneal graft donations to the Sorocaba Eye Bank after the implementation of a corneal graft procurement system; to draw the socioeconomic profile of corneal graft donors of the Sorocaba Eye Bank (SEB). Retrospective study on donations to SEB from its creation and after the development of media marketing. Prospective analysis of the socioeconomic profile of corneal graft donors by a questionnaire sent as letters to the families of the donors in a certain month. SEB began its work in 1971 by spreading need of organ donation through lectures in churches, shopping malls, community meetings, radio programs, television programs, etc. In the 70s, the number of retrieved corneal grafts was 1 or 2/month. Between 1984 - 1989 a procurement coordination team was trained to act in mortuaries and by 2000 they also began to work in public hospitals. In 1984 only 260 corneal grafts were retrieved. This number has been increasing to 2,778 corneal graft donations in 2004. The questionnaire was answered by 76 of the 93 donor families, with a response rate of 81.7%. Donor age had a mean of 65.1 +/- 14.7 y/o, forty-two (55.3%) were men. Educational level of the donor families was an important factor for organ donation, once 36.8% had concluded high school and 34.2% completed university. The great majority, sixty-three (82.9%) of the corneal grafts were donated through the efforts of the procurement coordination team. The role of the media and institutional credibility are mandatory for public commitment to organ donation. The proficiency of the procurement coordination team requires intensive training, as the results show that 82.9% donations were made thanks to their efforts.

Prior Family Communication and Consent to Organ Donation: Using Intensive Care Physicians’ Perception to Model Decision Processes

PubMed Central

Schulz, Peter J.; van Ackere, Ann; Hartung, Uwe; Dunkel, Anke

2012-01-01

Generally, the Swiss hold favourable attitudes to organ donation, but only few carry a donor card. If no card is found on a potential donor, families have to be approached about donation. The aim of this paper is to model the role that some family communication factors play in the family decision to consent or not to organ donation by a brain dead relative. Information was gathered in face-to-face interviews, using a questionnaire and recording open answers and comments. Eight heads of intensive care units (ICU) of Swiss hospitals and one representative from Swisstransplant were interviewed. Questions asked respondents to estimate the prevalence and effect of communication factors in families facing a decision to consent to donation. Answers were averaged for modelling purposes. Modelling also relies on a previous representative population survey for cross-validation. The family of the deceased person is almost always approached about donation. Physicians perceive that prior thinking and favourable predisposition to donation are correlated and that the relatives’ predisposition is the most important factor for the consent to donation, up to the point that a negative predisposition may override an acknowledged wish of the deceased to donate. Donor cards may trigger family communication and ease the physicians’ approach to family about donation. Campaigns should encourage donate-willing people to talk to their families about it, make people think about organ donation and try to change unfavourable predispositions. Acknowledgement the authors wish to thank the interviewees whose collaboration has provided them an overview of today’s situation in Switzerland. PMID:25170455

Policy perspectives: international survey of nephrologists' perceptions of and attitudes towards rewards and compensation for kidney donation.

PubMed

Randhawa, Gurch

2013-06-01

The challenge to resolve the gap between supply and demand for organs is a global phenomenon. The possible solutions can invariably involve a range of ethical and moral dilemmas. This is certainly the case when considering rewards and compensation for kidney donation. In their thought provoking study, Ghahramami et al. provide the perspectives of medical professionals on these issues. The views of nephrologists concerning rewards and compensation chime with views of the public, which have been highlighted in many previous studies. Rewards and compensation for organ donation are perceived, by some, as barriers to successful organ donation transplant programmes; whereas others view them as potential facilitators to increasing organ donation rates. It is interesting to note that two-thirds of survey respondents believe that introducing some kind of reward or offering compensation would lead to an increase in organ donation. This finding is not unique to this study and is evident in many public surveys where respondents have expressed a belief that offering some form of incentive would have a positive impact on organ donation rates. Disappointingly, the debates concerning the type of reward or compensation and its potential impact on donation rates continue to take place in a relatively 'evidence base-free' vacuum. What is abundantly clear is that many lives continue to be lost in many countries due to a lack of suitable organs for transplant. What is less clear is which forms of reward and compensation actually have an impact on donation rates and whether they positively impact the life experiences of donors, recipients and their families. This level of evidence- base is urgently required.

Ancillary hospital personnel faced with organ donation and transplantation.

PubMed

Ríos, A; Conesa, C; Ramírez, P; Galindo, P J; Martínez, L; Fernández, O M; Montoya, M J; Rodríguez, M M; Lucas, D; Parrilla, P

2006-04-01

To reduce the number of family organ donation refusals, it is necessary not only to act on the general public but also on the health care system. In this respect, there are data suggesting that the percentage of hospital personnel against donation is high, especially among ancillary personnel. The objective herein was to analyze the attitudes of ancillary hospital professionals toward donation of their own organs and determine factors that conditioned such attitudes. A random sample in a third-level hospital with a solid organ transplant program was stratified by ancillary services: administrative, porters, maintenance, cleaning, and cooking. Attitudes toward donation of one's own organs after death were evaluated using a questionnaire on psychosocial aspects validated in our area. It included various psychosocial variables that could affect such attitudes. The Student t test and chi-square test were used to evaluate the data. We analyzed 277 respondents of mean age 43 +/- 8 years and 96% women. The level of acceptance of organ donation was 64% (n = 178), whereas 46% were either against or undecided (n = 98). The variables which determined the attitudes were understanding of brain death (P = .004); attitude toward cadaveric manipulation, especially toward autopsy (P = .013) and cremation (P = .004); concern about mutilation after donation (P = .014); religion (P = .032); partner's attitude toward donation (P < .0001); and possibility of needing an organ in the future (P = .031). Ancillary hospital personnel had similar attitudes toward donation as those of the general public as observed in other studies. The attitudes were determined by many psychosocial factors. A campaign to raise awareness among professionals has become a priority, given that working in a hospital, their unfavorable attitude could have a strong negative impact on the general public.

Donating blood and organs: using an extended theory of planned behavior perspective to identify similarities and differences in individual motivations to donate.

PubMed

Hyde, Melissa K; Knowles, Simon R; White, Katherine M

2013-12-01

Due to the critical shortage and continued need of blood and organ donations (ODs), research exploring similarities and differences in the motivational determinants of these behaviors is needed. In a sample of 258 university students, we used a cross-sectional design to test the utility of an extended theory of planned behavior (TPB) including moral norm, self-identity and in-group altruism (family/close friends and ethnic group), to predict people's blood and OD intentions. Overall, the extended TPB explained 77.0% and 74.6% of variance in blood and OD intentions, respectively. In regression analyses, common contributors to intentions across donation contexts were attitude, self-efficacy and self-identity. Normative influences varied with subjective norm as a significant predictor related to OD intentions but not blood donation intentions at the final step of regression analyses. Moral norm did not contribute significantly to blood or OD intentions. In-group altruism (family/close friends) was significantly related to OD intentions only in regressions. Future donation strategies should increase confidence to donate, foster a perception of self as the type of person who donates blood and/or organs, and address preferences to donate organs to in-group members only.

[Religious and cultural aspects of organ transplantation].

PubMed

Janssen, F; Richet, I; Caekelberghs, E; Attyia, R; Gauthier, M; Gergely, T; Mayer, M; Sosnowski, M; Lucidi, V; Berré, J; Preiser, J C

2017-01-01

The number of transplantations is mainly limited by the shortage of organs, thereby leading to potentially lethal delays for patients registered on waiting lists. Among the causes of refusals of organ donation, religious reasons are often advocated. In order to make the point, we organized a debate between representatives of secularism ( " laïcité ") and of the most represented religions in Belgium, i.e. catholic, Islamic and Judaic. Even though the representation of death was variable, organ donation is authorized and even encouraged by the fundamental texts. Refusals of organ donation result more often from personal interpretations by local preachers. Therefore, the gathering of political and religious authorities in order to promote organ donation is desirable instead of sowing doubt for pseudo-religious reasons.

Effects of financial incentives on the intention to consent to organ donation: a questionnaire survey.

PubMed

Mayrhofer-Reinhartshuber, D; Fitzgerald, A; Benetka, G; Fitzgerald, R

2006-11-01

Shortage of donor organs is a serious problem for transplantation medicine. One controversial suggestion to increase the number of organ donors is financial incentives for consent. The aim of this study was to test whether different forms and amounts of financial incentives were apt to increase the consent to organ donation. Data were collected via questionnaires in urban and rural regions of Austria and randomly assigned to settings with three different amounts of financial incentives. The questionnaire was designed by using the theory of planned behaviour of Ajzen. Parents 69 mothers and 35 fathers; ages 25 to 65 years were evaluated for intention to consent to organ donation, perceived social norm, and positive/ negative aspects of organ donation without and with various financial incentives. The intention to consent to organ donation dropped highly significantly (Z = -7.556 P = .000) from the basic condition (M = 1.13; confidence interval [CIs] 0.78 to 1.51) to the condition with financial incentives (M = -1.58; CI, 1.96 to -1.15). No influence of the amount of financial incentive was observed. Highly significant differences were measured between both conditions for the social norm (Z = -5.638; P < .000) and the attitude toward organ donation (Z = -1.962; P < .05; Z = -2.104; P < .035). Financial incentives led to decreased consents and elicited strong rejections and negative reactions of the participants. Taking money for consent to organ donation seems to be a strict taboo for most people in Austrian society.

Assessing Transplant Attitudes: Understanding Minority Men's Perspectives on the Multifarious Barriers to Organ Donation.

PubMed

Hinck, Bryan D; Naelitz, Bryan D; Jackson, Brielle; Howard, Mariah; Nowacki, Amy; Modlin, Charles S

2017-08-01

African Americans comprise 11 % of living organ donors, yet constitute 34 % of the kidney transplant waiting list. There are many barriers to organ donation among minorities that include decreased awareness of transplantation, cultural mistrust of the medical community, financial concerns, and fear of the transplant operation. This study investigates the societal misconceptions and demographic health factors that correlate with minority participation in organ and tissue donation. A 57 question Health and Wellness survey was designed to assess participants' demographic information, medical history, professional background, and opinions regarding organ transplantation. Participants were also asked to complete Quality Metric's Short Form-8 (SF-8) survey to assess physical health, mental health, and quality-of-life. Three hundred twenty-six surveys were administered to minority men. The majority of men were identified as African American, and 55 % were below the age of 40. Though 44 % of participants were willing to donate, only 27 % were registered as organ and tissue donors. Minorities who held misconceptions about organ donation-including the belief that they were too old or unhealthy to donate, for example-had lower general, physical, and mental health scores than those who did not (p = <0.0001). Minorities aware of the shortage for organs or who know a registered donor, an organ recipient, a dialysis patient, or someone on the waiting list were more willing to donate organs. Improving the general, physical, and mental health of minorities, coupled with an active educational outreach program, could result in a greater percentage of minorities registering and willing to be organ and tissue donors.

Organ donation after death in Ontario: a population-based cohort study

PubMed Central

Redelmeier, Donald A.; Markel, Frank; Scales, Damon C.

2013-01-01

Background: Shortfalls in deceased organ donation lead to shortages of solid organs available for transplantation. We assessed rates of deceased organ donation and compared hospitals that had clinical services for transplant recipients (transplant hospitals) to those that did not (general hospitals). Methods: We conducted a population-based cohort analysis involving patients who died from traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage or other catastrophic neurologic conditions in Ontario, Canada, between Apr. 1, 1994, and Mar. 31, 2011. We distinguished between acute care hospitals with and without transplant services. The primary outcome was actual organ donation determined through the physician database for organ procurement procedures. Results: Overall, 87 129 patients died from catastrophic neurologic conditions during the study period, of whom 1930 became actual donors. Our primary analysis excluded patients from small hospitals, reducing the total to 79 746 patients, of whom 1898 became actual donors. Patients who died in transplant hospitals had a distribution of demographic characteristics similar to that of patients who died in other large general hospitals. Transplant hospitals had an actual donor rate per 100 deaths that was about 4 times the donor rate at large general hospitals (5.0 v. 1.4, p < 0.001). The relative reduction in donations at general hospitals was accentuated among older patients, persisted among patients who were the most eligible candidates and amounted to about 121 fewer actual donors per year (adjusted odds ratio 0.58, 95% confidence interval 0.36–0.92). Hospital volumes were only weakly correlated with actual organ donation rates. Interpretation: Optimizing organ donation requires greater attention to large general hospitals. These hospitals account for most of the potential donors and missed opportunities for deceased organ donation. PMID:23549970

Saudi Nursing and Medical Student’s Knowledge and Attitude toward Organ Donation- A Comparative Cross-Sectional study

PubMed Central

Majeed, Farrukh

2016-01-01

Objectives Proper awareness among health professionals about organ donation is important for increasing organ procurement. Personal commitment and attitude of nurses are imperative as they have key role in identifying potential donors. The aim of this study was to compare prevailing knowledge and attitude of undergraduate female Saudi nursing and medical students’ toward organ donation. Methodology A cross sectional questionnaire using 29 item were filled by nursing (n=46) and medical (n=63) students’ at University of Dammam (KSA) during academic year 2014–15, to check and compare their knowledge and attitude about organ donation. The data were analyzed by descriptive statistics; chi square test and bivariate analysis to find out correlation. Results Level of knowledge of nursing group were significantly lower (p=0.000) than medical group while no significant difference in attitude score (p=0.591) between the two groups were found. Major source of knowledge for nursing was media (65.2%) and college/university for medical (50.8%) group. Both groups chose “anyone in need” as preferred recipients’ upon donation (nursing 60.3% and medical 52.2%) and opted “anyone” as donor in case of recipient (nursing 52.2% and medical 49.2%). The results indicate positive correlation between level of knowledge and attitude toward organ donation. Conclusions Nursing students have low knowledge toward organ donation as compared to medical students although they shows positive attitude toward this issue. This study ascertains the need of an effective educational program for nursing students of Saudi Arabia to improve their knowledge regarding organ donation and to raise organ procurement. PMID:27103903

Recruitment and retention of blood donors in four Canadian cities: an analysis of the role of community and social networks.

PubMed

Smith, André; Matthews, Ralph; Fiddler, Jay

2013-12-01

This study approaches the decision to donate blood as a dynamic process involving interplay between blood donors' personal motives, donors' social contexts, and the donor recruitment and retention activities of blood collection agencies. Data were gathered from four blood donation clinics using in-depth interviews with Canadian Blood Services employees, donors, and nondonors in 25 organizations participating in Life Link, a donor recruitment program that supports organizations to educate employees about the benefits of blood donation. Further data were obtained from ethnographic observations of blood collection and donor recruitment activities. Thematic analysis resulted in three umbrella themes: leveraging social networks, embedding the clinic in the community, and donating blood and social reciprocity. Donor recruitment activities at all four clinics enhanced awareness of blood donation in the workplace by using experienced donors to motivate their coworkers in making a first-time donation. Clinic employees reported varying success in improving awareness of blood donation in the broader community, in part because of varying employee engagement in community-wide activities and celebrations. Altruistic motives were mentioned by experienced donors, who also identified a desire to reciprocate to their community as another strong motive. This study contextualizes donor recruitment and retention as involving activities that tie blood donation to meaningful aspects of donors' social networks and community. The findings point to the need for further analyses of the institutional dimensions of blood donation to develop effective strategies beyond appeals to altruism. © 2013 American Association of Blood Banks.

Organ transplantation scandal influencing corneal donation rate.

PubMed

Röck, Tobias; Bramkamp, Matthias; Bartz-Schmidt, Karl Ulrich; Röck, Daniel

2017-01-01

In the majority of countries, there is a shortage of donor corneas for corneal transplantations. This study investigated the impact of organ transplantation scandals on corneal donation rate at the University Hospital Tübingen. Each deceased patient was considered as a potential corneal donor. An ophthalmic resident handled with stable methods of procedures the corneal donor procurement from 2009 to 2015. The rates of corneal donation were examined and analyzed. Among the 5712 hospital deaths, consent for corneal donation was obtained in 711 cases. The mean annual corneal donation rate was 12.4%. Since 2009, the donation rate per year could be increased with exception of 2013 and 2015. In the end of 2012 and 2014 two huge organ donation scandals were known in Germany. In the following years 2013 and 2015 corneal donation rate decreased significantly ( P =0.0181 and P =0.0006). We concluded that transplantation scandals have a significant impact on corneal donation rate. Improving professional's performance through full transparency and honesty is very important to earn trust of potential donors and their families.

Organ transplantation scandal influencing corneal donation rate

PubMed Central

Röck, Tobias; Bramkamp, Matthias; Bartz-Schmidt, Karl Ulrich; Röck, Daniel

2017-01-01

In the majority of countries, there is a shortage of donor corneas for corneal transplantations. This study investigated the impact of organ transplantation scandals on corneal donation rate at the University Hospital Tübingen. Each deceased patient was considered as a potential corneal donor. An ophthalmic resident handled with stable methods of procedures the corneal donor procurement from 2009 to 2015. The rates of corneal donation were examined and analyzed. Among the 5712 hospital deaths, consent for corneal donation was obtained in 711 cases. The mean annual corneal donation rate was 12.4%. Since 2009, the donation rate per year could be increased with exception of 2013 and 2015. In the end of 2012 and 2014 two huge organ donation scandals were known in Germany. In the following years 2013 and 2015 corneal donation rate decreased significantly (P=0.0181 and P=0.0006). We concluded that transplantation scandals have a significant impact on corneal donation rate. Improving professional's performance through full transparency and honesty is very important to earn trust of potential donors and their families. PMID:28730094

Outcome of referrals for deceased organ donation to the government organ procurement organization.

PubMed

Suguitan, G A; Cabanayan-Casasola, C B; Danguilan, R A; Jaro, J M A

2014-05-01

The Human Organ Preservation Effort is a government organ procurement organization that pioneered the Deceased Organ Donation Program in the Philippines. Deceased organ donation comprises only 20% of kidney transplantation in the Philippines in the last 3 years. Various measures were implemented to improve deceased organ donor referrals and organ retrieval. To compare outcome of deceased organ donor referrals from 2002 to 2008 and 2009 to 2012 in the Philippines. This retrospective study reviewed the deceased organ donor referrals from 2002 to 2008 and 2009 to 2012. There were 437 referrals for potential deceased organ donors from 2009 to 2012, compared to 434 referrals from 2002 to 2008. Referrals were mainly trauma victims (76%) followed by those with cerebrovascular accidents (12%). In the recent cohort, 81% were approached and 60% consented for donation, but only 23% were retrieved and transplanted. Among those not retrieved, the majority (19%) were medically unsuitable and 6% retracted their consent. Although there was an increasing trend of organ donation referrals in the last 4 years, only 25% were procured. The reasons for nonprocurement should be addressed. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors of the willingness to consent to the donation of a deceased family member's organs among the Romanian urban population.

PubMed

Holman, A; Karner-Huţuleac, A; Ioan, B

2013-11-01

Romania ranks near the bottom of the European hierarchy of posthumous organ donation rates. Objectives of this study were as follows: (1) to assess the willingness to donate (WTD) a family member's organs in the inhabitants of a large Romanian city (Iasi) and to analyze its factors; and (2) to determine the most important behaviors of the medical staff for our respondents in a hypothetical donation decision scenario. The study included a representative sample of the Iasi population. The instrument addressed WTD a family member's organs, both in general and in the particular situation of knowing that the deceased had a positive attitude toward organ donation, knowledge of transplantation-related issues, endorsement of beliefs concerning organ donation, and the importance of a set of medical staff's behaviors. The questionnaire was completed by 1,034 participants, 48% (n = 496) of whom would most likely consent to donate a family member's organs, 18% (n = 191) would most likely refuse and 34% (n = 347) were unsure. The following factors were found to influence this variable: believing in the possible reversibility of brain death (P = .004); believing that body integrity should be preserved after death (P < .001); believing that part of the deceased continues to live through the organ recipients (P = .001); and being concerned about mutilation after donation (P < .001). The WTD the organs of a deceased next of kin in the Iasi population, even when the deceased had positive attitudes on the matter, is lower than that reported by other studies in other European countries. It is mainly influenced by knowledge and concerns regarding the posthumous manipulation of the body. Consent in a potential donation situation also depends on the way in which the medical staff interacts with the bereaved family. Copyright © 2013 Elsevier Inc. All rights reserved.

Addressing Consent Issues in Donation After Circulatory Determination of Death.

PubMed

Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

2015-01-01

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.

