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Sample records for organ donation developing

  1. Organ Donation

    MedlinePlus

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

  2. Organ donation in China: current status, challenges, and future development.

    PubMed

    Sui, Weiguo; Zheng, Can; Yang, Ming; Dai, Yong

    2014-12-01

    Development of effective immunosuppressive agents and advances in surgical practice are the main reasons for the success of transplantation in China. In some key areas such as liver, lung, and kidney transplants, Chinese transplant success rates are similar to the rates in developed countries. Organ donation also has developed rapidly. However, China is facing a serious organ shortage that restricts clinical treatment and medical research. This shortage is due to imperfect laws and improper management of organ donation, as well as Chinese traditional ethics. Finding an efficient way to make the number of donated organs keep pace with the need for organ transplants and to optimize allocation of organ resources is a long-term and arduous task. In some ways, Chinese organ donation nowadays is constrained more by legal issues than by medical issues. The current status of and challenges facing organ donation in China are analyzed with respect to ethics, management, laws, and policy, and the future development of transplantation in China is discussed.

  3. 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.

  4. [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.

  5. 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

  6. Role of Religion in Organ Donation-Development of the United Kingdom Faith and Organ Donation Action Plan.

    PubMed

    Randhawa, G; Neuberger, J

    2016-04-01

    At a national policy level, the United Kingdom is at the forefront of recognizing the role of faith and its impact on organ donation. This is demonstrated by the recommendations of the Organ Donation Taskforce, National Institute for Clinical Excellence guidelines on organ donation, All-Party Parliamentary Kidney Group, and National Black, Asian and Minority Ethnic Taskforce Alliance. Evidence to date shows that further thought is required to ensure the active engagement of faith communities with organ donation in the UK. The "Taking Organ Transplantation to 2020" strategy was launched in July 2013 by National Health Service Blood and Transplant (NHSBT) in collaboration with the Department of Health and Welsh, Scottish, and Northern Irish governments and seeks to increase the number of people, from all sections of the UK's multiethnic and multifaith population, who consent to and authorize organ donation in their life. NHSBT seeks to work in partnership with faith leaders and this culminated in a Faith and Organ Donation Summit. Faith leaders highlight that there is a need for engagement at both national and local levels concerning organ donation as well as diagnosis and definition of death.

  7. The ethics of organ donation.

    PubMed

    Dunstan, G R

    1997-01-01

    As organ transplantation is physically possible within a tension between common biological properties and individual immunities, so it is ethically possible within a tension between individual personality in full integrity and the human community of which each member, social by nature, is an organic part. Ethical donation is by consent, explicit or presumed, spontaneously offered or procured by request. Altruism or commercial dealing is now a live issue in organ procurement, whether cadaveric or by live donation, related or unrelated. Attention is given to children in transplantation, and to new developments with fetal organs, neural tissue, bone marrow and xenografts. Given all that medical science and skill can now offer, patients are still free to decline.

  8. 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

  9. Organization and Development of Bone Marrow Donation and Transplantation in Poland.

    PubMed

    Filipiak, Jagoda; Dudkiewicz, Małgorzata; Czerwiński, Jarosław; Kosmala, Karolina; Łęczycka, Anna; Malanowski, Piotr; Żalikowska-Hołoweńko, Jolanta; Małkowski, Piotr; Danielewicz, Roman