The Implications of the Shift Toward Donation After Circulatory Death in Australia

PubMed Central

Reiling, Janske; Forrest, Elizabeth; Bridle, Kim R.; Britton, Laurence J.; Santrampurwala, Nishreen; Crawford, Darrell H.G.; Dejong, Cornelis H.C.; Fawcett, Jonathan

2017-01-01

Background In recent years, an increasing number of donor livers are being declined for transplantation in Australia. The aim of this study was to evaluate the impact of donation after cardiac death and other factors associated with organ quality on liver utilization rates in Australia. Methods Data on organ donors who donated at least 1 organ between 2005 and 2014 were obtained from the Australia and New Zealand organ donation registry. Temporal changes in donor characteristics were assessed and a logistical regression analysis was performed to evaluate their association with liver nonuse. Results The number of organ donors increased from 175 in 2005 to 344 in 2014, with overall 19% being donation after cardiac death donors (P < 0.001). The percentage of livers deemed unsuitable for transplantation increased from 24% in 2005 to 41% in 2014 (P < 0.001). Donation after cardiac death was identified as the most important risk factor for nonuse with an odds ratio of 25.88 (95% confidence interval, 18.84-35.56), P < 0.001) followed by donor age, obesity, and diabetes. Discussion This study shows that livers donated after circulatory death are an underused resource in Australia. Better use of these currently available organs would be a highly cost-effective way of reducing waiting list mortality in liver transplantation. PMID:29536027

Life and Death Decisions: Using School-Based Health Education to Facilitate Family Discussion about Organ and Tissue Donation

ERIC Educational Resources Information Center

Waldrop, Deborah P.; Tamburlin, Judith A.; Thompson, Sanna J.; Simon, Mark

2004-01-01

Public education that encourages family discussions about organ and tissue donation can enhance understanding, facilitate a donor's wishes and increase the numbers of donations. Action research methods were used to explore the impact of a student-initiated family discussion about donation. Most discussions were positive; only 7% middle school and…

Sequential improvements in organ procurement increase the organ donation rate.

PubMed

Billeter, Adrian T; Sklare, Seth; Franklin, Glen A; Wright, Jerry; Morgan, Gary; O'Flynn, Paul E; Polk, Hiram C

2012-11-01

Organ demand exceeds availability of transplantable organs. Organ procurement continues to suffer from failures to identify potential donors, inability to obtain consent for donation, as well as failures to retrieve certain organs as donor demographics change. The purpose of this article is to propose how sequentially introduced measures can increase organ donation rates as well as improve organ procurement. We analysed the effect of stepwise improvements in the organ procurement process patients in a university-based surgical intensive care unit over a 20-year period. We related newly introduced measures in the organ retrieval process with changes in donation rates. We specifically targeted these three main steps in the donation process: donor identification, conversion of potential donors to actual donors, and organ protection during the procurement process. Finally, we assessed the effect of the same measures on organ procurement after introduction in other hospitals of the same organ procurement region. Introduction of quality improvement steps increased all of the observed parameters. The number of organ donors was stabilised due to a better identification of potential donors, a major increase in conversion from potential to actual donors, and an increase in extended criteria donor. Improvements in organ protection led to higher rates of organs transplanted per donor and increased recovery of lungs and hearts despite increasing donor age. The same measures were introduced successfully in other hospitals in our organ procurement region. Sequential improvements in organ procurement can increase the yield of retrieved organs. The same measures can be applied to other hospitals and lead to comparable improvements in organ donation. Published by Elsevier Ltd.

The Rule of Threes: three factors that triple the likelihood of families overriding first person consent for organ donation in the UK

PubMed Central

Hopkinson, Cathy; Hudson, Cara; Murphy, Paul; Gardiner, Dale; McGowan, Olive; Miller, Cathy

2017-01-01

Between 1 April 2012 and 31 March 2015, 263 of the 2244 families in the UK whose loved ones had registered to donate organs for transplantation after their death on the NHS Organ Donor Register chose to override this decision; an override rate of 11.7%. Multivariable logistic regression analysis was applied to data relating to various aspects of the family approach in order to identify factors associated with such overrides. The factors associated with family overrides were failure to involve the Specialist Nurse for Organ Donation in the family approach (odds ratio 3.0), donation after circulatory death (odds ratio 2.7) and Black, Asian or Minority Ethnicity (odds ratio 2.7). This highlights the need to further engage with these groups in exploring donation as an end of life choice, and suggests that there may be, from the perspective of the family, fundamental differences between donation after brainstem death and circulatory death. It further adds to the body of data linking involvement of the Specialist Nurse for Organ Donation in the family approach to improved UK consent rates.

The Rule of Threes: three factors that triple the likelihood of families overriding first person consent for organ donation in the UK.

PubMed

Morgan, James; Hopkinson, Cathy; Hudson, Cara; Murphy, Paul; Gardiner, Dale; McGowan, Olive; Miller, Cathy

2018-05-01

Between 1 April 2012 and 31 March 2015, 263 of the 2244 families in the UK whose loved ones had registered to donate organs for transplantation after their death on the NHS Organ Donor Register chose to override this decision; an override rate of 11.7%. Multivariable logistic regression analysis was applied to data relating to various aspects of the family approach in order to identify factors associated with such overrides. The factors associated with family overrides were failure to involve the Specialist Nurse for Organ Donation in the family approach (odds ratio 3.0), donation after circulatory death (odds ratio 2.7) and Black, Asian or Minority Ethnicity (odds ratio 2.7). This highlights the need to further engage with these groups in exploring donation as an end of life choice, and suggests that there may be, from the perspective of the family, fundamental differences between donation after brainstem death and circulatory death. It further adds to the body of data linking involvement of the Specialist Nurse for Organ Donation in the family approach to improved UK consent rates.

Organ donation as an 'altruistic gift': incentives and reciprocity in deceased organ donation from a UK Polish migrant perspective.

PubMed

Sharp, Chloe; Randhawa, Gurch

2014-01-17

Incentives and reciprocity have been widely debated within the literature as an alternative to altruism to motivate the public to register and consent to organ donation. This pilot study was the first to examine the views of the UK Polish migrant community toward these issues. One-to-one and small group interviews were conducted in English and Polish to collect data. The interviews were recorded and transcribed and interviews in Polish were translated into English. All transcripts were coded, codes were grouped by theme and emergent themes were constantly compared to the new data until saturation. Participants were motivated to donate altruistically but would accept reciprocity for organs once consent was given. Payment for organs was viewed as unfavourable but participants would accept contribution toward funeral expenses. Deceased organ donation was viewed as an 'altruistic gift'. 'Altruism' and 'gift' are problematic in deceased organ donation and could explain the challenges that arise in the incentives and reciprocity debate. Mauss's gift exchange theory could frame incentives as forming the 'obligation to give' and could encourage registration but could lead to coercion. Reciprocity could benefit families and be viewed as 'fair' and a token of gratitude.

Does the Attitude Toward Organ Donation Change as a Function of the Country Where People Emigrate? Study Between Uruguayan Emigrants to the United States and Spain.

PubMed

Ríos, A; López-Navas, A I; Sánchez, Á; Ayala, M A; Garrido, G; Sebastián, M J; Martinez-Alarcón, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

The Uruguayan population is sensitized toward transplantation. However, it has not been studied how this awareness can change when emigrating to different countries. To analyze the attitude toward cadaveric organ donation and living organ donation between the Uruguayan population residing in Florida (United States) and the Uruguayan population residing in Spain. Adults born in Uruguay and residing in Florida and Spain were screened. The questionnaire "PCID-DTO Ríos" (donation of cadaveric organs) and "PCID-DVR Ríos" (living renal donation) were used. Subjects were randomly selected according to age and gender stratification. Support from Latin-American immigration associations in Spain and Florida was needed. The survey was anonymized and self-administered. Verbal consent was obtained to collaborate in the study. Because the emigrant population to Spain is far larger than the emigrant population to the United States, a 2:1 proportional sampling was performed (n = 132). Sixty-seven percent of residents in Spain were in favor of organ donation at the time of death compared with 50% among residents in Florida (P = .082), and 100% of residents in Spain were in favor of living renal donation compared with 50% of those living in Florida (P < .001). The attitude toward donation is more favorable among Uruguayan emigrants to Spain than emigrants to the United States, especially in related kidney donation. Copyright © 2017 Elsevier Inc. All rights reserved.

The Instability of Organ Donation Decisions by Next-of-Kin and Factors that Predict It

PubMed Central

Rodrigue, James R.; Cornell, Danielle L.; Howard, Richard J.

2008-01-01

We examined the instability of organ donation decisions made by next-of-kin and factors that predict whether non-donors wish they had consented to donation. Next-of-kin of donor-eligible individuals from one organ procurement organization participated in a semi-structured telephone interview. Participants were asked if they would make the same decision if they had to make it again today. Of the 147 next-of-kin donors, 138 (94%) would make the same decision again; 6 (4%) would not consent to donation, and 3 (2%) were unsure. Of the 138 next-of-kin non-donors, 89 (64%) would make the same decision again, 37 (27%) would consent to donation, and 12 (9%) were unsure. Regret among non-donors was more likely when the next-of-kin had more favorable transplant attitudes (OR=1.76, CI=1.15, 2.69), had the first donation discussion with a non-OPO professional (OR=0.21, CI=0.13, 0.65), was not told their loved one was dead before this discussion (OR=0.23, CI=0.10, 0.50), did not feel they were given enough time to make the decision (OR=0.25, CI=0.11, 0.55), had not discussed donation with family members (OR=0.30, CI=0.13, 0.72), and had not heard a public serve announcement about organ donation (OR=0.29, CI=0.13, 0.67). OPOs should consider targeting these variables in educational campaigns and donation request approaches. PMID:18853951

From attitude formation to behavioral response in organ donation: using marketing to increase consent rates.

PubMed

Aldridge, Alicia; Guy, Bonnie; Roggenkamp, Susan

2003-01-01

This article presents a theoretical analysis of attitude formation and the relationship to stated behavioral intentions as it relates to the decision to donate organs. This analysis reveals the presence of three distinct paths to behavior of potential donors, groups differing in their involvement with organ donation. Promotional objectives and campaign strategies designed to influence attitudes and behaviors should differ according to the behavioral path in operation and the involvement of the audience. Mass media campaigns are likely to reach high involvement groups only. Therefore, personal selling, underutilized in previous donation campaigns, should be brought into the donation strategy to appeal to low involvement groups. By recognizing differences in audience involvement and implementing different strategies, overall donation rates could substantially increase.

A study on the development of public campaign messages for organ donation promotion in Korea.

PubMed

Sun, Hye-Jin

2015-12-01

This study aims to find an effective method of expressing a message in public service ads by investigating whether or not a message framing type affects the outcome. Specifically, the study looks into the effects of messaging on organ donation by identifying how the type of message framing (positive vs. negative) and appeal type (rational vs. emotional) affect the attitude and behavioural intention of the consumer. The individual characteristics of each subject such as altruistic mind, level of self-monitoring and issue involvement were selected as intermediate variables that may affect the impact of a message. The study therefore tries to establish a proposition that can be used to generate an effective promotional message on organ donation in a systematic way. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Knowledge, Attitudes, and Beliefs Toward Organ Donation Among Social Media Users.

PubMed

Hajjar, W M; Bin Abdulqader, S A; Aldayel, S S; Alfardan, A W; Alzaidy, N I

2016-09-01

Organ transplantation is the optimal treatment for end-stage organ diseases. The demand for organs has exceeded the available supply, which becomes a major obstacle worldwide. Identifying the factors affecting this gap will help in overcoming this obstacle. The purpose of the work was to study the knowledge, attitudes, and beliefs of organ donation and to determine the knowledge of brain death among social media users. A cross-sectional study was conducted among social media users living in Saudi Arabia. A pre-designed self-administrated questionnaire was distributed online randomly on social media networks in 2015. Of the total 1368 participants, only 913 met the criteria. Most respondents were between 18 and 29 years of age (61.2%) and living in the central region of Saudi Arabia (64.5%). The majority of respondents received their information from television (57%) and social media (50%) networks; 46.4% of respondents knew that the religious fatwa allowed organ donation; 51% of respondents were willing to donate their organs; 46.5% considered the brain-dead to be deceased, whereas 37.7% considered it a coma; 33.3% did not know if someone who was brain-dead would ever wake up; on the other hand, 323 (35.4%) said yes. Our study showed that the vast majority of our sample had enough information about organ donation. On the contrary, they had minimal knowledge about brain death. Moreover, a fair percentage of the participants had positive attitudes toward organ donation. Also, the media had a significant effect on the information about organ donation and brain death. Copyright © 2016 Elsevier Inc. All rights reserved.

Change of focus: from intensive care towards organ donation.

PubMed

Meyer, Käthe; Bjørk, Ida T

2008-02-01

To progress from identifying a potential organ donor to implementing the actual organ donation effectively is a challenging process for all involved. The nurses might find the change of focus difficult, as the donor organ acquisition process often starts before the relatives had been informed and have had the time to reorient themselves about the severe situation of the patient and have been briefed on the option of organ donation. The purpose was to investigate the hospital-based education in organ donation at the 28 Norwegian donor hospitals, and elicit the needs of the intensive care nurses for imparting of required knowledge and support in shifting their focus from intensive care towards the process of organ procurement. Hospital-based education and guidelines in organ donation were analyzed by scrutinizing the documents available. Eleven units were found to have their own guidelines and only three hospitals had organ donation in their educational programme. Intensive care nurses at three hospitals participated in focus groups. The main finding was the need for collaboration and mutual understanding within the treatment team. Nurses expounded the multiple responsibilities that they discharged during the course of intensive care. In reorienting their focus from intensive care to donor organ procurement, the time of death was explained as the crucial turning point. The knowledge of intensive care staff and professional competence were crucial in winning the relatives' trust and were central in the communication processes. Donor hospitals should implement systematic training and debriefing, where both nurses and physicians contribute to this process. Well-prepared protocols for organ donation at hospitals can define responsibilities assigned to different members of the donor organ acquisition team.

Organ donation video messaging: differential appeal, emotional valence, and behavioral intention.

PubMed

Rodrigue, J R; Fleishman, A; Vishnevsky, T; Fitzpatrick, S; Boger, M

2014-10-01

Video narratives increasingly are used to draw the public's attention to the need for more registered organ donors. We assessed the differential impact of donation messaging videos on appeal, emotional valence, and organ donation intentions in 781 non-registered adults. Participants watched six videos (four personal narratives, one informational video without personal narrative, and one unrelated to donation) with or without sound (subtitled), randomly sequenced to minimize order effects. We assessed appeal, emotional valence, readiness to register as organ donors, and donation information-seeking behavior. Compared to other video types, one featuring a pediatric transplant recipient (with or without sound) showed more favorable appeal (p < 0.001), generated more positive emotional valence (p < 0.01), and had the most favorable impact on organ donor willingness (p < 0.001). Ninety-five (12%) participants clicked through to a donation website after viewing all six videos. Minority race (OR = 1.94, 95% CI = 1.20, 3.13, p = 0.006), positive change in organ donor readiness (OR = 0.26, 95% CI = 0.14, 0.48, p < 0.001), and total positive emotion (OR = 1.05, 95% CI = 1.03, 1.07, p < 0.001) were significant multivariable predictors of clicking through to the donation website. Brief, one-min videos can have a very dramatic and positive impact on willingness to consider donation and behavioral intentions to register as an organ donor. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

PubMed

Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

2017-11-01

Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation.

Does uncontrolled cardiac death for organ donation raise ethical questions? An opinion survey.

PubMed

Goudet, V; Albouy-Llaty, M; Migeot, V; Pain, B; Dayhot-Fizelier, C; Pinsard, M; Gil, R; Beloucif, S; Robert, R

2013-11-01

Organ donation after uncontrolled cardiac death raises complex ethical issues. We conducted a survey in a large hospital staff population, including caregivers and administrators, to determine their ethical viewpoints regarding organ donation after uncontrolled cardiac death. Multicenter observational survey using a questionnaire, including information on the practical modalities of the procedure. Respondents were asked to answer 15 detailed ethical questions corresponding to different ethical issues raised in the literature. Ethical concerns was defined when respondents expressed ethical concerns in their answers to at least three of nine specifically selected ethical questions. One thousand one hundred ninety-six questionnaires were received, and 1057 could be analysed. According to our definition, 573 respondents out of 1057 (54%) had ethical concerns with regard to donation after cardiac death and 484 (46 %) had no ethical concerns. Physicians (55%) and particularly junior intensivists (65%) tended to have more ethical issues than nurses (52%) and hospital managers (37%). Junior intensivists had more ethical issues than senior intensivists (59%), emergency room physicians (46%) and transplant specialists (43%). Only 46% of hospital-based caregivers and managers appear to accept easily the legitimacy of organ donation after cardiac death. A significant number of respondents especially intensivists, expressed concerns over the dilemma between the interests of the individual and those of society. These results underline the need to better inform both healthcare professionals and the general population to help to the development of such procedure. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

OPTN/SRTR 2013 Annual Data Report: deceased organ donation.

PubMed

Israni, A K; Zaun, D A; Rosendale, J D; Snyder, J J; Kasiske, B L

2015-01-01

The status of deceased organ donation is assessed using metrics such as donation/conversation rate, organ yield, and rate of organs recovered for transplant and not transplanted. These metrics are based on eligible deaths (brain death of a person aged 70 years or younger) as well as on actual donors. The 9132 eligible deaths reported in 2013 represented a slight increase over 2012. The donation/conversion rate was 71.3 eligible donors per 100 eligible deaths, a slight decline from 2012, and varied by donation service area from 50.0 to 87.0. The number of organs recovered per donor, 3.55, also varied by donation service area, from 2.79 to 4.10. The mean number of organs transplanted per donor was 3.08 in 2013, slightly higher than 3.02 in 2012. The mean observed/expected organ yield ratio for kidneys varied from 0.86 to 1.18; for pancreata, from 0.29 to 2.59; for livers, from 0.69 to 1.17; for hearts, from 0.68 to 1.41; and for lungs, from 0.33 to 1.41. The rate of organs recovered for transplant and not transplanted in 2013 for all organs combined was 0.13 per recovered organ, slightly lower than the rate of 0.14 in 2012. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

[Presumptive organ donations for transplants agreement of the Ethics Committee of the University of Chile Medical School].

PubMed

Roa, A; Rosselot, E

1995-04-01

The ethics committee of the Faculty of Medicine, University of Chile was consulted about the ethical aspects of presumptive organ donation for transplantation. After analyzing the problem, the committee concluded that every human being has the right to make use of his organs freely, voluntarily and according to his own discernment. The society has no right to make obligatory this donation, even after death. The foundations of this agreement were laid in a series of reasons. In fact, the corpse is not a juridical but a ethical asset and deserves respect for whom it was. It cannot be commercialized and is the only non-religious object susceptible of profanation. It is also object of popular affective and religious manifestations. Beliefs and affects must be respected. Organ donation is an act of charity and cannot be compulsory. The organ donation consent must be explicit, voluntary and solemn.

Organ donation agency: A discourse analysis of correspondence between donor and organ recipient families.

PubMed

Galasiński, Dariusz; Sque, Magi

2016-11-01

Studies about the psychosocial issues concerning organ donation and transplantation tend to focus on the experiences of donor or recipient families. Little is known about the part played by correspondence exchanged between these two groups; in particular how they perceive the agency of organ donation. This is the first analysis to address the representation of the act of donation from the viewpoint of both donor and recipient families through interrogation of archived correspondence data, using linguistic techniques. The data was drawn from a collection of letters, from four USA organ procurement organisations, exchanged between donor and transplant recipient families. Donor families consistently linguistically ascribed agency and accountability for donation to the person who died, the donor. For the recipient families, on the other hand, the 'giver' was mainly implied, ambiguous or ascribed to the donor family. © 2016 Foundation for the Sociology of Health & Illness.

The PIERDUB project: International Project on Education and Research in Donation at University of Barcelona: training university students about donation and transplantation.

PubMed

Manyalich, M; Paredes, D; Ballesté, C; Menjívar, A

2010-01-01

Donation and transplantation is an accepted therapeutic option when organ failure or tissue replacements are needed to save or improve the quality of life. However, in most medical schools there is no specific training for it, thus disregarding the key role of university students for the future success of the process. Knowledge diffusion about the donation procedure to clarify doubts and stimulate positive attitudes toward donation. Training university students in the donation and transplantation process. Research about the previous donation knowledge and the impact in donation indexes. Three different phases have been designed: (1) Training the University of Barcelona Health Sciences School students; (2) Training the Health Sciences School students in other faculties of Catalonia, Spain, and International; and (3) research. Since 2005, we have offered yearly an Optional Credits Course to medical students with duration of 45 hours, and two Donation days opened to health sciences students. Since 2007, promotional campaigns have been carried out in medicine and other health sciences faculties. Until now, 818 answered surveys have been collected to evaluate previous knowledge among university students. Training medical and other health sciences students in the donation process will improve quality of medical education and develop a trainer role for future professionals to help improve donation rates.

A Scarcity of Organs.

ERIC Educational Resources Information Center

Areen, Judith

1988-01-01

Resistance to organ donation and the continuing shortage of donated organs is discussed and four legal approaches to organ acquisition are examined. A fifth, based on the principle of supported individual autonomy, is proposed. (MSE)

Help, I need to develop communication skills on donation: the "VIDEO" model.

PubMed

Smudla, A; Mihály, S; Hegedüs, K; Nemes, B; Fazakas, J

2011-05-01

Information about brain stem death and donation can be influence the consent rate for donation and its psychosocial effects. The aim of this study was to create a "VIDEO" model that could be used to help physicians to develop communication skills. A video recorded 32 simulations of family interviews: 16 under-age and 16 adult donors. They were analyzed during 8 courses conducted in 2008 and 2009. During the VIDEO process, the visual presentation was followed by participants (n=192) discussing interactively the donation situation. After the transcription of the video records, family interviews were explored retrospectively regarding informing relatives about brain stem death and donation, typical communication gaps and common questions from families. The data were examined qualitatively and semiquantitatively. We think that teaching can be optimized by our results. A comprehensible explanation about brain stem death was provided to relatives in 65.63% of cases. The consent of the family was more important for the physicians than the application of the law in 93.75%; 78.13% of physicians emphasized altruism to support donation. Remarkable mistakes of communication included using the teams coma and brain stem death interchangeably (9.38%); applying expressions connected with life in the present tense (21.88%) and mechanically kept alive (21.88%); organ-focused behavior such as "organs to be usable" (34.38%). The frequent questions and statements of "relatives" were "heart beats" (100%), "did he really die?" (65.63%), "fear of loss of integrity of the corpse" (59.38%), and "wake up from the coma" (46.88%). Interaction with the family requires great preparation. The communication skills of physicians can be developed through the VIDEO model. The results can be integrated into educational programs that consider the particular features of the given country. Copyright © 2011 Elsevier Inc. All rights reserved.

End-of-life practices in patients with devastating brain injury in Spain: implications for organ donation.

PubMed

Domínguez-Gil, B; Coll, E; Pont, T; Lebrón, M; Miñambres, E; Coronil, A; Quindós, B; Herrero, J E; Liébanas, C; Marcelo, B; Sanmartín, A M; Matesanz, R

2017-04-01

To describe end-of-life care practices relevant to organ donation in patients with devastating brain injury in Spain. A multicenter prospective study of a retrospective cohort. 1 November 2014 to 30 April 2015. Sixty-eight hospitals authorized for organ procurement. Patients dying from devastating brain injury (possible donors). Age: 1 month-85 years. Type of care, donation after brain death, donation after circulatory death, intubation/ventilation, referral to the donor coordinator. A total of 1,970 possible donors were identified, of which half received active treatment in an Intensive Care Unit (ICU) until brain death (27%), cardiac arrest (5%) or the withdrawal of life-sustaining therapy (19%). Of the rest, 10% were admitted to the ICU to facilitate organ donation, while 39% were not admitted to the ICU. Of those patients who evolved to a brain death condition (n=695), most transitioned to actual donation (n=446; 64%). Of those who died following the withdrawal of life-sustaining therapy (n=537), 45 (8%) were converted into actual donation after circulatory death donors. The lack of a dedicated donation after circulatory death program was the main reason for non-donation. Thirty-seven percent of the possible donors were not intubated/ventilated at death, mainly because the professional in charge did not consider donation alter discarding therapeutic intubation. Thirty-six percent of the possible donors were never referred to the donor coordinator. Although deceased donation is optimized in Spain, there are still opportunities for improvement in the identification of possible donors outside the ICU and in the consideration of donation after circulatory death in patients who die following the withdrawal of life-sustaining therapy. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Policy statement--pediatric organ donation and transplantation.

PubMed

2010-04-01

Pediatric organ donation and organ transplantation can have a significant life-extending benefit to the young recipients of these organs and a high emotional impact on donor and recipient families. Pediatricians, pediatric medical specialists, and pediatric transplant surgeons need to be better acquainted with evolving national strategies that involve organ procurement and organ transplantation to help acquaint families with the benefits and risks of organ donation and transplantation. Efforts of pediatric professionals are needed to shape public policies to provide a system in which procurement, distribution, and cost are fair and equitable to children and adults. Major issues of concern are availability of and access to donor organs; oversight and control of the process; pediatric medical and surgical consultation and continued care throughout the organ-donation and transplantation process; ethical, social, financial, and follow-up issues; insurance-coverage issues; and public awareness of the need for organ donors of all ages.

Analysis of knowledge of the general population and health professionals on organ donation after cardiac death.

PubMed

Bedenko, Ramon Correa; Nisihara, Renato; Yokoi, Douglas Shun; Candido, Vinícius de Mello; Galina, Ismael; Moriguchi, Rafael Massayuki; Ceulemans, Nico; Salvalaggio, Paolo

2016-09-01

To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. The three hospitals with the most brain death notifications in Curitiba were selected, and two groups of respondents were established for application of the same questionnaire: the general public (i.e., visitors of patients in intensive care units) and health professionals working in the same intensive care unit. The questionnaire contained questions concerning demographics, intention to donate organs and knowledge of current legislation regarding brain death and donation after cardiac death. In total, 543 questionnaires were collected, including 442 from family members and 101 from health professionals. There was a predominance of women and Catholics in both groups. More females intended to donate. Health professionals performed better in the knowledge comparison. The intention to donate organs was significantly higher in the health professionals group (p = 0.01). There was no significant difference in the intention to donate in terms of education level or income. There was a greater acceptance of donation after uncontrolled cardiac death among Catholics than among evangelicals (p < 0.001). Most of the general population intended to donate, with greater intentions expressed by females. Education and income did not affect the decision. The type of transplant that used a donation after uncontrolled cardiac death was not well accepted in the study population, indicating the need for more clarification for its use in our setting.

Emigration From Puerto Rico to Florida: Multivariate Analysis of Factors That Condition Attitudes of the Puerto Rican Population Toward Organ Donation for Transplant.

PubMed

Ríos, A; López-Navas, A I; Sánchez, Á; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Sebastián, M J; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

The Puerto Rican population represents one of the largest immigration groups in Florida, and this has an impact on the organ transplant donation process. Our aim was to analyze attitudes toward organ donation among Puerto Ricans who currently reside in the state of Florida (USA). The population screened consisted of individuals >15 years old, who were born in Puerto Rico, living in Florida, and awaiting organs for transplant. All participants completed the "PCID-DTO Rios" questionnaire. Random selection was done according to stratification. Support from immigration associations in Spain was needed for advice on the locations of potential respondents. Study participation was anonymized and self-administered. There were 259 respondents, 37% (n = 95) were in favor of donation, 36% (n = 93) were against donation, and 27% (n = 71) were undecided. The variables associated with these attitudes were: age (P = .017); civil status (P = .021); level of education (P < .001); previous experience with donation and transplant (P < .001); attitude toward organ donation of a relative (P < .001); carrying out pro-social activities (P < .001); discussing the issue of transplant with the family (P < .001) or couple (P < .001); attitude toward incineration (P < .001), burial (P < .001), and autopsy (P < .001); fear of mutilation after donation (P < .001); and religious beliefs (P < .001). In the multivariate study, it remained an independent variable to have discussed the issue at the family level (odds ratio = 11.627; P = .009). The Puerto Rican study population residing in Florida has an unfavorable attitude toward organ donation. Copyright © 2017 Elsevier Inc. All rights reserved.

Willingness to Donate Organs among People Living with HIV.

PubMed

Nguyen, Anh Q; Anjum, Saad K; Halpern, Samantha E; Kumar, Komal; Van Pilsum Rasmussen, Sarah E; Doby, Brianna; Shaffer, Ashton A; Massie, Allan B; Tobian, Aaron A R; Segev, Dorry L; Sugarman, Jeremy; Durand, Christine M

2018-05-16

With passage of the HIV Organ Policy Equity (HOPE) Act, people living with HIV (PLWH) can donate organs to PLWH awaiting transplant. Understanding knowledge and attitudes regarding organ donation among PLWH in the US is critical to implementing the HOPE Act. PLWH were surveyed regarding their knowledge, attitudes, and beliefs about organ donation and transplantation at an urban academic HIV clinic in Baltimore, MD between 08/2016-10/2016. Responses were compared using Fisher's exact and chi-squared tests. Among 114 survey respondents, median age was 55 years, 47.8% were female, and 91.2% were African American. Most were willing to be deceased donors (79.8%) or living donors (62.3%). Most (80.7%) were aware of the US organ shortage; however, only 24.6% knew about the HOPE Act and only 21.1% were registered donors. Respondents who trusted the medical system or thought their organs would function adequately in recipients were more likely to be willing to be deceased donors (p<0.001). Respondents who were concerned about surgery, worse health post-donation, or need for changes in HIV treatment due to donation were less likely to be willing to be living donors (p<0.05 for all). Most believed that PLWH should be permitted to donate (90.4%) and that using HIV+ donor organs for transplant would reduce discrimination against PLWH (72.8%). Many of the PLWH surveyed expressed willingness to be organ donors. However, knowledge about the HOPE Act and donor registration was low, highlighting a need to increase outreach.

Attitude Toward Death, Fear of Being Declared Dead Too Soon, and Donation of Organs After Death.

ERIC Educational Resources Information Center

Hessing, Dick J.; Elffers, Henk

1987-01-01

Describes a study of willingness to donate organs for transplantation after death based on Weyant's cost-benefit model for altruistic behavior. Two death anxieties (the attitude toward death and the fear of being declared dead too soon) were introduced to help explain the discrepancy between attitudes and behavior in the matter of organ donation.…

Cultural diversity and patients with reduced capacity: the use of ethics consultation to advocate for mentally handicapped persons in living organ donation.

PubMed

Spike, J

2001-01-01

Living organ donation will soon become the source of the majority of organs donations for transplant. Should mentally handicapped people be allowed to donate, or should they be considered a vulnerable group in need of protection? I discuss three cases of possible living organ donors who are developmentally disabled, from three different cultures, the United States, Germany, and India. I offer a brief discussion of three issues raised by the cases: (1) cultural diversity and cultural relativism; (2) autonomy, rationality, and self-interest; and (3) the proper use and role for clinical ethics consults.

Family perception of the process of organ donation. Qualitative psychosocial analysis of the subjective interpretation of donor and nondonor families.

PubMed

López Martínez, Jorge S; Martín López, María Jesús; Scandroglio, Barbara; Martínez García, José Manuel

2008-05-01

Family perception of organ donation has been explored by numerous authors using statements by the people who decided whether or not to donate the organs of a relative in a situation of brain death. Within this tradition, in this work, we analyze the discourse of six families who granted permission for organ donation and three who refused. We describe the process-based interpretation of this experience and identify psychosocial variables and processes that further our understanding of the decision finally adopted. We have identified two heuristics that guide family decision when organ donation is requested: the explicit or inferred will of the deceased and family attitudes to organ donation and transplant. It is postulated that the interaction of these two factors explains a large amount of the decisions made. We also hypothesize that a marked discrepancy between these two factors increases the importance of other aspects, especially the role of the transplant coordinator and of other healthcare personnel. These results support, at a social level, the implementation of transplant promotion programs; and at a healthcare level, the combined use of techniques of crisis intervention and attitude change.

Theological reflections on donation after circulatory death: the wisdom of Paul Ramsey and Moshe Feinstein.

PubMed

Jotkowitz, A

2008-10-01

Due to the worldwide shortage of organs for transplantation, there has been an increased use of organs obtained after circulatory death alone. A protocol for this procedure has recently been approved by a major transplant consortium. This development raises serious moral and ethical concerns. Two renowned theologians of the previous generation, Paul Ramsey and Moshe Feinstein, wrote extensively on the ethical issues relating to transplantation, and their work has much relevance to current moral dilemmas. Their writings relating to definition of death, organ transplantation and the care of the terminally ill are briefly presented, and their potential application to the moral problem of organ donation after circulatory death is discussed.

Decision-making regarding organ donation in Korean adults: A grounded-theory study.

PubMed

Yeun, Eun Ja; Kwon, Young Mi; Kim, Jung A

2015-06-01

The aim of this study was to identify the hidden patterns of behavior leading toward the decision to donate organs. Thirteen registrants at the Association for Organ Sharing in Korea were recruited. Data were collected using in-depth interview and the interview transcripts were analyzed using Glaserian grounded-theory methodology. The main problem of participants was "body attachment" and the core category (management process) was determined to be "pursuing life." The theme consisted of four phases, which were: "hesitating," "investigating," "releasing," and "re-discovering. " Therefore, to increase organ donations, it is important to find a strategy that will create positive attitudes about organ donation through education and public relations. These results explain and provide a deeper understanding of the main problem that Korean people have about organ donation and their management of decision-making processes. These findings can help care providers to facilitate the decision-making process and respond to public needs while taking into account the sociocultural context within which decisions are made. © 2014 Wiley Publishing Asia Pty Ltd.

Experiencing organ donation: feelings of relatives after consent1

PubMed Central

Fernandes, Marli Elisa Nascimento; Bittencourt, Zélia Zilda Lourenço de Camargo; Boin, Ilka de Fátima Santana Ferreira

2015-01-01

Objective: to identify experiences and feelings on the organ donation process, from the perspective of a relative of an organ donor in a transplant unit. Method: this was exploratory research using a qualitative approach, performed with seven family members of different organ donors, selected by a lottery. Sociodemographic data and the experiences regarding the donation process were collected through semi-structured interviews. The language material was transcribed and submitted to content analysis. Results: poor sensitivity of the medical staff communicating the relative's brain death - the potential donor - and the lack of socio-emotional support prior to the situation experienced by the family was highlighted by participants. Conclusions: the study identified the need to provide social-emotional support for families facing the experience of the organ donation process. From these findings, other care and management practices in health must be discussed to impact the strengthening of the family ties, post-donation, as well as the organ procurement indexes. PMID:26487140

Improving organ donation rates by modifying the family approach process.

PubMed

Ebadat, Aileen; Brown, Carlos V R; Ali, Sadia; Guitierrez, Tim; Elliot, Eric; Dworaczyk, Sarah; Kadric, Carie; Coopwood, Ben

2014-06-01

The purpose of this study was to identify steps during family approach for organ donation that may be modified to improve consent rates of potential organ donors. Retrospective study of our local organ procurement organization (OPO) database of potential organ donors. Modifiable variables involved in the family approach of potential organ donors were collected and included race and sex of OPO representative, individual initiating approach discussion with family (RN or MD vs. OPO), length of donation discussion, use of a translator, and time of day of approach. Of 1137 potential organ donors, 661 (58%) consented and 476 (42%) declined. Consent rates were higher with matched race of donor and OPO representative (66% vs. 52%, p < 0.001), family approach by female OPO representative (67% vs. 56%, p = 0.002), if approach was initiated by OPO representative (69% vs. 49%, p < 0.001), and if consent rate was dependent on time of day the approach occurred: 6:00 am to noon (56%), noon to 6:00 pm (67%), 6:00 pm to midnight (68%), and midnight to 6:00 am (45%), p = 0.04. Family approach that led to consent lasted longer than those declining (67 vs. 43 minutes, p < 0.001). Independent predictors of consent to donation included female OPO representative (odds ratio [OR], 1.7; p = 0.006), approach discussion initiated by OPO representative (OR, 1.9; p = 0.001), and longer approach discussions (OR, 1.02; p < 0.001). The independent predictor of declined donation was the use of a translator (OR, 0.39; p = 0.01). Variables such as race and sex of OPO representative and time of day should be considered before approaching a family for organ donation. Avoiding translators during the approach process may improve donation rates. Education for health care providers should reinforce the importance of allowing OPO representatives to initiate the family approach for organ donation. Epidemiologic study, level IV. Therapeutic study, level IV.

Education on organ donation and transplantation in primary school; teachers' support and the first results of a teaching module

PubMed Central

Siebelink, Marion J.; Van de Wiel, Harry B. M.

2017-01-01

Organ and tissue donation can also involve children. Because of its sensitivity, this topic requires careful decision making. Children have the ability to carefully reflect on this subject and enjoy participating in family discussions about it. Therefore, what children need is proper information. When schools are used to educate children about this subject, information about teacher support for this type of lesson along with its effects on the depth of family discussions is important. Methods: A questionnaire was sent to all 7,542 primary schools in the Netherlands. The goal was to gather information on teachers’ perspectives about a neutral lesson devoted to organ and tissue donation, and also on the best age to start giving such a lesson. The second part of our study examined the effects of a newly developed lesson among 269 primary school pupils. The school response was 23%. Of these, 70% were positive towards a lesson; best age to start was 10–11 years. Pupils reported 20% more family discussions after school education and enjoyed learning more about this topic. There is significant support in primary schools for a school lesson on organ and tissue donation. Educational programs in schools support family discussions. PMID:28531238

The high cost of organ transplant commercialism.

PubMed

Danovitch, Gabriel M

2014-02-01

The Declaration of Istanbul defines organ transplant commercialism as '…a policy or practice in which an organ is treated as a commodity, including by being bought or sold or used for material gain.' It is this treatment of the organ that inevitably leads to its financial value being placed before the welfare of either its donor or its recipient or others in need of organ transplantation. International experience over the past two decades has proven this point and outcomes of commercial donation for both organ donors and their recipients have been poor. Commercial organ donation also comes at the expense of, not in addition to, unpaid, 'altruistic' donation. Other consequences of commercial donation are discussed in addition to a review of measures taken by the international community to put an end to the exploitation of vulnerable organ donors and the provision of ethically acceptable options for those in need of organ transplantation.

Bone Tissue Donation: Tendency and Hurdles.

PubMed

El Hage, S; Dos Santos, M J; de Moraes, E L; de Barros E Silva, L B

2018-03-01

The aim of this study was to identify the percentage of bone tissue donation in a brain death situation and the tendency of donation rate of this tissue in an organ procurement organization in the county of Sao Paulo from 2001 to 2016. It is a retrospective and quantitative study, based on the Organ and Tissue Donation Term of donors who died of brain death between 2001 and 2016. A logistic regression model was applied, and the odds of donation were identified throughout the years, regarding the odds ratio different from zero. Finally, it was measured the accuracy of the odds ratio through the confidence interval. The analysis has shown a significant change on the trend of bone donation (P < .001). In this case, the odds ratio was >1, indicating that the donation rate has increased. However, the percentage of growth is still considered low. The study evidences a growth trend regarding the donation of bone tissue, but the percentage is still too low to adequately meet the demand of patients who need this modality of therapeutic intervention. It is believed that educational campaigns of donation are not emphasizing the donation of tissues for transplantation, which may be directly impacting their consent rates. Copyright © 2018 Elsevier Inc. All rights reserved.

[Myths about organ donation on health personnel, potential recipients and relatives of potential donors in a peruvian hospital: a qualitative study].

PubMed

Gómez-Rázuri, Katherine; Ballena-López, José; León-Jiménez, Franco

2016-03-01

To explore the myths regarding organ donation at a national hospital in Lambayeque, Peru during 2014. A qualitative-phenomenological study was performed using 24 unstructured in-depht interview of health personnel, potential recipients and relatives of potential donors. Sampling was intentional opinion-based, completed by theoretical saturation in each group. An interview guide was used, which was assessed by five experts, and data triangulation was performed. Twenty-three interviewees (95,8%) reported a favorable attitude towards organ donation. On their National Identification Document, thirteen (54,2%) had marked "no" for donation. The myths were: age or illness can preclude donation; that the recipient may experience the donor's behaviours and lives in it; brain death is undestood as the immobility of the body and a reversible state; religions do not accept organ donation because it affects physical integrity and resurrection; and that there are preferences on the organ donor waiting list and that organ trafficking taxes place. Myths explored in this study involved religious, socio-cultural, psychological and ethical misperceptions. The apparent lack of knowledge of the brain death diagnosis is the starting point of the donation process. Therefore, the presence of a hospital coordinator, the role of spiritual leaders and the correct information provided by media would be key parts to dispell these myths.

The Public Face of Transplantation: The Potential of Education to Expand the Face Donor Pool.

PubMed

Plana, Natalie M; Kimberly, Laura L; Parent, Brendan; Khouri, Kimberly S; Diaz-Siso, J Rodrigo; Fryml, Elise M; Motosko, Catherine C; Ceradini, Daniel J; Caplan, Arthur; Rodriguez, Eduardo D

2018-01-01

Despite the growing success of facial transplantation, organ donor shortages remain challenging. Educational health campaigns can effectively inform the general public and institute behavioral modifications. A brief educational introduction to facial transplantation may positively influence the public's position on facial donation. The authors anonymously surveyed 300 participants, gathering basic demographic information, donor registration status, awareness of facial transplantation, and willingness to donate solid organs and facial allografts. Two-hundred of these participants were presented an educational video and subsequently resurveyed on facial donation. Factorial parametric analyses were performed to compare exposure responses before and after watching video exposure. Among participants completing the survey alone (control group), 49 percent were registered donors, 78 percent reported willingness to donate solid organs, and 52 percent reported willingness to donate facial allograft. Of participants who watched the video (video group) 52 percent were registered; 69 and 51 percent were willing to donate solid organs and face, respectively. Following educational intervention, 69 percent of participants in the video group reported willingness to donate facial tissue, an 18 percent increase (p < 0.05), that equated to those willing to donate solid organs. The greatest increase was observed among younger participants (23 percent); women (22 percent); Jewish (22 percent), Catholic (22 percent), and black/African American (25 percent) participants; and respondents holding a higher degree. No significant differences according to gender or ethnicity were observed. Educational interventions hold much promise for increasing the general public's awareness of facial transplantation and willingness to participate in donation of facial allografts.