    2015-10-01

    This paper describes bone marrow donation and transplantation in Poland in terms of its history, current state, and information on the quality control system. Based on data gathered from the informatics systems of the Polish Central Unrelated Potential Bone Marrow Donor and Cord Blood Registry and the Polish transplant registries, as well as World Marrow Donor Association statistics, we performed an overview study to collect and compare numbers on hematopoietic stem cells donations and transplantations in Poland in the years 2010-2014. In the last 5 years, the number of registered potential hematopoietic stem cells donors in Poland increased by more than 4 times, from about 146,000 to over 750,000. During the same period, the number of patients qualified to hematopoietic stem cells transplantation from unrelated donor increased from 557 in 2010 to 817 in 2014. We observed a striking change in the percentage of transplantations performed in Polish centers using material collected from national donors--from 24% to 60%. This shift was also evident in the number of search procedures closed with acceptation of Polish donors--from 27% in 2010 to 58% in 2014. Another consequence of Polish registry growth is the increasing number of donations from Polish donors for international patients. Between 2010 and 2014, the percent of donation for non-national patient increased from 33% to 76%, placing Poland in 6th place in the ranking of the HSC "exporters" worldwide. Growth of transplantation rates involves standardization process, which is a natural way of development for national organizations in the field of HSCT because of its international character.

  10. Public Opinion on Organ Donation After Death and Its Influence on Attitudes Toward Organ Donation.

    PubMed

    Aijing, Luo; Wenzhao, Xie; Wei, Wei; Qiquan, Wan; Xuantong, Deng

    2016-08-18

    BACKGROUND China officially launched a pilot program of organ donation after cardiac death to overcome the shortage of available organs since 2011. Voluntary organ donation by deceased citizens became the only source of transplant organs beginning January 1, 2015. To investigate public opinions on organ donation by deceased donors, and discuss the effect of these opinions on the willingness and attitude of the public regarding voluntary organ donation. MATERIAL AND METHODS We designed a questionnaire. The survey was conducted from December 2014 to January 2015 in Changsha City, and 417 valid questionnaires were recovered. RESULTS A total of 162 respondents explicitly expressed a willingness to donate organs, and 269 believed that the organ donors' relatives should be compensated. A total of 255 respondents thought it acceptable to complete the donation-consent form when receiving a driver's license. Among the respondents, 65.3% did not agree with the statement "My body is bestowed by my parents, and to donate my body parts would not display filial respect"; 88.9% agreed that "It is necessary to consider the willingness of my family"; 74.4% agreed that "Donated organs have not been fairly and appropriately used; the wealthy and celebrities have been favored"; and 61.4% agreed that "Organ donation laws and regulations are not well developed, and organ donations will result in unnecessary difficulties." More than 80% believed that organ donation and transplantation extend life. CONCLUSIONS Public opinions on organ donation after death are associated with various factors, including traditional values, religious beliefs, compensation mechanisms, donor registration, institutional credibility, and ideals.

  11. Transformation of organ donation in China.

    PubMed

    Zhang, Lei; Zeng, Li; Gao, Xinpu; Wang, Haibo; Zhu, Youhua

    2015-04-01

    The organ donation system in China has far lagged behind international levels. Transformation of this situation began in July 2005. A complete organ donation system that ensures fairness, impartiality, transparency, and respect for life has now been developed. This system is composed of regulations and policies, an organizational structure, operational guidelines, organ procurement organizations, registration of donors and recipients, and an organ allocation system. Since March 2010, pilot trials on donation after circulatory death (DCD) have been carried out. In 4 years, organ donation has started in 25 of 32 provinces in the country. From 2010 to 2013, the ratio of DCD liver transplantation to total case numbers in China rose from 1.38% to 26.1%, whereas for kidney, the ratio were 0.59% and 24.6%, respectively. The total number of DCD in China has accumulated to 1564 cases, and 4243 organs were transplanted. To alleviate the further difficulties of donation, establishment of professional organ procurement organizations in transplant hospitals, legislation of brain death, and promulgation of legal guidelines on DCD will be the main targets of organ donation development in China.