Ethical issues in critical care and cardiac arrest: clinical research, brain death, and organ donation.

PubMed

Donatelli, Luke A; Geocadin, Romergryko G; Williams, Michael A

2006-09-01

Cardiac arrest results in global hypoxic-ischemic brain injury from which there is a range of possible neurological outcomes. In most cases, patients may require a surrogate to make decisions regarding end-of-life care, including the withdrawal of life-sustaining therapies. This article reviews ethical considerations that arise in the clinical care of patients following cardiac arrest, including decisions to continue or withdraw life-sustaining therapies; brain death determination; and organ donation in the context of brain death and cardiac death (so-called non-heart-beating donation). This article also discusses ethical concerns pertaining to the design and conduct of resuscitation research that is necessary for the development of effective therapies to prevent anoxic brain injury or promote neurological recovery.

Improving transplantation programs and patient care.

PubMed

Shaheen, F A M; Souqiyyeh, M Z

2005-09-01

Organ transplantation is the preferred mode of replacement therapy. Currently acceptable 5-year posttransplantation survival rates are 85% for renal grafts, 70% for liver, and 65% for heart. Organ donation, however, remains a significant factor in organ transplantation, as humans are the only possible donors and the numbers of patients on waiting lists remain high. Several factors affect organ transplantation in countries in the Middle East Society for Organ Transplantation (MESOT) region, including inadequate preventive medicine, differing health infrastructures, poor awareness within the medical community and lay public regarding the importance of organ donation and transplantation, a high level of ethnicity, and poor government support of organ transplantation. Moreover, there is lack of team spirit among transplant physicians, a lack of coordination between groups that manage organ procurement and the transplant centers, and a lack of effective health insurance coverage for many persons. Three models of organ donation and transplantation exist in the MESOT region-the Saudi, Iranian, and Pakistani models. Living-organ donation, the most widely practiced form of donation in countries in the MESOT region, includes kidney and partial liver. Cadaveric organ donation has significant potential in the MESOT region. However, numerous obstacles must be overcome in MESOT countries. Resolution of these obstacles will require continuous work on many fronts. Experiences from all sources must be incorporated into new and improved models that can overcome current inadequacies. Solutions will require continued focus within the medical community, steady support from the lay public and religious institutions, as well as governmental assistance.

Why might people donate tissue for cancer research? Insights from organ/tissue/blood donation and clinical research.

PubMed

Axler, Renata E; Irvine, Rob; Lipworth, Wendy; Morrell, Bronwen; Kerridge, Ian H

2008-01-01

Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissue to research. A review of the literature on motivations to participate in clinical research and to donate tissues/organs for therapeutic use may provide some insights relevant to tumour banking research. While more research is necessary, a better understanding of the factors that motivate patients to give or refuse consent to tumour banking may ultimately improve consent practices, public trust and donation rates. Copyright 2008 S. Karger AG, Basel.

Interim Results of a National Test of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD)

PubMed Central

Traino, H. M.; Alolod, G. P.; Shafer, T.; Siminoff, L. A.

2012-01-01

Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital health-care providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed. PMID:22900761

Stimulus for organ donation: a survey of the American Society of Transplant Surgeons membership.

PubMed

Rodrigue, J R; Crist, K; Roberts, J P; Freeman, R B; Merion, R M; Reed, A I

2009-09-01

Federal legislation has been proposed to modify the National Organ Transplant Act in a way that would permit government-regulated strategies, including financial incentives, to be implemented and evaluated. The Council and Ethics Committee of the American Society of Transplant Surgeons conducted a brief web-based survey of its members' (n = 449, 41.6% response rate) views on acceptable or unacceptable strategies to increase organ donation. The majority of the membership supports reimbursement for funeral expenses, an income tax credit on the final return of a deceased donor and an income tax credit for registering as an organ donor as strategies for increasing deceased donation. Payment for lost wages, guaranteed health insurance and an income tax credit are strategies most strongly supported by the membership to increase living donation. For both deceased and living donation, the membership is mostly opposed to cash payments to donors, their estates or to next-of-kin. There is strong support for a government-regulated trial to evaluate the potential benefits and harms of financial incentives for both deceased and living donation. Overall, there is strong support within the ASTS membership for changes to NOTA that would permit the implementation and careful evaluation of indirect, government-regulated strategies to increase organ donation.

Bereaved relatives' decision about deceased organ donation: An integrated psycho-social study conducted in Spain.

PubMed

López, Jorge S; Martínez, José M; Soria-Oliver, María; Aramayona, Begoña; García-Sánchez, Rubén; Martín, María J; Almendros, Carmen

2018-05-01

Family refusal to organ donation of a deceased relative represents one of the most important barriers to organ transplantation. Although a large literature about family decisions has amassed, the existing evidence needs further integration and structuring. This study seeks to analyse relationships between bereaved relatives' decisions and a wide range of factors that converge in the family decision process, including interactions and complex relationship patterns, and taking psychosocial theoretical frameworks as reference to conceptualize empirical findings. This observational study examined 16 Spanish hospitals during a 36-month period. Transplant coordination teams collected data of 421 cases of family decision processes about donation (338 donations/83 refusals) through a previously validated instrument. Indicators of the following factors were collected: deceased's characteristics; circumstances of death; bereaved relatives' characteristics, beliefs, and expressions; behaviour of health and coordination staff; and family's emotional responses. Three global hypotheses related to bivariate and multivariate relations of factors with family decisions and relationships/interactions among factors were tested. Relatives' beliefs about the deceased's wishes concerning donation are the strongest predictor of family decisions. However, family decisions are also related to the deceased's characteristics, relatives' characteristics, satisfaction with medical attention, satisfaction with personal treatment and relatives' emotional responses, and other factors. Relatives' emotional reactions are related to satisfaction with health-staff interventions and condition family decision, even if deceased's will concerning donation is known and positive. Relatives' beliefs about deceased's wishes concerning donation vary as a function of deceased's characteristics and according to relatives' characteristics. Understanding of family decisions underlying organ donation may greatly benefit from a more complex, integrated, and theoretically based approach. Educational efforts should stress the need to register or simply communicate own willingness to donate organs. However, an adequate training and performance of the health-staff involved in the organ donation process may generate substantive differences in consent rates. Copyright © 2018 Elsevier Ltd. All rights reserved.

Should We Reject Donated Organs on Moral Grounds or Permit Allocation Using Non‐Medical Criteria?: A Qualitative Study

PubMed Central

Moorlock, Greg; Ives, Jonathan; Bramhall, Simon

2015-01-01

Abstract Conditional and directed deceased organ donations occur when donors (or often their next of kin) attempt to influence the allocation of their donated organs. This can include asking that the organs are given to or withheld from certain types of people, or that they are given to specified individuals. Donations of these types have raised ethical concerns, and have been prohibited in many countries, including the UK. In this article we report the findings from a qualitative study involving interviews with potential donors (n = 20), potential recipients (n = 9) and transplant staff (n = 11), and use these results as a springboard for further ethical commentary. We argue that although participants favoured unconditional donation, this preference was grounded in a false distinction between ‘medical’ and ‘non‐medical’ allocation criteria. Although there are good reasons to maintain organ allocation based primarily upon the existing ‘medical’ criteria, it may be premature to reject all other potential criteria as being unacceptable. Part of participants' justification for allocating organs using ‘medical’ criteria was to make the best use of available organs and avoid wasting their potential benefit, but this can also justify accepting conditional donations in some circumstances. We draw a distinction between two types of waste – absolute and relative – and argue that accepting conditional donations may offer a balance between these forms of waste. PMID:26132802

Increased organ donations from people born outside Spain.

PubMed

Frutos, M A; Mansilla, J J; Ruiz, P; Guerrero, F; Lebrón, M; Ortuño, R; Daga, D; Carballo, M

2008-11-01

Organs donated from persons born outside Spain are becoming increasingly numerous. These persons now account for 26.1% of all donors in the "Malaga sector," an area of tourism with a high percentage of immigrants. Acceptance to donation among persons from Europe and South America is similar to that of Spanish persons but lower among those born in Africa. We must recognize the great help that cultural mediators provided not only by assistance with the language barrier but also by generating confidence among families and understanding their emotions, feelings, and traditions, mainly during interviews with families from different social and cultural miliere. To be efficient, the interpreters or cultural mediators need to have received specific training in the organ donation process and to be involved and convinced that organ donation and transplantation is the best solution for severe health problems.

How modifiable factors influence parental decision-making about organ donation.

PubMed

Luberda, Kamila; Cleaver, Karen

2017-11-07

A global shortage of organs from children and adults available for transplantation is compounded by the failure of next of kin to consent for organs to be donated after death. Non-modifiable and modifiable factors influence decision-making in this area. Modifiable factors are of interest when examining families' decision-making about the donation of organs from their deceased child. A scoping review was undertaken to determine how modifiable factors influence parental decision-making about organ donation. Thematic analysis identified two themes: interactions with healthcare professionals and pre-disposition to organ donation. Satisfaction with experiences of hospital care, the information provided and the way it was communicated, as well as interactions pertaining to emotional support were all found to be modifiable factors that influenced decision making. Likewise, a predisposition to organ donation and knowing the deceased's wishes were associated with the consent decision. Nurses working in critical care environments need to be able to support parents during this difficult time. This article aims to raise awareness of modifiable factors that influence parental decision-making, highlighting their relevance for children's nursing practice. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Organ Donation Campaigns: Perspective of Dialysis Patient's Family Members.

PubMed

Tumin, Makmor; Raja Ariffin, Raja Noriza; Mohd Satar, NurulHuda; Ng, Kok-Peng; Lim, Soo-Kun; Chong, Chin-Sieng

2014-07-01

Solving the dilemma of the organ shortage in Malaysia requires educating Malaysians about organ donation and transplantation. This paper aims at exploring the average Malaysian households ' preferred channels of campaigns and the preferred campaigners in a family setting, targeting at the dialysis family members. We analyzed the responses of 350 respondents regarding organ donation campaigns. The respondents are 2 family members of 175 dialysis patients from 3 different institutions. The information on respondents' willingness to donate and preferred method and channel of organ donation campaign were collected through questionnaire. Malaysian families have a good tendency to welcome campaigns in both the public and private (their homes) spheres. We also found that campaigns facilitated by the electronic media (Television and Radio) and executed by experienced doctors are expected to optimize the outcomes of organ donation, in general. Chi-square tests show that there are no significant differences in welcoming campaigns among ethnics. However, ethnics preferences over the campaign methods and campaigners are significantly different (P <0.05). Ethnic differences imply that necessary modifications on the campaign channels and campaigners should also be taken under consideration. By identifying the preferred channel and campaigners, this study hopes to shed some light on the ways to overcome the problem of organ shortage in Malaysia.

Organ Donation Campaigns: Perspective of Dialysis Patient's Family Members

PubMed Central

TUMIN, Makmor; RAJA ARIFFIN, Raja Noriza; MOHD SATAR, NurulHuda; NG, Kok-Peng; LIM, Soo-Kun; CHONG, Chin-Sieng

2014-01-01

Abstract Background Solving the dilemma of the organ shortage in Malaysia requires educating Malaysians about organ donation and transplantation. This paper aims at exploring the average Malaysian households ’ preferred channels of campaigns and the preferred campaigners in a family setting, targeting at the dialysis family members. Methods We analyzed the responses of 350 respondents regarding organ donation campaigns. The respondents are 2 family members of 175 dialysis patients from 3 different institutions. The information on respondents’ willingness to donate and preferred method and channel of organ donation campaign were collected through questionnaire. Results Malaysian families have a good tendency to welcome campaigns in both the public and private (their homes) spheres. We also found that campaigns facilitated by the electronic media (Television and Radio) and executed by experienced doctors are expected to optimize the outcomes of organ donation, in general. Chi-square tests show that there are no significant differences in welcoming campaigns among ethnics. However, ethnics preferences over the campaign methods and campaigners are significantly different (P <0.05). Conclusion Ethnic differences imply that necessary modifications on the campaign channels and campaigners should also be taken under consideration. By identifying the preferred channel and campaigners, this study hopes to shed some light on the ways to overcome the problem of organ shortage in Malaysia. PMID:25909060

Organs and organisations: Situating ethics in organ donation after circulatory death in the UK.

PubMed

Cooper, Jessie

2018-05-25

Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome' the ethical challenge of DCD. In contrast, by drawing on Lynch's call to 'respecify' ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the 'minority ethnic organ donor' within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

The global diffusion of organ transplantation: trends, drivers and policy implications.

PubMed

White, Sarah L; Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-11-01

Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory's data to describe the current distribution of - and trends in - transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization's Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network.

Cost Evaluation of a Donation after Cardiac Death Program: How Cost per Organ Compares to Other Donor Types.

PubMed

Lindemann, Jessica; Dageforde, Leigh Anne; Vachharajani, Neeta; Stahlschmidt, Emily; Brockmeier, Diane; Wellen, Jason R; Khan, Adeel; Chapman, William C; Doyle, Mb Majella

2018-05-01

Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. Donation after cardiac death program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected. Mean costs per donor and per organ were calculated. Cost of DCD donors that did not yield a transplantable organ were included in cost analyses resulting in total cost of the DCD program. Donation after cardiac death donor costs were compared with costs of in-hospital donation after brain death (DBD) donors. There were 289 organs transplanted from 264 DCD donors evaluated. Mean cost per DCD donor yielding transplantable organs was $9,306. However, 127 donors yielded no organs, at a mean cost of $8,794 per donor. The total cost of the DCD program was $32,020 per donor and $15,179 per organ. Mean cost for an in-hospital DBD donor was $33,546 and $9,478 per organ transplanted. Mean organ yield for DBD donors was 3.54 vs 2.21 for DCD donors (p < 0.0001), making the cost per DBD organ 63% of the cost of a DCD organ. Mean cost per DCD donor is comparable with DBD donors, however, individual cost of DCD organs increases by almost 40% when all costs of an entire DCD program are included. Published by Elsevier Inc.

Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy.

PubMed

Sarnaik, Ajit A

2015-01-01

The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation.

Organ Donation Among Health Care Providers: Is Giving and Receiving Similar?

PubMed

Leon, M; Einav, S; Varon, J

2015-01-01

Health care providers encourage organ donation on a regular basis. The objective of this study was to analyze the coherence of the attitudes of health care providers toward organ donation, their willingness to receive organs and the differences among different health care practitioners and other hospital workers regarding to this ethical issue. A 33-question survey was conducted among staff members from 9 different health care institutions in different sites from North and Central America. The confidential and anonymous questionnaire addressed personal opinions regarding organ donation as well as other ethical/religious issues. Of 858 surveys conducted, 853 were completed. Among the participants, physicians accounted for 21.1% (n = 180), nurses 37.1% (n = 317), and other hospital workers 41.7% (n = 356). Respondents were almost equally divided into organ donors 45.7% (n = 392) and nondonors 53.7% (n = 461). Doctors and nurses were significantly more likely to be organ donors than other hospital workers (P < .043). An overwhelming majority of responders would accept an organ transplant if required (90.2%; n = 774). Organ donors were more likely to accept an organ transplant if required than nonorgan donors (96.4% [n = 370] vs 88.7% [n = 400], respectively; P < .001). Among health care providers, physicians and nurses tended to be more likely to be in favor of organ donation. The majority of the participants were willing to accept an organ, and there was a statistical correlation between disposition to donation and willingness to receive an organ. Copyright © 2015 Elsevier Inc. All rights reserved.

Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy

PubMed Central

Sarnaik, Ajit A.

2015-01-01

The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation. PMID:26636051

Gift Exchange Theory: a critique in relation to organ transplantation.

PubMed

Sque, M; Payne, S A

1994-01-01

Organ transplantation is becoming more important as a viable method of treatment for certain severe medical conditions. It is a complex and demanding process for all involved. Nursing as a developing science must respond to cultural and economic changes. Therefore, a need exists to develop a body of empirically based knowledge to understand and support the process of organ transplantation. This paper will argue that as trading in organs is unacceptable to the moral standards of western society and outlawed in many countries, an alternative framework must be considered for understanding the mechanisms through which organs are donated and utilized. The donating and receiving of organs may be equated with gift-giving, as there is no barter of commodities involved. Therefore, a useful framework to explore this phenomenon will be one that underpins the process of giving and receiving of gifts. Gift Exchange Theory will be evaluated and critically examined in relation to organ transplantation and the role of nurses in this process.

Many facets of reluctance: African Americans and the decision (not) to donate organs.

PubMed Central

Morgan, Susan E.

2006-01-01

Although the body of research on African Americans and organ donation continues to grow, the literature still suffers from a lack of reliance on theory to guide research as well as a surfeit of advanced statistical analytical strategies. A more sophisticated approach to understanding the barriers and facilitating factors that African Americans experience in the process of making the decision to become potential organ donors would yield more sound campaign strategies to increase donation. In this study, a sample of 310 African-American adult members of the NAACP was surveyed about their attitudes, knowledge and beliefs about organ donation. Logistic regression demonstrated that the level of knowledge, attitudes, social norms and altruism resulted in correct classification of organ donor card status in 69.3% of cases. When variables such as medical mistrust, bodily integrity and religiosity were added, an even more powerful model resulted, with 73.2% of the cases correctly classified according to organ donor card status. Recommendations for campaigns targeting African Americans' willingness to donate organs are offered. PMID:16749644

The Negative Impact of Death Anxiety on Self-Efficacy and Willingness to Donate Organs among Chinese Adults

ERIC Educational Resources Information Center

Wu, Anise M. S.; Tang, Catherine So-Kum

2009-01-01

Chinese people are consistently reported to be less likely to commit to posthumous organ donation than the Westerners. This study aims at investigating how death anxiety may hinder them from expressing their willingness to donate organs. Among 290 Hong Kong Chinese adults (age greater than or equal 25 years), a higher level of death anxiety was…

Living donation and cosmetic surgery: a double standard in medical ethics?

PubMed

Testa, Giuliano; Carlisle, Erica; Simmerling, Mary; Angelos, Peter

2012-01-01

The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation.

Recovery of transplantable organs after cardiac or circulatory death: Transforming the paradigm for the ethics of organ donation

PubMed Central

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2007-01-01

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. PMID:17519030

Organ donation and transplantation within the Zulu culture.

PubMed

Bhengu, B R; Uys, H H M

2004-08-01

Greater knowledge and technological advancement in the field of transplantation has increased the demand for organ donation beyond the supply of organs, especially among the black communities. This imbalance arises from the few sources of organs, limitations on the techniques of organ retrieval, disparities in the allocation of organs and socio-cultural factors. The aim of this study was to investigate the extent to which Zulu cultural norms and social structures influence an individual's decision to donate an organ or to undergo transplantation. A qualitative approach using an ethno-nursing method was selected. Semi-structured interviews were conducted with a transplant co-ordinator representing the professional sector, with traditional healers and religious leaders representing the folk sector, and with the general public representing the popular sector of the health care system. Both urban and rural settings were used. Conclusions arrived at showed that knowledge was lacking among Zulu speaking people about organ donation and transplantation and misconceptions about the topic were related to Zulu life patterns, beliefs about death, burial and life hereafter, and values and social structures. Recommendations with regard to the promotion of organ donation and transplantation among Zulu speaking people were made based on culture-sensitive and culture-congruent principles.

A public forum to promote organ donation amongst Asians: the Scottish initiative.

PubMed

Baines, Lyndsay S; Joseph, John T; Jindal, Rahul M

2002-03-01

There is a chronic shortage of organs for transplantation in the UK. This problem is particularly acute amongst Asians living within the UK. The Transplant Unit, University of Glasgow, joined forces with local businessmen to initiate a public meeting to promote awareness of transplant issues affecting Asians in the greater Glasgow area. During the Forum, we conducted a survey to determine the level of knowledge about organ transplantation, donation and willingness to donate, in relationship to the age, gender, marital status and religious affiliation amongst the attendees. The Forum was conducted at a public hall after publicity in the local press and Asian shops. The meeting was attended by over 300 people of Asian origin. Of the 90 survey forms handed out, 80 were returned fully completed. There was almost no opposition to organ donation, and many of the respondents were aware that religious leaders in the UK had endorsed organ donation. However, favourable disposition to these issues was not accompanied by carrying of the organ donor card, despite an awareness of the National Donor Register. The majority of the respondents were willing to undergo live organ donation, but were undecided about cadaveric donation. The issue of presumed consent drew mixed responses. Asians in the Glasgow region are not sympathetic to the matter of organ transplantation and donation, despite their recognition of the issues of organ shortage. We suggest that the matter needs to be further integrated into Asian culture by religious leaders and business persons. Our findings indicate that women over the age of 30 and based in the home may be in a unique position of influence by virtue of their position of centrality within the social network. This approach may also be suitable in other areas of the UK and the world with a large number of ethnic minorities.

Changing Metrics of Organ Procurement Organization Performance in Order to Increase Organ Donation Rates in the United States.

PubMed

Goldberg, D; Kallan, M J; Fu, L; Ciccarone, M; Ramirez, J; Rosenberg, P; Arnold, J; Segal, G; Moritsugu, K P; Nathan, H; Hasz, R; Abt, P L

2017-12-01

The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009-2012, 96,028 (3.3%) were a "possible deceased-organ donor." The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0-57.0%); and (2) organs transplanted per possible donor (range: 0.52-1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Perceptions, motivations, and concerns about living organ donation among people living with HIV.

PubMed

Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

2018-05-03

Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

Can evidence-based health policy from high-income countries be applied to lower-income countries: considering barriers and facilitators to an organ donor registry in Mumbai, India.

PubMed

Vania, Diana K; Randall, Glen E

2016-01-13

Organ transplantation has become an effective means to extend lives; however, a major obstacle is the lack of availability of cadaveric organs. India has one of the lowest cadaver organ donation rates in the world. If India could increase the donor rate, the demand for many organs could be met. Evidence from high-income countries suggests that an organ donor registry can be a valuable tool for increasing donor rates. The purpose of this study is to determine whether the implementation of an organ donor registry is a feasible and appropriate policy option to enhance cadaver organ donation rates in a lower-income country. This qualitative policy analysis employs semi-structured interviews with physicians, transplant coordinators, and representatives of organ donation advocacy groups in Mumbai. Interviews were designed to better understand current organ donation procedures and explore key informants' perceptions about Indian government health priorities and the likelihood of an organ donor registry in Mumbai. The 3-i framework (ideas, interests, and institutions) is used to examine how government decisions surrounding organ donation policies are shaped. Findings indicate that organ donation in India is a complex issue due to low public awareness, misperceptions of religious doctrines, the need for family consent, and a nation-wide focus on disease control. Key informants cite social, political, and infrastructural barriers to the implementation of an organ donor registry, including widely held myths about organ donation, competing health priorities, and limited hospital infrastructure. At present, both the central government and Maharashtra state government struggle to balance international pressures to improve overall population health with the desire to also enhance individual health. Implementing an organ donor registry in Mumbai is not a feasible or appropriate policy option in India's current political and social environment, as the barriers, identified through the 3-i framework lens, may be too difficult to overcome. Despite the evidence supporting the use of donor registries as a means to enhance organ donation rates, it is clear that context is critical and that it is not always practical to apply evidence-based policy solutions from high-income countries to lower-income settings.

A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation

PubMed Central

Siminoff, Laura A.; Molisani, Anthony J.

2015-01-01

BACKGROUND AND OBJECTIVES: Although existing studies suggest that factors affecting families’ decisions regarding pediatric organ donation mirror those for adult patients, health professionals working in this area maintain that pediatric and adult decision-makers differ in significant ways. This study compared the request process, experiences, and authorization decisions between family decision-makers (FDMs) of adult and pediatric donors and nondonors. METHODS: Perceptions of the donation request were collected via telephone interviews with 1601 FDMs approached by staff from 9 US organ procurement organizations (OPOs). Authorization regarding donation (ie, authorized/refused) was obtained from FDM reports and verified by using OPO records. Tests of association were used to estimate differences between FDMs of adult and pediatric patients. A logistic regression analysis was conducted to identify variables predicting FDM authorization. RESULTS: FDMs of children were significantly more likely to authorize donation than were FDMs of adults (89.7% vs 83.2%; χ2 = 6.2, P = .01). Differences were found between pediatric and adult families’ initial feelings toward donation, donation-related topics discussed, communication behaviors and techniques used, perceptions of the request, and receipt and preference of grief information. The likelihood of FDM authorization increased with the number of topics discussed and communication skills employed during requests. Authorization was not predicted by patient age (ie, adult versus pediatric). CONCLUSIONS: FDMs of children are willing to donate and experience no more psychological distress from the request for donation than do FDMs of adults. Communication emerged as a critical factor of family authorization, reinforcing its importance in requests for donation. PMID:26034251

Knowledge and Attitudes Toward Organ Donation in Health Care Undergraduate Students in Italy.

PubMed

Fontana, F; Massari, M; Giovannini, L; Alfano, G; Cappelli, G

2017-11-01

The number of organ donors in Italy is increasing, but with still disappointing living donation activity and relatively frequent objection by potential deceased donors' relatives to organ recovery. Few studies have assessed health care students' knowledge and attitude on donation. We administered a questionnaire to medical (MS) and nursing students (NS) at University of Modena and Reggio Emilia, Italy, and 749 students (406 MS and 343 NS) completed the questionnaire. Although 95% of students were in favor of donation, only 21.9% of NS and 24.9% of MS were registered as donors. One quarter of students reported family disagreement. MS appeared more confident with personnel involved in donation. Overall, 60% of students knew the term donation after brain death but only 40% were aware of the criteria used to define it. Barely 27.1% of NS and 15.3% of MS believed they had received sufficient information in lessons. Backward logistic regression demonstrated that students whose families agree with them and who knew the definition of donation after brain death were more likely to express the disposition of registering, and those who showed distrust in the declaration of brain death were half as likely to register as donors. Students expressed a lack of knowledge, controversial attitudes on donation, and strong need for education; increased awareness may help increase donation rates. The majority of educational institutions in Italy do not directly address training on organ donation and transplantation for health care students; an integrated curriculum favoring interpersonal discussion including practical aspects is urgently required. Copyright © 2017 Elsevier Inc. All rights reserved.

A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation.

PubMed

Siminoff, Laura A; Molisani, Anthony J; Traino, Heather M

2015-07-01

Although existing studies suggest that factors affecting families' decisions regarding pediatric organ donation mirror those for adult patients, health professionals working in this area maintain that pediatric and adult decision-makers differ in significant ways. This study compared the request process, experiences, and authorization decisions between family decision-makers (FDMs) of adult and pediatric donors and nondonors. Perceptions of the donation request were collected via telephone interviews with 1601 FDMs approached by staff from 9 US organ procurement organizations (OPOs). Authorization regarding donation (ie, authorized/refused) was obtained from FDM reports and verified by using OPO records. Tests of association were used to estimate differences between FDMs of adult and pediatric patients. A logistic regression analysis was conducted to identify variables predicting FDM authorization. FDMs of children were significantly more likely to authorize donation than were FDMs of adults (89.7% vs 83.2%; χ(2) = 6.2, P = .01). Differences were found between pediatric and adult families' initial feelings toward donation, donation-related topics discussed, communication behaviors and techniques used, perceptions of the request, and receipt and preference of grief information. The likelihood of FDM authorization increased with the number of topics discussed and communication skills employed during requests. Authorization was not predicted by patient age (ie, adult versus pediatric). FDMs of children are willing to donate and experience no more psychological distress from the request for donation than do FDMs of adults. Communication emerged as a critical factor of family authorization, reinforcing its importance in requests for donation. Copyright © 2015 by the American Academy of Pediatrics.

Impact of gender and professional education on attitudes towards financial incentives for organ donation: results of a survey among 755 students of medicine and economics in Germany

PubMed Central

2014-01-01

Background There is an ongoing expert debate with regard to financial incentives in order to increase organ supply. However, there is a lacuna of empirical studies on whether citizens would actually support financial incentives for organ donation. Methods Between October 2008 and February 2009 a quantitative survey was conducted among German students of medicine and economics to gain insights into their point of view regarding living and deceased organ donation and different forms of commercialization (n = 755). Results The average (passive) willingness to donate is 63.5% among medical students and 50.0% among students of economics (p = 0.001), while only 24.1% of the respondents were actually holding an organ donor card. 11.3% of students of economics had signed a donor card, however, the number is significantly higher among students of medicine (31.9%, p < 0.001). Women held donor cards significantly more often (28.6%) than men (19.4%, p = 0.004). The majority of students were against direct payments as incentives for deceased and living donations. Nevertheless, 37.5% of the respondents support the idea that the funeral expenses of deceased organ donors should be covered. Women voted significantly less often for the coverage of expenses than men (women 31.6%, men 44.0%, p = 0.003). The number of those in favor of allowing to sell one’s organs for money (living organ donation) was highest among students of economics (p = 0.034). Conclusion Despite a generally positive view on organ donation the respondents refuse to consent to commercialization, but are in favor of removing disincentives or are in favor of indirect models of reward. PMID:24996438

Attitude towards organ donation in German medical students.

PubMed

Terbonssen, Tobias; Settmacher, Utz; Wurst, Christine; Dirsch, Olaf; Dahmen, Uta

2016-12-01

It is well known that personal decision making in respect to organ donation is highly dependent on the balance of knowledge, trust, and fear. We wanted to explore the attitude of German medical students towards organ donation and investigate the relationship between knowledge, trust, and fear in this special subgroup. We conducted an online survey utilizing (1) the snowball effect of using Facebook groups and advertisement as well as (2) mailing lists of medical faculties in Germany for distribution. We surveyed 1370 medical students. 75.8 % (N = 988) of the participants stated to carry an organ donor card and allowed their organs to be donated. 1.8 % (N = 23) refused donation. 22.5 % (N = 293) did not carry an organ donor card. Analysis of the "decided" versus the "undecided" group revealed substantial differences regarding transplantation knowledge (mean knowledge score of 4.23 vs. 3.81; P < 0.001), trust in (mean trust score 4.11 vs. 3.39; P < 0.001), and fear of (mean fear score 1.63 vs. 2.22; P < 0.001) organ donation. 45.9 % of the undecided group (N = 134) opted for accessing additional information material. After reading the info material, 22.7 % (N = 29) stated their willingness to sign a donor card, whereas 76.6 % (N = 98) still could not reach a decision. The willingness to potentially act as organ donor was related to the pre-existent knowledge, trust, and fear. Access to information material did promote the decision towards organ donation in a group of previously undecided medical students. This advocates initiating information campaigns even in population groups with strong medical background.

Impact of gender and professional education on attitudes towards financial incentives for organ donation: results of a survey among 755 students of medicine and economics in Germany.

PubMed

Inthorn, Julia; Wöhlke, Sabine; Schmidt, Fabian; Schicktanz, Silke

2014-07-05

There is an ongoing expert debate with regard to financial incentives in order to increase organ supply. However, there is a lacuna of empirical studies on whether citizens would actually support financial incentives for organ donation. Between October 2008 and February 2009 a quantitative survey was conducted among German students of medicine and economics to gain insights into their point of view regarding living and deceased organ donation and different forms of commercialization (n = 755). The average (passive) willingness to donate is 63.5% among medical students and 50.0% among students of economics (p = 0.001), while only 24.1% of the respondents were actually holding an organ donor card. 11.3% of students of economics had signed a donor card, however, the number is significantly higher among students of medicine (31.9%, p < 0.001). Women held donor cards significantly more often (28.6%) than men (19.4%, p = 0.004). The majority of students were against direct payments as incentives for deceased and living donations. Nevertheless, 37.5% of the respondents support the idea that the funeral expenses of deceased organ donors should be covered. Women voted significantly less often for the coverage of expenses than men (women 31.6%, men 44.0%, p = 0.003). The number of those in favor of allowing to sell one's organs for money (living organ donation) was highest among students of economics (p = 0.034). Despite a generally positive view on organ donation the respondents refuse to consent to commercialization, but are in favor of removing disincentives or are in favor of indirect models of reward.

Standardized deceased donor kidney donation rates in the UK reveal marked regional variation and highlight the potential for increasing kidney donation: a prospective cohort study†

PubMed Central

Summers, D. M.; Johnson, R. J.; Hudson, A. J.; Collett, D.; Murphy, P.; Watson, C. J. E.; Neuberger, J. M.; Bradley, J. A.

2014-01-01

Background The UK has implemented a national strategy for organ donation that includes a centrally coordinated network of specialist nurses in organ donation embedded in all intensive care units and a national organ retrieval service for deceased organ donors. We aimed to determine whether despite the national approach to donation there is significant regional variation in deceased donor kidney donation rates. Methods The UK prospective audit of deaths in critical care was analysed for a cohort of patients who died in critical care between April 2010 and December 2011. Multivariate logistic regression was used to identify the factors associated with kidney donation. The logistic regression model was then used to produce risk-adjusted funnel plots describing the regional variation in donation rates. Results Of the 27 482 patients who died in a critical care setting, 1528 (5.5%) became kidney donors. Factors found to influence donation rates significantly were: type of critical care [e.g. neurointensive vs general intensive care: OR 1.53, 95% confidence interval (CI) 1.34–1.75, P<0.0001], patient ethnicity (e.g. ‘Asian’ vs ‘white’: OR 0.17, 95% CI 0.11–0.26, P<0.0001), age (e.g. age >69 vs age 18–39 yr: OR 0.2, 0.15–0.25, P<0.0001), and cause of death [e.g. ‘other’ (excluding ‘stroke’ and ‘trauma’) vs ‘trauma’: OR 0.04, 95% CI 0.03–0.05, P<0.0001]. Despite correction for these variables, kidney donation rates for the 20 UK kidney donor regions showed marked variation. The overall standardized donation rate ranged from 3.2 to 7.5%. Four regions had donation rates of >2 standard deviations (sd) from the mean (two below and two above). Regional variation was most marked for donation after circulatory death (DCD) kidney donors with 9 of the 20 regions demonstrating donation rates of >2 sd from the mean (5 below and 4 above). Conclusions The marked regional variation in kidney donation rates observed in this cohort after adjustment for factors strongly associated with donation rates suggests that there is considerable scope for further increasing kidney donation rates in the UK, particularly DCD. PMID:24335581

History of deceased organ donation, transplantation, and organ procurement organizations.

PubMed

Howard, Richard J; Cornell, Danielle L; Cochran, Larry

2012-03-01

The historical development of deceased organ donation, transplantation, and organ procurement organizations is reviewed. The concept of transplantation, taking parts from one animal or person and putting them into another animal or person, is ancient. The development of organ transplantation brought on the need for a source of organs. Although many early kidney transplants used kidneys from living donors, these donors could not satisfy the ever-growing need for organs, and extrarenal organs were recovered only from deceased donors. This need for organs to satisfy the great demand led to specialized organizations to identify deceased donors, manage them until recovery occurred, and to notify transplant centers that organs were available for their patients. The functions of these organ procurement organizations expanded to include other required functions such as education, accounting, and compliance with state and federal requirements. Because of the shortage of organs relative to the demand, lack of a unified organ allocation system, the perception that organs are a national resource and should be governed by national regulations, and to improve results of organ procurement organizations and transplant centers, the federal government has regulated virtually all phases of organ procurement and transplantation.

In their own words: the reasons why people will (not) sign an organ donor card.

PubMed

Morgan, Susan E; Harrison, Tyler R; Afifi, Walid A; Long, Shawn D; Stephenson, Michael T

2008-01-01

This multisite, qualitative study of 78 family-pair dyads provides rich data on the reasons people cite for (not) wanting to sign an organ donor card in the context of family conversations. In this study, dyads were videotaped as they discussed 8 questions pertaining to their views on organ donation, beginning with the most general opinions and progressing to more detailed questions. Analysis of the transcribed data revealed that the most common reasons for wanting to donate organs were based on religion or a desire to help other people in need. The most common reasons cited for not wanting to donate organs were mistrust (of doctors, hospitals, and the organ allocation system), a belief in a black market for organs in the United States, and deservingness issues (that one's organs would go to someone who brought on his or her own illness, or who could be a "bad person"). One of the most surprising findings is that religion is offered far more often as a rationale for wanting to help sick people through organ donation than it was for not wanting to donate organs. These findings both support and contradict past studies based on quantitative survey data. Implications for the construction of more effective future organ donor campaigns are discussed.

If you needed an organ transplant would you have one? The effect of reciprocity priming and mode of delivery on organ donor registration intentions and behaviour.

PubMed

O'Carroll, Ronan E; Haddow, Lorna; Foley, Laura; Quigley, Jody

2017-09-01

There are approximately 6,500 people on the UK national transplant waiting list, around 400 of whom die every year. Only 35% of the UK population are currently on the organ donation register. We report two studies examining whether a reciprocity prime, in which participants were asked whether they would accept a donated organ, increased organ donation intentions and behaviour. Between-participants, randomized controlled design. In two studies, participants who were not currently registered organ donors took part either face-to-face or online and were randomly allocated to a reciprocity prime or control condition. Following the manipulation, they were asked to indicate, on either a paper or online questionnaire, their intention to join the organ donor register. Study 2 was similar to Study 1 but with the addition that after reporting intention, participants were then offered an organ donation information leaflet or the opportunity to click a link for further information (proxy behavioural measure). In both studies, reciprocity primed participants reported greater intentions to register than controls. However, in Study 2, no effect on donation behaviour was found. Reciprocal altruism may be a useful tool in increasing intentions to join the organ donor register. Further evaluation is required to determine whether this increase in intention can be translated into organ donation behaviour. Statement of contribution What was already known? Demand for organs in the United Kingdom far outstrips supply, so finding strategies to increase registration on the organ donor register could save hundreds of lives per year. Despite the majority of people in the United Kingdom agreeing that organ donation is a good thing, most people do not register as donors. A limited amount of evidence of the impact of perceived reciprocity suggests that encouraging people to consider themselves as recipients and priming ideas of shared responsibility may increase the likelihood of their subsequent willingness to register. What does this study add? Novel evidence that employing a simple reciprocity prime increases organ donor registration intentions. Replication of findings across two separate studies. Novel examination of the impact of mode of delivery of messages to encourage organ donation. A basis for further research into the translation of intentions into organ donor registration behaviour. © 2017 The British Psychological Society.

Ethical issues in non-heart-beating donation.

PubMed

Papalois, Vassilios; Vlachos, Konstantinos; Barlas, Alexander; Zarka, Zaki Anas; El-Tayar, Adil; Hakim, Nadey S

2004-10-01

A shortage of organ donors and the large number of patients desperately waiting for kidney transplant have led to the search for new sources of transplantable organs. The waiting list has grown at an alarming rate resulting in increased waiting times and deaths. The introduction of non heart beating (NHB) donation programmes generates a lot of ethical issues. How should death of a patient be defined in the case of NHB donation? Is there a strict separation of responsibilities of the medical teams in the different phases of the procedure (patient treatment and actual donation)? How should consent be obtained? Is sufficient respect and care given to the patient and his family? How is the viability of the organs assessed and how should the organs be allocated? We believe that it is very important to debate these issues and to try to outline an ethical framework for NHB donation that can enjoy the widest possible community support.

Public ideas and values concerning the commercialization of organ donation in four European countries.

PubMed

Schweda, Mark; Schicktanz, Silke

2009-03-01

Against the background of the increasing academic and political debate on financial incentives for organ donation, we conducted a qualitative investigation on the conditions under which European citizens would actually consider or refuse financial incentives for organ donation. Our paper combines an analysis of data that were collected in eight Focus Group discussions on transplantation medicine with lay people and patients from four European countries (Cyprus, Germany, the Netherlands, and Sweden) with a critical re-assessment of the dichotomy between gift and commodity in the recent political and academic discourse. We find that the distinction between living and post mortem donation on the one hand, and between different models of financial incentives on the other, plays a crucial role for the participants' values and ideas about organ donation. We discuss the significance of our results with particular respect to the central role of reciprocity and draw conclusions for the bioethical and biopolitical debate.

[Knowledge and attitudes toward organ donation among health professionals in a third level hospital].

PubMed

Montero Salinas, Alejandro; Martínez-Isasi, Santiago; Fieira Costa, Eva; Fernández García, Antón; Castro Dios, Diana Josefa; Fernández García, Daniel

2018-04-18

The Spanish model is the model adopted by many countries to increase their donation rate, being the implication of the healthcare professionals one of the keys to this success. The attitude of these before the donation is crucial for the hour of influence on the population. Organ transplantation has been established as an effective treatment that has been improving over the years. The objective was to determine the knowledge and attitudes of health professionals before the donation of organs. Cross-sectional descriptive study. An ad hoc questionnaire was conducted and distributed among the health professionals (medical staff, nurses and nursing assistants) of a tertiary hospital during February 2015. A total of 615 potential participants were estimated in the different areas of the hospital. A total of 342 completed questionnaires were collected (55%). The statistical analysis with SPSS® Statistics for Windows. Version 20.0. A level of significance P lower than 0.05 was used in all the analyses. The average age of the respondents was 43.34 (SD = 10.37) years, being 86.6% women and 60% nurses. 35.5% showed good knowledge about the donation process, being higher in men (51.1% Vs 33.1%, p lower than 0.05), medical personnel (55% vs 34.3% vs 31.9%). %; p lower than 0.05) and lower in those services with a direct relationship with the donation process (36.8% vs 31.9%, p lower than 0.05). 71% of the professionals expressed their willingness to donate their organs, with special sensitivity towards donation those services in direct relation with the donation program (82.2% vs 65.9%, OR: 1.24, p lower than 0.001 ). 50% of the professionals would donate the organs of a family member; the medical group had the highest percentage (70% vs 50.7% vs 40.4%, OR: 3.8, p lower than 0.05). 74.5% knew some Spanish legal document about donation and transplants. Health professionals as a whole have a low level of knowledge; but a good attitude towards donation.