  12. The national program for deceased organ donation in China.

    PubMed

    Huang, Jiefu; Wang, Haibo; Fan, Sheung Tat; Zhao, Baige; Zhang, Zongjiu; Hao, Lina; Huo, Feng; Liu, Yongfeng

    2013-07-15

    China has developed a new national program for deceased-organ donation to address the need for organ transplantation in the country. The program adheres to the World Health Organization (WHO) guiding principles, is compliant with the Declaration of Istanbul, and respects the cultural and social values of the Chinese people. The experience of pilot trials conducted between 2010 and 2012 was evaluated to generate a comprehensive design of a national program of organ donation and transplantation for implementation throughout China. The legal framework for this program was established from a series of legislative steps since 2007. Accountable national committees have been established to oversee activities of organ donation and transplantation across the nation. The Ministry of Health (MOH) has accredited 164 organ transplant hospitals in China, each of which has an organ procurement organization (OPO) to conduct organ donation and organ recovery. National protocols for deceased-organ donation in China include category I (organ donation after brain death), category II (organ donation after circulatory death), and category III (organ donation after brain death followed by circulatory death). The China Organ Transplant Response System (COTRS) has been developed to allocate organs equitably and transparently. Scientific registries have been established to evaluate the performance of transplant centers and OPOs. China is in the process of implementing a new national program for deceased-organ donation. The program includes a unique approach of organ donation, China category III, which will be promulgated throughout China and is intended to gain widespread acceptance of Chinese society.

  13. 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.

  14. FAQ: Blood Donation and Organ Transplant

    MedlinePlus

    ... Mosquito Surveillance Software Health Education Public Service Videos Blood Donation & Organ Transplant Recommend on Facebook Tweet Share ... get infected with West Nile virus by donating blood? No. You cannot get West Nile virus by ...

  15. [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.

  16. Philippine law on donations of human organs.

    PubMed

    Ancog, Amelia C

    1992-09-01

    The Philippines "Organ Donation Act of 1991" updates the "1949 Act to legalize permissions to use human organs". Under the new legislation, each individual can donate all or any part of his body by way of legacy or will. The members of the family may also authorize such a donation in the absence of contrary intention by the decedent. Donations are only valid when made for therapy, research or medical education. International sharing of organs is recognized but subject to approval by the Department of Health. Regulations are about to be formulated in order to implement the Act which will be largely publicized to encourage donations.

  17. Organ donation: a communitarian approach.

    PubMed

    Etzioni, Amitai

    2003-03-01

    Recently, various suggestions have been made to respond to the increasingly great shortage of organs by paying for them. Because of the undesirable side effects of such approaches (commodification, injustice, and costs), a communitarian approach should be tried first. A communitarian approach to the problem of organ shortage entails changing the moral culture so that members of society will recognize that donating one's organs, once they are no longer of use to the donor, is the moral (right) thing to do. This approach requires much greater and deeper efforts than sharing information and making public service announcements. It entails a moral dialogue, in which the public is engaged, leading to a change in what people expect from one another. Among the devices that could help change the moral culture are a public statement, endorsed by community members and leaders, that expresses the community sense that donation "is what a good person does" and a community-specific web page that lists those who have made the commitment. A change in law so that a person's wishes in the matter are recognized as final and binding are also desired. This position paper deals only with cadaver organs and not living donors.

  18. Marketing organ donation around the globe.

    PubMed

    Guy, B S; Aldridge, A

    2001-01-01

    Marketing to potential organ donors in different countries requires knowledge about religious beliefs and cultural norms that might influence the decision to donate. Because beliefs vary so widely from country to country, marketers need to consider whether a standardized or adaptive approach is suitable for marketing organ donation in different countries. This article takes a look at the variables that influence the decision to donate an organ and suggests marketing strategies that may work in various parts of the world.