Does quality improvement work? Evaluation of the Organ Donation Breakthrough Collaborative.

PubMed

Howard, David H; Siminoff, Laura A; McBride, Virginia; Lin, Monica

2007-12-01

The Organ Donation Breakthrough Collaborative is a quality improvement initiative to encourage adoption of "best practices" for identifying potential donors and obtaining consent for deceased organ donation. We evaluate the impact of the first phase on organ donation rates. We study donation rates in the 95 hospitals that participated in the first phase and a control group of 125 hospitals. We use a controlled pre/post design. The preperiod is the year before the start of the Collaborative (September 2002 to August 2003), the postperiod is the final 6 months of the first phase (March 2004 to August 2004). We use administrative data from the Organ Procurement and Transplantation Network to compute the conversion rate in each hospital group and time period. The conversion rate is the proportion of eligible donors who became actual donors. Preperiod conversion rates in Collaborative and control hospitals were similar: 52 and 51 percent, respectively. In the postperiod, the conversion rate increased to 60 percent among Collaborative hospitals and remained at 51 percent among control hospitals. The relative change was 8 percentage points (95 percent confidence interval: 2-13: p<.001). Our findings suggest that the Breakthrough Collaborative led to an increase in donation rates at participating hospitals.

Family, friends, and faith: how organ donor families heal.

PubMed

Stouder, Donald B; Schmid, Adam; Ross, Sharon S; Ross, Larry G; Stocks, Lisa

2009-12-01

Understanding how organ donors' families recover from their grief can help organ procurement organizations improve consent rates and increase the number of deceased donor organs available for transplant. To determine what helps the loved ones of deceased organ donors heal from their grief and loss, and to better understand families' needs during the consent process as a way of improving overall consent rates for organ donation. Written survey of all organ and tissue donors' families in the San Diego and Imperial County (California) service area during 2006 and 2007. Responses to the 20-question survey addressing factors that help healing from grief, as well as contextual information about the families' experience at the hospital and the consent process. Most respondents (84%) indicated that family support was the most helpful thing in dealing with their grief, followed by the support of friends (74%) and religious and cultural beliefs (37%). Most (75%) indicated that they agreed to donation so that something positive could result from their loss. Most respondents (93%) felt that they were given enough information to make an informed decision about donation, and 6% indicated that the donation process interfered with funeral or memorial arrangements. More than 95% understood that their loved one had died before they were approached for consent. Consistent with previous studies, 12% said they still had unanswered questions about aspects of donation, and 15% of respondents indicated that the discussion about organ donation added more emotional stress to their overall experience.

The influence of sociocultural factors on organ donation and transplantation in Korea: findings from key informant interviews.

PubMed

Kim, Jung Ran; Elliott, Doug; Hyde, Cheryl

2004-04-01

Although brain death was formally recognized in Korea in 2000 for the purpose of organ donation, traditional Confucian-based thought still prevails. The aim of this study was to explore sociocultural perspectives that influence health professionals' attitudes and perceptions regarding organ donation. Semistructured interviews were conducted with nine key informants from three major hospitals providing transplant services in South Korea. Several themes were identified as barriers to organ donation: Confucianism, misunderstandings and myths, organs as spare for selling, lack of clarity in the definition of death in the new legislation, and limited medical insurance coverage. It remains difficult for brain death to be accepted as true death, and there is currently a poor rate of organ procurement. Findings of the study will help identify socioculturally appropriate strategies to promote acceptance and accessibility of organ transplantation among South Koreans.

Should We Formulate an Incentivized Model Facilitating Kidney Donation from Living Donors? A Focus on Turkey's Current System.

PubMed

Avci, Ercan

2018-04-23

Kidney transplantation is a lifesaving medical treatment. However, very high demand for kidneys with low kidney donation causes a black market that exploits patients' desperation and donors' vulnerability. The current kidney donation programs fail to produce promising results to avoid illegal and unethical kidney trafficking and commercialism. Even though the primary goal of kidney donation is to increase the number of deceased organ donations, in some countries, like Turkey, due to religious or cultural concerns, it is impossible to supply adequate deceased kidney donations. In this view, the aim of this paper is to examine kidney trafficking in the scope of Turkey's current organ donation system and propose a new model, named the Incentivized Kidney Donation Model (IKDM), to increase kidney donation from living donors. The model encompasses the following benefits offered to kidney donors; lifetime health insurance, exemptions from copayments/contribution shares, priority when receiving an organ, priority when finding a job, income tax exemptions for salaried employees, and free or discounted public utilities. This normative model has the potential to promote donors' altruistic acts as well as the solidarity and loyalty among members of a society without violating ethical values and internationally accepted principles. © 2018 John Wiley & Sons Ltd.

Coercion, dissatisfaction, and social stigma: an ethnographic study of compensated living kidney donation in Iran.

PubMed

Fry-Revere, Sigrid; Chen, Deborah; Bastani, Bahar; Golestani, Simin; Agarwal, Rachana; Kugathasan, Howsikan; Le, Melissa

2018-02-26

This article updates the qualitative research on Iran reported in the 2012 article by Tong et al. "The experiences of commercial kidney donors: thematic synthesis of qualitative research" (Tong et al. in Transpl Int 25:1138-1149, 2012). The basic approach used in the Tong et al. article is applied to a more recent and more comprehensive study of Iranian living organ donors, providing a clearer picture of what compensated organ donation is like in Iran since the national government began regulating compensated donation. Iran is the only country in the world where kidney selling is legal, regulated, and subsidized by the national government. This article focuses on three themes: (1) coercion and other pressures to donate, (2) donor satisfaction with their donation experience, and (3) whether donors fear social stigma. We found no evidence of coercion, but 68% of the paid living organ donors interviewed felt pressure to donate due to extreme poverty or other family pressures. Even though 27% of the living kidney donors interviewed said they were satisfied with their donation experience, 74% had complaints about the donation process or its results, including some of the donors who said they were satisfied. In addition, 84% of donors indicated they feared experiencing social stigma because of their kidney donation.

An assessment of advance relatives approach for brain death organ donation.

PubMed

Michaut, Carine; Baumann, Antoine; Gregoire, Hélène; Laviale, Corinne; Audibert, Gérard; Ducrocq, Xavier

2017-01-01

Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'. The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses' attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.

An investigation into the factors effective in the consent of families with brain-dead patients candidates for organ donation in Isfahan, Iran in 2012-13

PubMed Central

Khajooei, Maryam Khalifehsoltani; Zamani, Fereshteh; Mehr, Asieh Maghami

2016-01-01

Background: Studies have shown that, with regard to social, cultural, and institutional contexts, several factors affect family decision-making on organ donation. This study aimed to investigate the effective factors in organ donation by family members with brain-dead patients. Materials and Methods: This was a descriptive-comparative study in which a researcher-made questionnaire was used to collect data. The reliability of the questionnaire was obtained as 0.81 using Cronbach's alpha. The study sample consisted of 85 members of families with brain-dead patients in Isfahan, Iran in 2012–13. The collected data were analyzed using the Statistical Package for the Social Sciences version 20.0, and the level of significance was considered as <0.05. Results: The obtained results indicated that factors such as age, marital status, level of education, and cause of brain death did not have any effect on their families consent, whereas factors such as gender, duration of hospitalization, having an organ donation card, personal view of the brain-dead patient, and the number of patient's children had a significant relationship with the consent on organ donation. In addition, the care and treatment team were effective in family decisions regarding organ donation. Conclusions: In general, the necessary culture and increasing the population awareness and their knowledge can be a positive step in this regard and may bring about an easy and rapid acceptance of organ donation by the involved families. PMID:28194201

The global diffusion of organ transplantation: trends, drivers and policy implications

PubMed Central

Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-01-01

Abstract Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory’s data to describe the current distribution of – and trends in – transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization’s Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network. PMID:25378744

The First 2 Years of Activity of a Specialized Organ Procurement Center: Report of an Innovative Approach to Improve Organ Donation.

PubMed

Marsolais, P; Durand, P; Charbonney, E; Serri, K; Lagacé, A-M; Bernard, F; Albert, M

2017-06-01

The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized organ procurement center (OPC) with dedicated intensive care unit (ICU) beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians, and multidisciplinary staff. All organ donors within a designated geographic area were transferred to and managed within the OPC. During the first 2 years of operation, 126 patients were referred to the OPC. The OPC was in use for a total of 3527 h and involved 253 health workers. We retrieved 173 kidneys, 95 lungs, 68 livers, 37 hearts, and 13 pancreases for a total of 386 organs offered for transplantation. This translates to a total of 124.6 persons transplanted per million population, which compares most favorably to recently published numbers in developed countries. The OPC clearly demonstrates potential to increase the number of deceased donor organs available for transplant. Further studies are warranted to better understand the exact influence of the different components of the OPC on organ procurement. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Increasing organ donation by presumed consent and allocation priority: Chile.

PubMed

Zúñiga-Fajuri, Alejandra

2015-03-01

Chile, a middle-income country, recently joined Israel and Singapore as the world's only countries to require reciprocity as a precondition for organ transplantation. The Chilean reform includes opt-out provisions designed to foster donation and priority for organ transplantation for registered people. Although the reform has had serious difficulties in achieving its mission, it can be reviewed by other countries that seek to address the serious shortage of organs. As increased organ donation can substantially enhance or save more lives, the effect on organ availability due to incentives arising from rules of preference should not be underestimated.

Preliminary marked increase in the national organ donation rate in Israel following implementation of a new organ transplantation law.

PubMed

Lavee, J; Ashkenazi, T; Stoler, A; Cohen, J; Beyar, R

2013-03-01

Israel's organ donation rate has always been among the lowest in Western countries. In 2008 two new laws relevant to organ transplantation were introduced. The Brain-Respiratory Death Law defines the precise circumstances and mechanisms to determine brain death. The Organ Transplantation Law bans reimbursing transplant tourism involving organ trade, grants prioritization in organ allocation to candidates who are registered donors and removes disincentives for living donation by providing modest insurance reimbursement and social supportive services. The preliminary impact of the gradual introduction and implementation of these laws has been witnessed in 2011. Compared to previous years, in 2011 there was a significant increase in the number of deceased organ donors directly related to an increase in organ donation rate (from 7.8 to 11.4 donors per million population), in parallel to a significant increase in the number of new registered donors. In addition the number of kidney transplantations from living donors significantly increased in parallel to a significant decrease in the number of kidney transplantations performed abroad (from 155 in 2006 to 35 in 2011). The new laws have significantly increased both deceased and living organ donation while sharply decreasing transplant tourism. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Altruism and Religion: A New Paradigm for Organ Donation.

PubMed

Rabinowich, Aviad; Jotkowitz, Alan

2018-02-01

Activity of NGO's supporting living donor kidney donations can affect the shortage of kidneys. Matnat Chaim is a Jewish orthodox organization active in Israel since 2009. This is a voluntary organization with aims to shorten and eliminate the waiting list for kidneys. Since the beginning of its activity, it has said to play a key role in 379 kidney transplantations. In 2015, out of 174 live donor kidney transplantations that took place in Israel, Matnat Chaim had a key role in 88 of them (50.6%). We found some ethical issues concerning the organization's activity. The donor can restrict his or her donation to specific characteristics of recipient which can result in organs transplanted in a homogeneous group of the population. Another issue is the question of whether nudging people to kidney donation takes place and whether it is valid to do so. We found that Matnat Chaim does a great deal for promotion and intermediation of kidney donations in Israel. This form of promotion can be implemented by other organizations and countries.

Ethical issues with informed consent from potential living kidney donors.

PubMed

Petrini, C

2010-05-01

Living organ donation and participation in clinical research trials have several features in common from an ethical perspective. The primary similarity is risk justification: the risk of harm to living organ donors and clinical research participants is justified by a resulting benefit to one or more other individuals. Some authors hold that organ donation and clinical trial participation are full-fledged duties. Such an implicit likening of the two leads to several considerations regarding informed consent in each situation. Informed consent raises ethical concerns in every medical context, and some of those concerns, such as competence, understanding, autonomy, and free or voluntary choice, are uniquely relevant to living organ donation and clinical trial participation. Most countries regulate informed consent procedures for living organ donation in great detail, and although informed consent procedures for clinical trial participation are somewhat less detailed, their rules are subject to review by ethics committees. It would be constructive for research participation informed consent procedures and living organ donation informed consent procedures to learn from one another. Copyright (c) 2009 Elsevier Inc. All rights reserved.

Algerian Immigrants to Spain: Study of Attitude to the Donation of Organs for Transplantation.

PubMed

Ríos, A; Carrillo, J; López-Navas, A I; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Sebastián, M J; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

Many Africans are emigrating to the European Economic Community from countries with little knowledge of transplantation. This population has not yet been studied. Analyze the attitude toward donation among the Algerian population living in Spain. We studied the population born in Algeria and residing in Spain, over 15 years old, and stratified by age and sex. Attitude was surveyed using a questionnaire of organ donation for transplantation ("PCID-DTO Ríos"). Support from African immigration associations was needed to advise on the location of potential respondents. The completion was anonymous and self-administered. Verbal consent was obtained to assist in the study. Of the 441 respondents, 27% (n = 119) were in favor of donation after death, 43% (n = 191) were against, and 30% (n = 131) were undecided. The variables associated with the attitude toward the donation were sex (P = .033), having offspring (P = .027), having commented on the subject of organ transplantation at the family level (P < .001), attitude (P < .001), religion (P < .001), and partner's opinion on organ donation and transplantation (P < .001). Only 16% of the respondents have known a transplant recipient or donor, with this subgroup having the most favorable attitude (68% vs 19%, P < .001). The Algerian population emigrant to Spain has a very unfriendly attitude toward the donation of their own organs. Copyright © 2017 Elsevier Inc. All rights reserved.

Attitudes toward death criteria and organ donation among healthcare personnel and the general public.

PubMed

DuBois, James M; Anderson, Emily E

2006-03-01

To examine attitudes toward death criteria and their relation to attitudes and behaviors regarding organ donation. This article reviews empirical studies on the attitudes of healthcare personnel and the general public regarding death criteria and organ donation. The review was restricted to studies that had as a primary focus attitudes toward 1 or more of the following 3 specific criteria for determining death: (1) brain death, the irreversible loss of all functions of the entire brain; (2) higher brain death, the loss of cerebral cortex function alone; and (3) the circulatory-respiratory criteria commonly used in donation after cardiac death. Studies consistently show that the general public and some medical personnel are inadequately familiar with the legal and medical status of brain death; attitudes toward the dead donor rule are strong predictors of willingness to donate organs using controversial criteria; concerns about donation after cardiac death surround the withdrawal of life support more than the actual death criteria used; and concerns about death criteria correlate with less favorable attitudes toward organ donation. Both general and ethical education may serve to guide policy and facilitate family member requests and informed consent dialogues. Furthermore, helping families to understand and accept not only medical and legal criteria for determining death, but also ethical criteria for withdrawing life support may help them be more comfortable with their decisions.

Two perspectives on organ donation: experiences of potential donor families and intensive care physicians of the same event.

PubMed

Sanner, Margareta A

2007-12-01

The aim was to explore how relatives and physicians understood cases where organ donation had been requested and what factors were salient for the decision on donation. Physicians of 25 deceased patients and 20 relatives were interviewed. The material was analyzed using qualitative methods. Eleven patients had declared their wishes on donation before death; in 14 cases the relatives had to decide. Half of these relatives accepted donation and half refused. The donation request was of secondary importance to the families; they were totally occupied by the death and initially tried to avoid the request by regarding "no" as a nonresponse. They needed support to relieve their immediate reactions of uneasiness, start rational thought processes, and reach well-grounded answers. The basis for requesting donation was good; relatives, with regard to circumstances, had been well prepared for the death by continuous information from the physicians and had confidence in staff, accepted that the question was raised, and understood the death criteria. However, about half the physicians experienced conflicts regarding prerequisites of procuring organs and dealing with relatives. Three different approaches were displayed: prodonation, neutral, and ambivalent. Only physicians with a prodonation approach received acceptance for donation.

Knowledge and attitudes of health care professionals toward organ donation and transplantation.

PubMed

Alsaied, Osama; Bener, Abdulbari; Al-Mosalamani, Yousuf; Nour, Bakr

2012-11-01

To identify and assess the level of knowledge and attitudes of health care professionals (HCP) in Qatar toward organ donation and transplantation, this cross-sectional study was carried out from October 2007 to February 2008 in the Accident and Emergency Departments and Intensive Care Units of the hospitals of the Hamad Medical Corporation (HMC). A representative sample of 585 HCP working in the hospitals of the HMC was approached and 418 staff gave consent to participate in the study (71.5%). 36.8% were physicians, 48.6% nurses and 14.6% Emergency Medical Service (EMS) technicians. Of the surveyed HCP, 40.7% were males and 59.3% were females. Majority of the staff were in the age group of 30-39 years (58.6%). More than half of the physicians (59.7%) and technicians (57.4%) assumed that organs can be bought and sold in the State of Qatar. Most of the physicians (76.6%) and nurses (75.9%) knew that brain-dead persons are eligible for organ donation, whereas only 57.4% of the EMS technicians thought so. Majority of the HCP supported organ donation; physicians (89.0%), nurses (82.3%) and technicians (70.5%). The attitude of the physicians (24.0%) and nurses (20.2%) to donate a kidney to a family member was very poor compared with the attitude of the technicians (44.3%). Although the HCP support organ donation (83%), more than half of the physicians (51.3%), nurses (61.6%) and technicians (54.1%) wanted to be buried with all their organs intact. The findings, although they give cause for hope, suggest that there is much work yet to be done before organ donation and transplantation can become fully accepted by the medical community in Qatar.

Increasing the supply of kidneys for transplantation by making living donors the preferred source of donor kidneys.

PubMed

Testa, Giuliano; Siegler, Mark

2014-12-01

At the present time, increasing the use of living donors offers the best solution to the organ shortage problem. The clinical questions raised when the first living donor kidney transplant was performed, involving donor risk, informed consent, donor protection, and organ quality, have been largely answered. We strongly encourage a wider utilization of living donation and recommend that living donation, rather than deceased donation, become the first choice for kidney transplantation. We believe that it is ethically sound to have living kidney donation as the primary source for organs when the mortality and morbidity risks to the donor are known and kept extremely low, when the donor is properly informed and protected from coercion, and when accepted national and local guidelines for living donation are followed.

Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death—Summary Report*

PubMed Central

Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.

2017-01-01

Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. Conclusions: This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation. PMID:28925929

Current Canadian initiatives to reimburse live organ donors for their non-medical expenses.

PubMed

Vlaicu, Sorina; Klarenbach, Scott; Yang, Robert C; Dempster, Todd; Garg, Amit X

2007-01-01

Living organ donors frequently incur non-medical expenses for travel, accommodation, prescription drugs, loss of income, and child care in conjunction with organ donation. Despite international precedent and widespread public support, Canada currently lacks a unified strategy to reimburse donors for these expenses. In 2005, we communicated with 78 individuals within the field of Canadian transplantation to identify which initiatives for reimbursement of living donors existed in each province. Saskatchewan was the only province in which public employees were granted paid leave for organ donation. Six provincial governments partially reimbursed travel and accommodation. At the federal level, other expenses could be partially reimbursed through an income tax credit, while the Employment Insurance program and the Canada Pension Plan provided funding for donors who become unemployed or develop long-term disability as a result of donation. Charities helped a limited number of patients in financial need through grants and no-interest loans, but funding was generally limited by contributions received. While reimbursing living donors for their non-medical expenses is considered just, existing programs only partially reimburse expenses and are not available in all provinces. Developing future reimbursement policies will remove a disincentive faced by some potential donors, and may increase rates of transplantation in Canada.

Social media and organ donation: Ethically navigating the next frontier.

PubMed

Henderson, M L; Clayville, K A; Fisher, J S; Kuntz, K K; Mysel, H; Purnell, T S; Schaffer, R L; Sherman, L A; Willock, E P; Gordon, E J

2017-11-01

As the organ shortage continues to grow, the creation of social media communities by transplant hospitals and the public is rapidly expanding to increase the number of living donors. Social media communities are arranged in myriad ways and without standardization, raising concerns about transplant candidates' and potential donors' autonomy and quality of care. Social media communities magnify and modify extant ethical issues in deceased and living donation related to privacy, confidentiality, professionalism, and informed consent, and increase the potential for undue influence and coercion for potential donors and transplant candidates. Currently, no national ethical guidelines have been developed in the United States regarding the use of social media to foster organ transplantation. We provide an ethical framework to guide transplant stakeholders in using social media for public and patient communication about transplantation and living donation, and offer recommendations for transplant clinical practice and future research. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Liver transplant using donors after cardiac death: a single-center approach providing outcomes comparable to donation after brain death.

PubMed

Vanatta, Jason M; Dean, Amanda G; Hathaway, Donna K; Nair, Satheesh; Modanlou, Kian A; Campos, Luis; Nezakatgoo, Nosratollah; Satapathy, Sanjaya K; Eason, James D

2013-04-01

Organ donation after cardiac death remains an available resource to meet the demand for transplant. However, concern persists that outcomes associated with donation after cardiac death liver allografts are not equivalent to those obtained with organ donation after brain death. The aim of this matched case control study was to determine if outcomes of liver transplants with donation after cardiac death donors is equivalent to outcomes with donation after brain death donors by controlling for careful donor and recipient selection, surgical technique, and preservation solution. A retrospective, matched case control study of adult liver transplant recipients at the University of Tennessee/Methodist University Hospital Transplant Institute, Memphis, Tennessee was performed. Thirty-eight donation after cardiac death recipients were matched 1:2, with 76 donation after brain death recipients by recipient age, recipient laboratory Model for End Stage Liver Disease score, and donor age to form the 2 groups. A comprehensive approach that controlled for careful donor and recipient matching, surgical technique, and preservation solution was used to minimize warm ischemia time, cold ischemia time, and ischemia-reperfusion injury. Patient and graft survival rates were similar in both groups at 1 and 3 years (P = .444 and P = .295). There was no statistically significant difference in primary nonfunction, vascular complications, or biliary complications. In particular, there was no statistically significant difference in ischemic-type diffuse intrahepatic strictures (P = .107). These findings provide further evidence that excellent patient and graft survival rates expected with liver transplants using organ donation after brain death donors can be achieved with organ donation after cardiac death donors without statistically higher rates of morbidity or mortality when a comprehensive approach that controls for careful donor and recipient matching, surgical technique, and preservation solution is used.

The debate in Chile on organ donation revisited.

PubMed

Kottow Lang, Miguel Hugo

2016-08-29

The worldwide scarcity of cadaveric organs for transplants is on the rise, due in part to extended medical indications and longevity of chronic patients with organic insufficiencies. Chile has an extremely low donor rate of 6.7 per million. Although consent is presumed by law, and recently amended to include a “reciprocity principle”, nearly four million persons have expressed in writing their unwillingness to donate and, of those remaining, 53% of families have rejected donating the organs of their deceased. New proposals are urgently needed, even if some of them have previously been rejected: nonmaterial incentives, partial donations and unveiling anonymity to enhance personal ties between donors and recipients. Transparency, information and assistance are to be reinforced in order to regain trust in transplant procedures.

The "ick" factor, anticipated regret, and willingness to become an organ donor.

PubMed

O'Carroll, Ronan E; Foster, Catherine; McGeechan, Grant; Sandford, Kayleigh; Ferguson, Eamonn

2011-03-01

This research tested the role of traditional rational-cognitive factors and emotional barriers to posthumous organ donation. An example of an emotional barrier is the "ick" factor, a basic disgust reaction to the idea of organ donation. We also tested the potential role of manipulating anticipated regret to increase intention to donate in people who are not yet registered organ donors. In three experiments involving 621 members of the United Kingdom general public, participants were invited to complete questionnaire measures tapping potential emotional affective attitude barriers such as the "ick" factor, the desire to retain bodily integrity after death, and medical mistrust. Registered posthumous organ donors were compared with nondonors. In Experiments 2 and 3, nondonors were then allocated to a simple anticipated regret manipulation versus a control condition, and the impact on intention to donate was tested. Self-reported emotional barriers and intention to donate in the future. Traditional rational-cognitive factors such as knowledge, attitude, and subjective norm failed to distinguish donors from nondonors. However, in all three experiments, nondonors scored significantly higher than donors on the emotional "ick" factor and bodily integrity scales. A simple anticipated regret manipulation led to a significant increase in intention to register as an organ donor in future. Negative affective attitudes are thus crucial barriers to people registering as organ donors. A simple anticipated regret manipulation has the potential to significantly increase organ donation rates. (c) 2011 APA, all rights reserved

[Efficiency indicators to assess the organ donation and transplantation process: systematic review of the literature].

PubMed

Siqueira, Marina Martins; Araujo, Claudia Affonso; de Aguiar Roza, Bartira; Schirmer, Janine

2016-08-01

To search the literature and identify indicators used to monitor and control the organ donation and transplantation process and to group these indicators into categories. In November 2014, a systematic review of the literature was carried out in the following databases: Biblioteca Virtual em Saúde (BVS), EBSCO, Emerald, Proquest, Science Direct, and Web of Science. The following search terms (and the corresponding terms in Brazilian Portuguese) were employed: "efficiency," "indicators," "organ donation," "tissue and organ procurement," and "organ transplantation." Of the 344 articles retrieved, 23 original articles published between 1992 and 2013 were selected and reviewed for analysis of efficiency indicators. The review revealed 117 efficiency indicators, which were grouped according to similarity of content and divided into three categories: 1) 71 indicators related to organ donation, covering mortality statistics, communication of brain death, clinical status of donors and exclusion of donors for medical reasons, attitude of families, confirmation of donations, and extraction of organs and tissues; 2) 22 indicators related to organ transplantation, covering the surgical procedure per se and post-transplantation follow-up; and 3) 24 indicators related to the demand for organs and the resources of hospitals involved in the process. Even if organ transplantation is a recent phenomenon, the high number of efficiency indicators described in the literature suggests that scholars interested in this field have been searching for ways to measure performance. However, there is little standardization of the indicators used. Also, most indicators focus on the donation step, suggesting gaps in the measurement of efficiency at others points in the process. Additional indicators are needed to monitor important stages, such as organ distribution (for example, organ loss indicators) and post-transplantation aspects (for example, survival and quality of life).

Hispanic organ donation: impact of a Spanish-language organ donation campaign.

PubMed Central

Alvaro, Eusebio M.; Jones, Sara Pace; Robles, Antonio Santa Maria; Siegel, Jason

2006-01-01

OBJECTIVES: Hispanic Americans have a substantial need for organ transplants and are underrepresented among organ donors, yet very little is known about how to increase available donors in this community. This study assesses the impact of a Spanish-language media campaign targeting organ donation among Hispanic Americans in two urban Arizona counties. METHODS: The study collected data via four surveys conducted before and after implementation of a Spanish-language media campaign targeting organ donation among Spanish-dominant Hispanic Americans in Pima and Maricopa counties in Arizona. The main intervention consisted of four Spanish-language television advertisements and two Spanish-language radio advertisements. RESULTS: The media campaign was successfully implemented and attained substantial exposure among the target audience. Postintervention beliefs were more prodonation, and there was more family discussion postintervention. In both counties, residents exposed to the campaign reported more prodonation beliefs and family discussion. Exposed Maricopa residents were also more likely to be potential donors. CONCLUSIONS: Study data indicate a positive impact of a media campaign targeting organ donation beliefs and behaviors among Spanish-dominant Hispanic Americans in Arizona. It is hoped that these findings will stimulate further research in this important area. PMID:16532975

Conscientious objection to deceased organ donation by healthcare professionals.

PubMed

Shaw, David; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; Georgieva, Denie; Ploeg, Rutger; Broderick, Andrew

2018-02-01

In this article, we analyse the potential benefits and disadvantages of permitting healthcare professionals to invoke conscientious objection to deceased organ donation. There is some evidence that permitting doctors and nurses to register objections can ultimately lead to attitudinal change and acceptance of organ donation. However, while there may be grounds for conscientious objection in other cases such as abortion and euthanasia, the life-saving nature of donation and transplantation renders objection in this context more difficult to justify. In general, dialogue between healthcare professionals is a more appropriate solution, and any objections must be justified with a strong rationale in hospitals where such policies are put in place.

48 CFR 31.205-8 - Contributions or donations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-8 Contributions or donations. Contributions or donations, including cash, property and...

Organ procurement after cardiocirculatory death: a critical analysis.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

2008-01-01

To shorten the transplantation waiting time in the United States, federal regulations have been introduced requiring hospitals to develop policies for organ donation after cardiac (or circulatory) death (DCD). The practice of DCD is invoked based on the validity of the University of Pittsburgh Medical Center (UPMC) protocol and relies on the accuracy of the University of Wisconsin (UW) evaluation tool to appropriately identify organ donors. There is little evidence to support the position that the criteria for organ procurement adopted from the UPMC protocol complies with the dead donor rule. A high false-positive rate of the UW evaluation tool can expose many dying patients to unnecessary perimortem interventions because of donation failure. The medications and/or interventions for the sole purpose of maintaining organ viability can have unintended negative consequences on the timing and quality of end-of-life care offered to organ donors. It is essential to address and manage the evolving conflict between optimal end-of-life care and the necessary sacrifices for the procurement of transplantable organs from the terminally ill. The recipients of marginal organs recovered from DCD can also suffer higher mortality and morbidity than recipients of other types of donated organs. Finally, transparent disclosure to the public of the risks involved to both organ donors and recipients may contribute to open societal debate on the ethical acceptability of DCD.

Effect of organ donation after circulatory determination of death on number of organ transplants from donors with neurologic determination of death

PubMed Central

Rao, Vivek; Dhanani, Sonny; MacLean, Janet; Payne, Clare; Paltser, Elizabeth; Humar, Atul; Zaltzman, Jeffrey

2017-01-01

BACKGROUND: To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. METHODS: We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14). We compared these donor groups by categorical characteristics. RESULTS: Donation increased by 57%, from 578 donors in the pre-DCD era to 905 donors in the recent DCD era, with a 21% proportion (190/905) of DCD donors in the recent DCD era. However, overall NDD donation also increased. The mean length of hospital stay before declaration for NDD was 2.7 days versus 6.0 days before withdrawal of life support and subsequent asystole in cases of DCD. The average organ yield was 3.73 with NDD donation versus 2.58 with DCD (p < 0.001). Apart from hearts, all organs from DCD donors were successfully transplanted. From the pre-DCD era to the recent DCD era, transplant activity in each era increased for all solid-organ recipients, including heart (from 158 to 216), kidney (from 821 to 1321), liver (from 477 to 657) and lung (from 160 to 305). INTERPRETATION: Implementation of DCD in Ontario led to increased transplant activity for all solid-organ recipients. There was no evidence that the use of DCD was pre-empting potential NDD donation. In contrast to groups receiving other organs, heart transplant candidates have not yet benefited from DCD. PMID:28947546

To give is better than to receive: compliance with WHO guidelines for drug donations during 2000-2008.

PubMed

Bero, Lisa; Carson, Brittany; Moller, Helene; Hill, Suzanne

2010-12-01

to assess drug donations in terms of their adherence to the drug donation guidelines put forth by the World Health Organization (WHO). in 2009 we searched the academic and lay literature - journal articles, media articles and industry and donor web sites - to identify reports about drug donations made from 2000 to 2008. Publications focusing on molecular mechanisms of drug action, general descriptions of guidelines or specific one-time drug donations before 2000 were excluded. For cases with sufficient information, we assessed compliance with each of the 12 articles of WHO's guidelines. we found 95 articles describing 96 incidents of drug donations between 2000 and 2008. Of these, 50 were made in response to disaster situations, 43 involved the long-term donation of a drug to treat a specific disease and 3 were drug recycling cases. Disaster-related donations were less likely to comply with the guidelines, particularly in terms of meeting the recipient's needs, quality assurance and shelf-life, packaging and labelling, and information management. Recipient countries were burdened with the costs of destroying the drugs received through inappropriate donations. Although long-term donations were more likely to comply with WHO guidelines related to quality assurance and labelling, they did not consistently meet the needs of the recipients. Furthermore, they discouraged local drug production and development. drug donations can do more harm than good for the recipient countries. Strengthening the structures and systems for coordinating and monitoring drug donations and ensuring that these are driven by recipient needs will improve adherence to the drug donation guidelines set forth by WHO.

Organ donation on Web 2.0: content and audience analysis of organ donation videos on YouTube.

PubMed

Tian, Yan

2010-04-01

This study examines the content of and audience response to organ donation videos on YouTube, a Web 2.0 platform, with framing theory. Positive frames were identified in both video content and audience comments. Analysis revealed a reciprocity relationship between media frames and audience frames. Videos covered content categories such as kidney, liver, organ donation registration process, and youth. Videos were favorably rated. No significant differences were found between videos produced by organizations and individuals in the United States and those produced in other countries. The findings provide insight into how new communication technologies are shaping health communication in ways that differ from traditional media. The implications of Web 2.0, characterized by user-generated content and interactivity, for health communication and health campaign practice are discussed.

Family veto in organ donation in Canada: framing within English-language newspaper articles.

PubMed

Anthony, Samantha J; Toews, Maeghan; Caulfield, Timothy; Wright, Linda

2017-10-17

Because organ transplantation relies on public support for donation, an analysis of public discourse around organ donation is essential. We investigated the portrayal of family veto - when a family overrides the deceased person's prior legally executed wishes to donate - in Canadian news media. Using the Canadian Newsstream database, we identified articles published in English-language newspapers addressing family veto between 2000 and 2016. Guided by the theoretical perspectives of framing of media effects, we conducted a systematic content analysis of the articles to examine how the Canadian media framed family veto. An initial in-depth analysis of the data set in which themes and patterns were captured and recorded identified coding categories, including primary framing of family veto, prevalence, reasons, ethical or legal concerns and overall tone of the article. Two coders analyzed the data set to ensure intercoder reliability. A total of 133 relevant articles were identified. Family veto was framed predominantly as something that should not be allowed (81 articles [60.9%]) and as a reality that is little understood outside the transplantation community (45 [33.8%]). One-quarter of the articles (32 [24.1%]) highlighted ethical principles of autonomy and justice associated with family veto. Family veto was represented as a stumbling block in the present organ donation system, with most publications (107 [80.4%]) calling for change. There were differing interpretations of organ donation legislation, with 82 articles (61.6%) erroneously stating or suggesting that existing legislation permits family veto. Family veto in organ donation was portrayed predominantly negatively. Many publications reflected a misunderstanding of the law concerning this issue. Although the framing of family veto highlighted important ethical and legal concerns as well as practice and policy considerations, research is needed to enhance the understanding of family veto in organ donation. Copyright 2017, Joule Inc. or its licensors.

Donations After Circulatory Death in Liver Transplant

PubMed Central

Eren, Emre A.; Latchana, Nicholas; Beal, Eliza; Hayes, Don; Whitson, Bryan; Black, Sylvester M.

2017-01-01

The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review. We also review associated risk factors to suggest potential avenues to achieve improved outcomes and reduced complications. Future considerations and alternative techniques of organ preservation are discussed, which may suggest novel strategies to enhance preservation and donor expansion through the use of marginal donors. Ultimately, without effective measures to bolster organ supply, donations after circulatory death should remain a consideration; however, an understanding of inherent risks and limitations is necessary. PMID:27733105

Legal and ethical issues of uterus transplantation.

PubMed

Dickens, Bernard M

2016-04-01

The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors' genuine altruism and motivation. Donation by deceased women-i.e. cadaveric donation-raises issues of uterus suitability for transplantation, and how death is diagnosed. Organs' suitability for donation is often achieved by ventilation to maintain cardiac function for blood circulation, but laws and cultures could deem that a heartbeat indicates donors' live status. Issues could arise concerning ownership and control of organs between recovery from donors and implantation into recipients, and on removal following childbirth, that require legal resolution. Copyright © 2016. Published by Elsevier Ireland Ltd.

Donations After Circulatory Death in Liver Transplant.

PubMed

Eren, Emre A; Latchana, Nicholas; Beal, Eliza; Hayes, Don; Whitson, Bryan; Black, Sylvester M

2016-10-01

The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review. We also review associated risk factors to suggest potential avenues to achieve improved outcomes and reduced complications. Future considerations and alternative techniques of organ preservation are discussed, which may suggest novel strategies to enhance preservation and donor expansion through the use of marginal donors. Ultimately, without effective measures to bolster organ supply, donations after circulatory death should remain a consideration; however, an understanding of inherent risks and limitations is necessary.

Latin Americans in Spain and their attitude toward living kidney donation.

PubMed

Ríos, A; López-Navas, A; Martínez-Alarcón, L; Ramírez, P; Parrilla, P

2015-12-01

The Latin American (LA) population in Spain is ever increasing in size and is perfectly integrated into the social structure. The objectives were to analyze the attitude of citizens, born in Latin America and living in Spain, toward living kidney donation (LKD) and to determine the psychosocial variables affecting this attitude. A sample of LA residents living in Spain was obtained randomly in 2010 and stratified according to the respondent's nationality (n = 1314). Attitude was evaluated using a validated questionnaire ("Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Renal" Ríos). The survey was self-administered and completed anonymously. The questionnaire completion rate was 86% (n = 1.132). A total of 89% (n = 1003) were in favor of related living donation, and 30% if the donation were unrelated. The variables associated with attitude toward LKD were as follows: sex (p = 0.043); marital status (p = 0.013); previous experience of organ donation (p = 0.009); attitude toward deceased organ donation (p < 0.001); a respondent's belief that he or she could be a possible recipient of a future transplant (p < 0.001); knowledge of a partner's opinion (p = 0.021); family discussion about organ donation (p = 0.001); knowledge of the view of one's religion toward donation (p < 0.001); concern about "mutilation" after donation (p = 0.004); and evaluation of the risk from living donation (p = 0.036). The attitude of LA citizens residing in Spain was favorable both toward related LKD and unrelated living donation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perceptions of the gift relationship in organ and tissue donation: Views of intensivists and donor and recipient coordinators.

PubMed

Shaw, Rhonda

2010-02-01

The international literature on organ donation and transplantation has drawn attention to the popularity of "gift of life" discourse among pro-donation advocates, transplantation specialists, and within organisations lobbying for improved donation rates to promote the benefits of organ donation among members of the general public. In Aotearoa/New Zealand, gift of life discourse is robust. Aside from attempts to elicit altruism by promoting tissue donation in the public domain, gift terminology separates the act of donation from that of commerce and the commodification of body tissues. In distancing donation from commodification and the potential to degrade and exploit human beings, it is assumed that gift discourse transmits the positive message that donation is a noble and morally worthy act. Recent sociological research has shown that assumptions of the gift as one-way and altruistic do not necessarily align with people's perceptions and experience of donating body tissues, and that the vocabulary used to describe these acts is often at variance with reality. This article draws on interview data with 15 critical care specialists (intensivists) and donor and recipient coordinators, examining their perceptions of the relevance of gift discourse and its applicability in the context of deceased donation in Aotearoa/New Zealand. The data indicate several problems with gift rhetoric to describe the situations health professionals encounter. In sum, gift terminology tends to downplay the sacrifice involved in tissue donation generally, as well as depoliticising the exchange relations of tissue transfer in contemporary consumer culture and in the global context. This raises questions about the underlying ethics of language choice and what, if anything, empirical accounts of tissue transfer can contribute to ethical debates. Copyright 2009 Elsevier Ltd. All rights reserved.

Statement of the Declaration of Istanbul Custodian Group Regarding Payments to Families of Deceased Organ Donors.

PubMed

Capron, Alexander Morgan; Delmonico, Francis L; Dominguez-Gil, Beatriz; Martin, Dominique Elizabeth; Danovitch, Gabriel M; Chapman, Jeremy

2016-09-01

Governmental and private programs that pay next of kin who give permission for the removal of their deceased relative's organs for transplantation exist in a number of countries. Such payments, which may be given to the relatives or paid directly for funeral expenses or hospital bills unrelated to being a donor, aim to increase the rate of donation. The Declaration of Istanbul Custodian Group-in alignment with the World Health Organization Guiding Principles and the Council of Europe Convention Against Trafficking in Human Organs-has adopted a new policy statement opposing such practices. Payment programs are unwise because they produce a lower rate of donations than in countries with voluntary, unpaid programs; associate deceased donation with being poor and marginal in society; undermine public trust in the determination of death; and raise doubts about fair allocation of organs. Most important, allowing families to receive money for donation from a deceased person, who is at no risk of harm, will make it impossible to sustain prohibitions on paying living donors, who are at risk. Payment programs are also unethical. Tying coverage for funeral expenses or healthcare costs to a family allowing organs to be procured is exploitative, not "charitable." Using payment to overcome reluctance to donate based on cultural or religious beliefs especially offends principles of liberty and dignity. Finally, while it is appropriate to make donation "financially neutral"-by reimbursing the added medical costs of evaluating and maintaining a patient as a potential donor-such reimbursement may never be conditioned on a family agreeing to donate.

Palliative care consultation in the process of organ donation after cardiac death.