  19. 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…

  20. Indian ICU nurses' perceptions of and attitudes towards organ donation.

    PubMed

    Vijayalakshmi, Poreddi; Nagarajaiah; Ramachandra; Math, Suresh Bada

    Nurses play a significant role in identifying and securing potential organ donors in the clinical environment. Research among Indian nurses related to organ donation is sparse. The present study aimed to investigate nurses' attitudes towards organ donation. A cross-sectional descriptive survey was carried out among nurses (n=184) at a tertiary care centre. Data were collected through self-report questionnaire. A majority (81%) of the respondents were 'willing to sign the card' for organ donation; however, only 3.8% (n=7) of them actually 'signed the organ donation card'. There were significant associations found between intentions to sign the organ donation card and gender (x2=5.852; p<0.054), religion (x2=40.175; p<0.000), and experience caring for brain-dead patients (x2=22.790; p<0.001). The researchers strongly suggest continuing education for nurses to enhance skills and knowledge, as well as sensitivity to cultural, ethical, social, and religious issues, and advocacy in the area of organ donation. Furthermore, nurse administrators must take the initiative to develop guidelines clarifying the role of nurses in the organ donation and transplantation process to promote organ donation and improve rates.

  1. Organ donation consanguinity or universality.

    PubMed

    Kishore, R R

    1996-01-01

    1. Neither the "Diseased Persons" nor the "Genetic Relations" provide an answer to "trading" in human body parts. 2. Live human body constitutes a vital source of supply of organs and tissues and the possibilities of optimum utilisation should be explored. 3. There is no scope for dogmatic postures and open-mindedness should be the approach while dealing with the issue of Organ Transplantation. 4. Society owes a duty to save the file of a dying man and in the event of failure to do so, it is absolutely immoral to interfere with his own arrangements by making unrealistic laws. No immorality is involved if an individual disposes of his spare body parts for a valid consideration to a needy person. 5. The scarcity needs to be urgently overcome otherwise unwarranted trade and crime are liable to thrive. 6. Families are not unconnected or antagonistic fragments of humanity. After thousands of years of continuous efforts the individuals on this earth have attained the stage of organic and functional integration. Atomisation of society on the basis of consanguineous proximities amounts to reversing this holistic trend. Organ transplantation is a functional expression of a highly evolved pursuit with inherent and intimate interaction in the form of organic exchange at the individual level, independent of consanguineous inducements or motivations. As such there is absolutely no scope for restricting organ donations by strangers. 7. Commercialisation should be curbed by making the enforcement agencies more efficient and not by depriving a needy person of his genuine requirements. Legislative craftsmanship lies in providing an answer without curtailing the freedom of the people.

  2. Understanding Australian families' organ donation decisions.

    PubMed

    Neate, S L; Marck, C H; Skinner, M; Dwyer, B; McGain, F; Weiland, T J; Hickey, B B; Jelinek, G A

    2015-01-01

    Numbers of deceased organ donors in Australia have increased, but rates of consent to donation remain at around 60%. Increasing family consent is a key target for the Australian Organ and Tissue Authority. Reasons for donation decisions have been reported in the international literature, but little is known of reasons for Australian families' decisions. Potential organ donors in four Melbourne hospitals were identified and 49 participants from 40 families (23 consenting and 17 non-consenting) were interviewed to understand reasons for consent decisions. Themes for consent to organ donation included that: donation was consistent with the deceased's explicit wishes or known values, the desire to help others or self-including themes of altruism, pragmatism, preventing others from being in the same position, consolation received from donation and aspects of the donation conversation and care that led families to believe donation was right for them. Themes for non-consent included: lack of knowledge of wishes; social, cultural and religious beliefs; factors related to the donation process and family exhaustion; and conversation factors where negative events influenced decisions. While reasons for consent were similar to those described in international literature, reasons for non-consent differed in that there was little emphasis on lack of trust of the medical profession, concerns regarding level of care provided to the potential donor, preserving the deceased's body, fears of body invasion or organ allocation fairness.

  3. 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.

  4. 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.

  5. Brain death and organ donation of children.

    PubMed

    Gündüz, Ramiz Coşkun; Şahin, Şanlıay; Uysal-Yazıcı, Mutlu; Ayar, Ganime; Yakut, Halil İbrahim; Akman, Alkım Öden; Hirfanoğlu, İbrahim Murat; Kalkan, Gökhan

    2014-01-01

    We aimed to define the demographic characteristics, clinical features and outcome of patients with brain death, and to emphasize the importance of organ donation from children. Data for the period from September 2009 to October 2012 were collected retrospectively. Twenty children who were diagnosed as brain death were included. Data including demographics, major cause leading to brain death, duration of brain death evaluation, ancillary tests used to confirm brain death, complications and outcome, duration of hospitalization and organ donation were collected for statistical evaluation. The mean age was 6.2 years, and the male/female ratio 1.85. The major cause leading to brain death was most often traumatic brain injury, seen in 11 patients (55%). The mean duration of brain death evaluation was 6.7 and 1.7 days in Centers I and II respectively. The mean duration of hospitalization was 12.5 days. Electroencephalography (EEG) was used in 18 patients (90%). Complications included hyperglycemia in 13 cases and diabetes incipitus in 7 cases (65% and 35%, respectively). Mean duration of survival was 9.8 days. In Center I, one of the patients' parents gave consent to organ donation, while four parents in Center II agreed to organ donation. The study demonstrated that the duration of brain death evaluation was longer in Center I than in Center II (p<0.05). When both centers were compared, there was no significant difference in regard to obtaining consent for organ donation, survival after diagnosis of brain death and length of stay in the PICU (p>0.05). Early diagnosis of brain death and prompt evaluation of patients by ICU physicians once the diagnosis is taken into consideration will probably yield better organs and reduce costs. Training PICU physicians, nurses and organ donation coordinators, and increasing children's awareness of the need for organ donation via means of public communication may increase families' rate of agreement to organ donation in the future.

  6. 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.

  7. Psychosocial variables associated with willingness to donate organs.

    PubMed Central

    Nolan, B E; Spanos, N P

    1989-01-01

    Questionnaires were administered to 108 university psychology students to investigate attitudes and behaviour related to organ donation. Three groups (committed, uncommitted and opposed) were identified. A multivariate analysis of variance showed that, compared with uncommitted donors, committed donors felt better informed about organ donation, had discussed donation more often with family members and knew more people who had signed donor cards. The subjects in the opposed group and those in the uncommitted group cited different reasons for not signing a donor card. Empathy, religious beliefs and attitudes about death did not affect willingness to donate. Analyses of the interaction between willingness to donate one's own organs and willingness to donate those of a family member revealed a monotonic increase in willingness to donate the organs of a family member as the type of recipient became more personally relevant. Our findings indicate that when health care professionals request donor organs the potential recipients must be presented to the potential donors in a personally relevant manner. Educational programs must be developed to train medical personnel in how to effectively ask for organs without coercing the potential donor or invading the privacy of the potential recipient. PMID:2731099

  8. 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.

  9. [Organs, tissues, and cells donation in Mexico].

    PubMed

    Moreno-Treviño, María Guadalupe; Rivera-Silva, Gerardo

    2015-01-01

    Transplants are one of the most important advances of modern medicine; in the last 50 years in our country there have been more than fifty thousand transplants, which makes it clear that this is one of the most sought-after medical practices not only in Mexico but worldwide. In life, it is possible for a person to donate a kidney, a lung or a liver segment. When brain death occurs it is possible for a person to donate kidneys, heart, liver, pancreas, intestines, lungs, blood, hematopoietic cells, bone marrow, bones, corneas, heart valves, tendons, and arteries. However, the culture of organ donation is not widespread among Mexicans, hence in our country there is not even 50 % of the number of donations recommended by WHO, which impacts the number of patients who are waiting for an organ or tissue, which causes many of them die before receiving them.