PubMed

Kelso, Catherine McVearry; Lyckholm, Laurie J; Coyne, Patrick J; Smith, Thomas J

2007-02-01

Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after cardiac death (DCD). DCD allows patients with severe, irreversible brain injuries that do not meet standard criteria for brain death to donate organs when death is declared by cardiopulmonary criteria. The DCD method of donation has been deemed an ethically appropriate means of organ donation and is supported by the organ procurement and medical communities, as well as the public. The palliative care (PC) team can make a significant contribution to the care of the patient and family in the organ donation process. In this paper we describe the controlled DCD process at one institution that utilizes the PC team to provide expert end-of-life care, including comprehensive medical management and family support. PC skills and principles applicable to the DCD process include communication, coordination of care, and skillful ventilator withdrawal. If death occurs within 90 minutes of withdrawal of life support, organs may be successfully recovered for transplantation. If the patient survives longer than 90 minutes, his or her care continues to be provided by the PC team. Palliative care can contribute to standardizing quality end-of-life care practices in the DCD process and provide education for involved personnel. Further experience, research and national discussions will be helpful in refining these practices, to make this difficult and challenging experience as gentle and supportive as possible for the courageous families who participate in this process.

Health content analysis of organ donation and transplantation news on Turkish television channels and in Turkish print media.

PubMed

Colak, M Yavuz; Hekimoglu, D; Ersoy, K; Sozen, F; Haberal, M

2010-01-01

The media affects individuals' behaviors, especially by means of news and advertisements. In this study, we evaluated health content of organ donation and transplantation news in the printed media and on television programs for a 1-year period in Turkey. We examined 2449 news items in 230 newspapers and magazines; 1179 news programs on 45 television channels, all concerning organ donation and transplantation. The news obtained from the Media Pursuit Center were transferred to an electronic file to evaluate the format and content of the news. Nine variables were examined about the scope and the formal characteristics of the news: the publication name, its type, the province, the date, the headline, the title length, the presence of a photograph, or its kind, the news size, and the page number. In the content analysis of the news, we also examined 9 variables: the topic, the message of the headline, the property of the words in the title, the identification of photographs in the news, the age, gender of actors in the news, as well as donor or recipient. In a summary, print media and television channels, failed to show sufficient information about organ donation and transplantation. The percentage of news about organ donation and transplantation was small and mostly negative items in the media. On television channels, sufficient place was not given to organ donation and transplantation. The news in printed media and on television channels was not about motivated or altruistic behavior. The pattern of organ donation and transplantation news is important in terms of perception and comment by the public. Furthermore it directly affects the perception of the news by the reader.

Registration for deceased organ and tissue donation among Ontario immigrants: a population-based cross-sectional study

PubMed Central

Li, Alvin Ho-ting; Lam, Ngan N.; Dhanani, Sonny; Weir, Matthew; Prakash, Versha; Kim, Joseph; Knoll, Greg; Garg, Amit X.

2016-01-01

Background: Canada has low rates of deceased organ and tissue donation. Immigrants to Canada may differ in their registered support for deceased organ donation based on their country of origin. Methods: We used linked administrative databases in Ontario (about 11 million residents aged ≥ 16 yr) to study the proportion of immigrants and long-term residents registered for deceased organ and tissue donation as of October 2013. We used modified Poisson regression to identify and quantify predictors of donor registration. Results: Compared with long-term residents (n = 9 244 570), immigrants (n = 1 947 646) were much less likely to register for deceased organ and tissue donation (11.9% v. 26.5%). Immigrants from the United States, Australia and New Zealand had the highest registration rate (40.0%), whereas immigrants with the lowest registration rates were from Eastern Europe and Central Asia (9.4%), East Asia and Pacific (8.4%) and sub-Saharan Africa (7.9%). The largest numbers of unregistered immigrants were from India (n = 202 548), China (n = 186 678) and the Philippines (n = 125 686). Characteristics among the immigrant population associated with a higher likelihood of registration included economic immigrant status, living in a rural area (population < 10 000), living in an area with a lower ethnic concentration, less material deprivation, a higher education, ability to speak English and French, and more years residing in Canada. Interpretation: Immigrants in Ontario were less likely to register for deceased organ and tissue donation than long-term residents. There is a need to better understand reasons for lower registration rates among Canadian immigrants and to create culture-sensitive materials to build support for deceased organ and tissue donation. PMID:28443265

Transplant Ethics.

PubMed

Altınörs, Nur; Haberal, Mehmet

2016-11-01

The aim of this study was to review and discuss the great variety of ethical issues related to organ donation, organ procurement, transplant activities, and new ethical problems created as a result of technologic and scientific developments. An extensive literature survey was made, and expert opinions were obtained. The gap between demand and supply of organs for transplant has yielded to organ trafficking, organ tourism, and commercialism. This problem seems to be the most important issue, and naturally there are ethical dilemmas related to it. A wide number of ideas have been expressed on the subject, and different solutions have been proposed. The struggle against organ trafficking and commercialism should include legislation, efforts to increase deceased-donor donations, and international cooperation. China's policy to procure organs from prisoners sentenced to death is unethical, and the international community should exert more pressure on the Chinese government to cease this practice. Each particular ethical dilemma should be taken separately and managed.

Increasing organ donation by presumed consent and allocation priority: Chile

PubMed Central

2015-01-01

Abstract Chile, a middle-income country, recently joined Israel and Singapore as the world’s only countries to require reciprocity as a precondition for organ transplantation. The Chilean reform includes opt-out provisions designed to foster donation and priority for organ transplantation for registered people. Although the reform has had serious difficulties in achieving its mission, it can be reviewed by other countries that seek to address the serious shortage of organs. As increased organ donation can substantially enhance or save more lives, the effect on organ availability due to incentives arising from rules of preference should not be underestimated. PMID:25767299

Pediatric Perioperative Nurses and the Ethics of Organ Donation After Cardiac Death.

PubMed

Austin, Elizabeth A; Lovett, Pamela; Moore, Wendy C; Zuzarte, Ingrid

2018-04-01

Pediatric perioperative nurses are experiencing increased opportunities to participate in donations after cardiac death. An increased public awareness regarding transplantation has inspired more people to donate than in previous years. The demand for transplantable organs has led to opportunities that have increased donor candidates including living donors and cardiac death donors. Cardiac death in children is often sudden and unexpected, and is an emotional time not only for the family members but also for the hospital staff members, including perioperative nurses. However, when perioperative nurses adhere to standards and guidelines, they can perform their responsibilities in an ethical and compassionate manner and assist their team in doing so. This article reviews the guiding principles of pediatric organ donation after cardiac death, the phases of the process, and the ethical and moral issues surrounding donation. © AORN, Inc, 2018.

The viability of transplanting organs from donors who underwent cardiopulmonary resuscitation: A systematic review.

PubMed

West, Stephen; Soar, Jasmeet; Callaway, Clifton W

2016-11-01

To identify reports of patients who underwent cardiopulmonary resuscitation (CPR) prior to solid organ donation and compare recipient and organ function outcomes to those that did not undergo CPR. Donation after restoration of circulation then progressing to death and those donating with on-going CPR who would have otherwise have termination of efforts were both included. Systematic review. Clinical studies comparing the outcome of patients and organs retrieved from donors who underwent CPR with those that did not require CPR. Full-text articles were searched on EmBASE, MEDLINE, Cochrane Database of Systematic Reviews and the Cochrane Register of Controlled Trials. Twenty-two observational studies were included. There were 12,206 adult and 2552 paediatric organ transplantation identified. Comparing donation after restoration of circulation there was no difference in immediate, one year, and five-year graft function. Donation with on-going CPR was associated with reduced immediate graft function for both renal and hepatic transplantation, however long term function was not different. CPR does not appear to adversely affect graft function. Patients who have restored circulation after resuscitation and subsequently progress to death should be evaluated for organ donation. Those with on-going CPR should be considered for hepatic and renal transplantation but there may be worse initial graft function. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Nurses' attitudes and knowledge regarding organ and tissue donation and transplantation in a provincial hospital: A descriptive and multivariate analysis.

PubMed

Lomero, Maria Del Mar; Jiménez-Herrera, María F; Rasero, Maria José; Sandiumenge, Alberto

2017-09-01

The attitudes and knowledge of nursing personnel regarding organ and tissue donation can influence the decision to donate. This study aimed to determine these two factors among nurses at a district hospital in Barcelona, Spain. A survey was carried out using a 35 item questionnaire. Results were subjected to descriptive and comparative statistical analyses using bivariate and multivariate analyses to examine the relation between demographic data and attitudes toward donation. The completion rate was 68.2%, with 98.6% of those responding stating that they were in favor of organ donation. The respondents were unsure as to whether the criteria for inclusion in transplant waiting lists were appropriate (57.5%), whereas 72.2% agreed that brain death is equivalent to death. The bivariate analysis revealed a significant association between a positive attitude toward donation and working on permanent night shift no religious beliefs. Attitudes toward donation among nurses were generally positive; a negative attitude, although attitudes towards donation among the nurses participating in the study were generally positive, it should be pointed out that when a negative attitude does exist this affects significant aspects such as belief in the diagnosis of brain death or the criteria for inclusion on the waiting list, amongst others, which reflects that specific training in donation focused on nurses continues to be needed. © 2017 John Wiley & Sons Australia, Ltd.

Regulatory aspects of tissue donation, banking and transplantation in India.

PubMed

Lobo Gajiwala, Astrid

2018-05-04

Amendments to India's Transplantation of Human Organs Act, 1994, have established the legality of tissue donation and transplantation from deceased donors and the conditions under which they are permitted. The amended Act, now known as The Transplantation of Human Organs and Tissues Act, 1994, seeks to prevent the commercialization of tissue donation and to guarantee the safety of indigenous allografts. Registration of tissue banks, compliance with national standards and the appointment of transplant co-ordinators in hospitals registered under the Act are now mandatory. A national registry and Regional and State networks for donation and transplantation of tissues have been introduced. Despite the amendments a few anomalies of the principal Act persist as some of the differences between tissue and organ donation and transplantation have been overlooked. These include the possibility of skin donation in locations other than hospitals; the donation of medical and surgical tissue residues which does not pose any risk to the living donor; the non-requirement for compatibility between donor and recipient; the delayed time factor between tissue donation and transplantation which makes identification of a recipient at the time of donation impossible; and the easy availability of alternatives to tissues which make waiting lists redundant for many tissues. Rules for the implementation of the amended Act were framed in 2014 but like the Act must be adopted by the State health assemblies to become universally applicable in the country.

Balancing hope and despair at the end of life: The contribution of organ and tissue donation.

PubMed

Walker, Wendy; Sque, Magi

2016-04-01

Concern for the grieving family can moderate the intentions of critical care staff to advocate deceased organ and tissue donation. Conversely, benevolent actions may provoke distress through missed opportunities to save or transform lives. This article provides insight into the perceived benefits of organ and tissue donation for grieving families who experienced end-of-life care in the intensive care unit. Data were collected via semistructured, face-to-face or telephone interviews with 43 participants from 31 donor families. Audio recordings were transcribed verbatim and subjected to qualitative content analysis. The study findings affirmed the importance of person-centered end-of-life care. Donor families shared examples of good-quality care and communication that contained the hallmarks of compassion, respect, dignity, and choice. We uncovered a trajectory of hope and despair in which the option of organ and tissue donation appeared to give meaning to the life and death of the deceased person and was comforting to some families in their bereavement. Our study findings underlined the significance of donation decision making for grieving families. Organ and tissue donation has the potential to balance hope and despair at the end of life when the wishes of the dying, deceased, and bereaved are fulfilled. Copyright © 2015 Elsevier Inc. All rights reserved.

Neither property right nor heroic gift, neither sacrifice nor aporia: the benefit of the theoretical lens of sharing in donation ethics.

PubMed

Zeiler, Kristin

2014-05-01

Two ethical frameworks have dominated the discussion of organ donation for long: that of property rights and that of gift-giving. However, recent years have seen a drastic rise in the number of philosophical analyses of the meaning of giving and generosity, which has been mirrored in ethical debates on organ donation and in critical sociological, anthropological and ethnological work on the gift metaphor in this context. In order to capture the flourishing of this field, this article distinguishes between four frameworks for thinking about bodily exchanges in medicine: those of property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. These frameworks represent four different ways of making sense of donation of organs as well as tissue, gametes and blood, draw on different conceptions of the relations between the self and the other, and bring out different ethical issues as core ones. The article presents these frameworks, argues that all of them run into difficulties when trying to make sense of reciprocity and relational interdependence in donation, and shows how the three gift-giving frameworks (of heroism, sacrifice and aporia) hang together in a critical discussion about what is at stake in organ donation. It also presents and argues in favour of an alternative intercorporeal framework of giving-through-sharing that more thoroughly explicates the gift metaphor in the context of donation, and offers tools for making sense of relational dimensions of live and post mortem donations.

48 CFR 31.205-8 - Contributions or donations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Contributions or donations. 31.205-8 Section 31.205-8 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-8 Contributions or donations. Contributions or donations, including cash, property and...

48 CFR 31.205-8 - Contributions or donations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Contributions or donations. 31.205-8 Section 31.205-8 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-8 Contributions or donations. Contributions or donations, including cash, property and...

48 CFR 31.205-8 - Contributions or donations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Contributions or donations. 31.205-8 Section 31.205-8 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-8 Contributions or donations. Contributions or donations, including cash, property and...

48 CFR 31.205-8 - Contributions or donations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Contributions or donations. 31.205-8 Section 31.205-8 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-8 Contributions or donations. Contributions or donations, including cash, property and...

[Liver transplantation with living donor : current aspects, perspectives and significance in Germany].

PubMed

Settmacher, U; Bauschke, A; Malessa, C; Scheuerlein, H; Zanow, J; Rauchfuß, F

2013-05-01

More than 20 years ago living donor liver transplantation was introduced into clinical practice. Specifics of this method were developed initially for children and later on for adults particularly in regions where a liver transplantation program using deceased donors was not readily available. The most sensitive aspect of living donation, namely the danger to a healthy relative in order to perform the transplantation is immanent in the system and, thus, it is definitively a secondary option as compared to deceased organ donation. Following worldwide initial euphoria the numbers have markedly decreased in the western world since the start of the new millennium. In Asian countries in particular, much work has been done to optimize the procedure so that the donor safety and the outcome quality for the recipient have been impressively demonstrated in large patient populations. There is still a severe donor organ shortage and the option to allocate an optimal (partial) organ on an individual basis by living donation has given new impact to the discussion about a further rise in the profile of living donations here as well. The new version of the German transplantation legislation implemented in summer 2012 requires a number of conditions with respect to insurance for living donors. The current state and perspectives are presented here.

Spirituality as a predictive factor for signing an organ donor card.

PubMed

Bortz, Anat Peles; Ashkenazi, Tamar; Melnikov, Semyon

2015-01-01

To examine differences in spirituality, purpose in life, and attitudes toward organ donation between people who signed and those who did not sign an organ donor card. A descriptive cross-sectional survey conducted in Israel with a sample of 312 respondents from the general population, of whom 220 (70.5%) signed an organ donor card. Data were collected during April-June 2013. Participants completed a paper questionnaire and a Web-based questionnaire consisting of four sections: spiritual health, purpose in life, attitudes toward organ donation, and social-demographic questions. Descriptive statistics, t test, chi-square test, and a logistic regression analysis were performed. Differences in mean scores between respondents who signed an organ donor card and those who did not were indicated in transcendental spirituality (p < .01), purpose in life (p < .05), and attitudes toward organ donation (p < .01). No statistically significant difference was found between the groups in the overall spirituality mean score. The spiritual transcendental dimension, individual's purpose in life, and attitudes toward organ donation explained 34.3% of the variance of signing an organ donor card. Signing an organ donor card was found to be correlated with high purpose in life, positive attitudes toward organ donation, and low level of transcendental spirituality. Nurses should assess the patient's spiritual needs in order to construct appropriate programs for promoting signing an organ donor card. Nurses who signed an organ donor card should be encouraged to share this information with their patients. © 2014 Sigma Theta Tau International.

Empathy, social media, and directed altruistic living organ donation.

PubMed

Moorlock, Greg; Draper, Heather

2018-06-01

In this article we explore some of the ethical dimensions of using social media to increase the number of living kidney donors. Social media provides a platform for changing non-identifiable 'statistical victims' into 'real people' with whom we can identify and feel empathy: the so-called 'identifiable victim effect', which prompts charitable action. We examine three approaches to promoting kidney donation using social media which could take advantages of the identifiable victim effect: (a) institutionally organized campaigns based on historical cases aimed at promoting non-directed altruistic donation; (b) personal case-based campaigns organized by individuals aimed at promoting themselves/or someone with whom they are in a relationship as a recipient of directed donation; (c) institutionally organized personal case-based campaigns aimed at promoting specific recipients for directed donation. We will highlight the key ethical issues raised by these approaches, and will argue that the third option, despite raising ethical concerns, is preferable to the other two. © 2018 The Authors Bioethics Published by John Wiley & Sons Ltd.

Family communication coordination: a program to increase organ donation.

PubMed

Linyear, A S; Tartaglia, A

1999-09-01

To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, "decoupling," and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between "decoupling," appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.

[Legal aspects of transplant and donation].

PubMed

Teijeira, R

2006-01-01

The Spanish model of organ and tissue donation enjoys great prestige in the world medical sphere and has been the object of study and imitation in different countries. Part of this success is due to the fact that since the year 1979 different legal norms have been enacted that have regulated and facilitated donation. The current legislation on the donation and transplant of organs and tissues is based on the principles of the gratuity and confidentiality of the donation, indicating the need for facilitating the formation of organisations at the level of the autonomous communities and at the national level. It also contains the requisites for donation of both live donors and deceased donors, establishing the norms for certification of death due to cardiorespiratory arrest and due to the irreversible cease of brain functions.

How to achieve more accurate comparisons in organ donation activity: time to effectiveness indicators.

PubMed

Deulofeu, R; Bodí, M A; Twose, J; López, P

2010-06-01

We are used to comparisons of activity using donation or transplantation population (pmp) rates between regions or countries, without a further evaluation of the process. But crude pmp rates do not clearly reflect real transplantation capacity, because organ procurement does not finish with the donation step; it is also necessary to know the utilization of the obtained organs. The objective of this study was to present methods and indicators deemed necessary to evaluate the effectiveness of the process. We have proposed the use of simple definitions and indicators to more accurately measure and compare the effectiveness of the total organ procurement process. To illustrate the use and performance of these indicators, we have presented the donation and transplantation activity in Catalonia from 2002 to 2007.

When politics meets science: What impact might Brexit have on organ donation and transplantation in the United Kingdom?

PubMed

Shapey, Iestyn M; Summers, Angela M; Simkin, Iain J; Augustine, Titus; van Dellen, David

2018-06-21

Brexit may lead to major political, societal, and financial changes-this has significant implications for a tax revenue funded healthcare system such as the United Kingdom's (UK) National Health Service. The complex relationship between European Union (EU) legislation and clinical practice of organ donation and transplantation is poorly understood. However, it is unclear what impact Brexit may have on organ donation and transplantation in the UK and EU. This work aims to describe the current legislative interactions affecting organ donation and transplantation regulation and governance within the UK and EU. We consider the potential impact of Brexit on the practical aspects of transplantation such organ-sharing networks, logistics, and the provision of health care for transplant patients when traveling to the EU from the UK and vice versa, as well as personnel, and research. Successful organ donation and transplantation practices rely on close collaboration and co-operation across Europe and throughout the United Kingdom. The continuation of such relationships, despite the proposed legislative change, will remain a vital and necessary component for the ongoing success of transplantation programs. © 2018 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd.

Brain death organ donation potential and life support therapy limitation in neurocritical patients.

PubMed

Bodí, M A; Pont, T; Sandiumenge, A; Oliver, E; Gener, J; Badía, M; Mestre, J; Muñoz, E; Esquirol, X; Llauradó, M; Twose, J; Quintana, S

2015-01-01

To analyze the profile, incidence of life support therapy limitation (LSTL) and donation potential in neurocritical patients. A multicenter prospective study was carried out. Nine hospitals authorized for organ harvesting for transplantation. All patients consecutively admitted to the hospital with GCS < 8 during a 6-month period were followed-up until discharge or day 30 of hospital stay. Demographic data, cause of coma, clinical status upon admission and outcome were analyzed. LSTL, brain death (BD) and organ donation incidence were recorded. A total of 549 patients were included, with a mean age of 59.0 ± 14.5 years. The cause of coma was cerebral hemorrhage in 27.0% of the cases.LSTL was applied in 176 patients (32.1%). In 78 cases LSTL consisted of avoiding ICU admission. Age, the presence of contraindications, and specific causes of coma were associated to LSTL. A total of 58.1% of the patients died (n=319). One-hundred and thirty-three developed BD (24.2%), and 56.4% of these became organ donors (n=75). The presence of edema and mid-line shift on the CT scan, and transplant coordinator evaluation were associated to BD. LSTL was associated to a no-BD outcome. Early LSTL (first 4 days) was applied in 9 patients under 80 years of age, with no medical contraindications for donation and a GCS ≤ 4 who finally died in asystole. LSTL is a frequent practice in neurocritical patients. In almost one-half of the cases, LSTL consisted of avoiding admission to the ICU, and on several occasions the donation potential was not evaluated by the transplant coordinator. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.