  10. EFFECTS OF MESSAGE FRAMING AND EXEMPLARS ON PROMOTING ORGAN DONATION.

    PubMed

    Chien, Yu-Hung; Chang, Wen-Te

    2015-12-01

    People in many countries are unwilling to donate organs. Drawing on previous research regarding the use of message framing and the theory of exemplification promoting intentions to donate organs, this study examined messaging strategies. This study used a 2 × 2 between-subjects factorial design to examine the joint effects of gain/loss frames and statistical/exemplar appeals on the intentions of 189 Taiwanese college students (108 women, 81 men; age range = 19-24 yr., M = 21.6, SD = 2.9) regarding organ donation. Each participant was randomly assigned to read one of four versions of an organ donation promotional message and then to complete a questionnaire. The analysis of variance showed a significant interaction between the two factors. Loss-exemplar messages elicited significantly more positive intentions toward donation than did loss-statistical messages. There was no significant difference between the statistical and exemplar appeals observed under the gain-framed condition. The practical implications of developing effective organ donation promotional materials and the limitations of this study are discussed.

  11. 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…

  12. 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].

  13. [Blood donation: mechanic solidarity versus organic solidarity].

    PubMed

    Pereima, Rosane Suely May Rodrigues; Reibnitz, Kenya Schmidt; Martini, Jussara Gue; Nitschke, Rosane Gonçalves

    2010-01-01

    The article offers a reflection of blood donation in an hemocenter of Santa Catarina, with a mechanic and organic solidarity approach. It discuss the way of life in contemporary globalization and the cult of speed in a context pervaded by uncertainties and adversities. People live in a fast world, making social interaction difficult, contributing to the weakening of values and attitudes that could improve the quality of life. Considering the difficulties of everyday contemporary society, concerning Brazilian hemotherapy history on blood donation, there is a perception that attitudes and values, such as solidarity, have been modifying in subtle ways with a background of current events. It searches for understanding of blood donation as mechanic and organic solidarity.

  14. Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

    PubMed

    Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

    2015-01-01

    Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system.

  15. A profile of Australian adults who have discussed their posthumous organ donation wishes with family members.

    PubMed

    Newton, Joshua D; Burney, Sue; Hay, Margaret; Ewing, Michael T

    2010-07-01

    Next of kin who are aware of the deceased's organ donation wishes usually will honor those wishes, while next of kin who are unaware of these wishes typically withhold consent for posthumous donation. Encouraging individuals to communicate or register their organ donation wishes is therefore important. Using a sample of 409 participants, the current study sought to develop a profile of Australian adults who had communicated their organ donation wishes to family members. Christian participants and those who had a higher income were more likely to have communicated their donation wishes. Conversely, participants were less likely to have communicated their donation wishes if they were unregistered and undecided/opposed to organ donation, unregistered but willing to donate, or fearful of death. Finally, whether participants had communicated, registered, or communicated and registered their donation wishes was associated with their age, religion, attitude toward organ donation, and recall of media content about organ donation. Messages encouraging the communication of organ donation wishes to family members should therefore be targeted toward those individuals who are most likely to be receptive toward enacting this behavior.

  16. Cadaveric & living organ donation. Asian experience.

    PubMed

    Takagi, Hiroshi

    2004-01-01

    The number of organ transplants performed in Asian countries during 2001 and 2002 are reported along with the present status of dialysis patients. Questionnaires were sent to key persons of each country where transplantation currently takes place. The total number of organ transplants is gradually decreasing, particularly those using cadaveric donors, while liver and lung transplantation using living donors are growing in Japan and Korea. Education and stimulation of the public is strongly requested to promote donation.

  17. Development of the National Living Donor Assistance Center: reducing financial disincentives to living organ donation

    PubMed Central

    Warren, Patricia H.; Gifford, Kimberly A.; Hong, Barry A.; Merion, Robert M.; Ojo, Akinlolu O.

    2015-01-01

    Over the years, the transplant community has worked to advance the care of living organ donors; however, barriers remain, including the nonmedical expenses incurred by living donors. A new center, funded by a grant from the Health Resources and Services Administration (HRSA), was established to operate a nationwide system to remove these financial disincentives. The HRSA grant was awarded to an academic institution and the daily operations are managed by a transplant professional society. Expenses are reimbursed prospectively for financially needy living donors. Combining the legislative authority and economic resources of the federal government, the research experience of an academic institution, and the management know-how of a professional society has proven to be successful. To date, the center has received 3918 applications submitted by 199 different transplant centers and receives about 80 applications per month. On average, a donor spends $2767 for their travel expenses to the transplant center. Of the 3918 applications that have been submitted, 1941 of those applicants (50%) have completed their donor surgery. PMID:24598569

  18. Organ donation: a significant marketing challenge.

    PubMed

    Clarke, Roberta N

    2007-01-01

    Unlike most health care markets, the organ donation market is one where patients are the marketers, prospective donors are the customers, and no payment is allowed in the exchange process. The assumption that altruistic behavior by donors would satisfy the need for organs has proven woefully untrue. As a result, those needing organs have resorted to relying on unwilling or impoverished donors, to having to promote themselves on websites which have achieved success for only small numbers of patients, or to waiting for organs which they may never receive. This remains a still unsolved marketing challenge.

  19. 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.

  20. A 15-year review of ABC, CBS, and NBC news coverage of organ donation: implications for organ donation campaigns.

    PubMed

    Quick, Brian L; Kim, Do Kyun; Meyer, Kevin

    2009-03-01

    This content analysis represents news coverage of organ donation from January 1990 to December 2005. Specifically, ABC, CBS, and NBC news broadcasts were examined to gain a greater understanding of organ donation coverage on TV. Overall this investigation revealed that organ donation received modest coverage (N = 1,507). Although the majority of coverage was positive, attention to the need for organs and the process of becoming a potential organ donor received modest exposure. In addition, non-living donor and living-donor donations received approximately equal coverage. Results are discussed with a focus on message design for practitioners and advocates of organ donation.

  1. Organ and tissue donation: a survey of nurse's knowledge and educational needs in an adult ITU.

    PubMed

    Collins, Timothy J

    2005-08-01

    The aim of this paper is to present the results of a survey that was undertaken to assess nurses' knowledge and educational needs towards organ donation within one adult general intensive care unit. The survey consists of 31 registered nurses who completed a confidential questionnaire that aimed to assess their existing knowledge and deficits in organ and tissue donation. The survey highlights the sample lacked confidence in approaching relatives for donation consent, deficits in brain stem death testing and donor criteria. It was also apparent that a significant number of nurses could not identify which tissues can be donated and the contraindications for tissue donation. A majority of the sample stated their knowledge of donation issues would improve if an educational programme were developed on organ donation. This is further supported by previous work by [Bidigare S, Oermann M, 1991. Attitudes and knowledge of nurses regarding organ procurement. Heart & lung 1:20-3; Smith-Brew S, Yanai L, 1996. The organ donation process through a review of the literature. Part 1. Accident & emergency nursing 4:5-11; Roark D, 2000. Overhauling the organ donation system. Am J Nurs 6:44-9] who suggest that educational programmes covering donation issues should enhance nurses' knowledge and confidence in the organ donation process and ultimately increase the number of potential donors.

  2. Incentives for organ donation: some ethical issues.

    PubMed

    Sells, Robert

    2004-01-01

    Objections to commerce in organs has not stopped the spread of such practice around the world. In most countries the gap between supply and demand for organs continues to increase. Kidneys from living donors are considered a valuable addition to the donor pool, and in a more acquisitive world, donor incentives are becoming thinkable, even acceptable. Current incentives for cadaver and living organ donation are reviewed from ethical and legal perspectives. A new principle of reimbursement for the living donor's risk and pain is defined and presented for debate.

  3. The Australian experience in organ donation--2003.

    PubMed

    Mathew, Timothy

    2004-01-01

    The Australian performance in deceased donor organ donation continues to languish near the bottom of the International ladder. This is despite a national expenditure on health 10% more than the average OECD country (dollars per capita) and the presence of active transplantation programs (heart, kidney, liver, lung and pancreas) with excellent success rates. The deceased donor rate has fallen from 14 donors pmp in 1989 to 9 at the present time and appears to be still falling. Living donors now outnumber deceased donors as a source of kidney transplants. Causes of the low deceased donor rate appear to include variable management of severe brain injury, shortage of ICU beds, lack of ICU priority to potential donors when beds are restricted, and a low family consent rate (50%) despite 83% of the public being willing to donate. Programs aimed at addressing these issues are planned and include additional funding for beds, improved identification of donors and a standard pathway for managing severe brain injury.

  4. Legal and ethical aspects of organ donation and transplantation.

    PubMed

    Shroff, Sunil

    2009-07-01

    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

  5. 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

  6. Social Donation and University Development: A Comparative Analysis between China's and America's Endowment for Public Education

    ERIC Educational Resources Information Center

    Gong-li, Luo; Xuan-liang, Yang; Huai-zu, Li

    2006-01-01

    Social donation is a means for individuals, government organizations, and non-government organizations (NGOs) to provide public products and services for society. Seeking social donation is vital in the improvement of the university. This paper probes into the relationship between social donation and university development by comparing social…

  7. [The ethics of organ donation for transplantation].

    PubMed

    Fernandes, F V

    1994-01-01

    The new law 12/93, which regulates organ donation for transplantation in Portugal, is reviewed. The author emphasizes the importance of some legal improvements to allow a better fulfillment of the first principles of ethics that will rule the conflicts of interest between living and dead donors and recipients. Criticism is made of the interference that the Ministry of Health will have in the decision of doctors' and Medical Centres' competence. The importance given to economic reasons which stimulate political promotion and minimise ethical and professional reasons would become future factors of obstruction and backwardness.

  8. 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.

  9. 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

  10. The Consequences of Vagueness in Consent to Organ Donation.

    PubMed

    Shaw, David M

    2016-12-28

    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.

  11. Donation after cardiac death in abdominal organ transplantation.

    PubMed

    Reich, David J; Guy, Stephen R

    2012-01-01

    This article reviews the field of donation after cardiac death, focusing on the history, ethicolegal issues, clinical outcomes, best practices, operative techniques, and emerging strategies to optimize utilization of this resource. Donation after cardiac death is one effective way to decrease the organ shortage and has contributed the largest recent increase in abdominal organ allografts. Currently, donation after cardiac death organs confer an increased risk of ischemic cholangiopathy after liver transplant and of delayed graft function after kidney transplant. As this field matures, risk factors for donation after cardiac death organ transplant will be further identified and clinical outcomes will improve as a result of protocol standardization and ongoing research.

  12. Knowledge and attitudes about deceased donor organ donation in Filipinos: a qualitative assessment.

    PubMed

    Albright, C L; Glanz, K; Wong, L; Dela Cruz, M R; Abe, L; Sagayadoro, T L

    2005-12-01

    Fewer ethnic minorities, especially Asian-Americans, become organ donors. There are cultural, religious, and personal barriers to becoming a designated organ donor. Factors that promote or inhibit organ donation in Asians, especially Filipinos, are not well understood. We conducted a series of focus groups to identify barriers and facilitators to organ donation (deceased donor) among Filipinos. Six focus groups were conducted with church members, adolescents, nurses, physicians, organ recipients, and organ donor families. The mean age of adult participants (n = 57) was 52.3 +/- 15 years, 83% were Catholic, and 72% were female. A qualitative theme analysis methodology identified dominant themes related to organ donation in the participants. The major themes were: awareness of organ donation (38%), family beliefs (25%), religion/spirituality (10%), attitude/emotions (10%), personal experience with organ donation (8%), health profession (6%), and cultural issues (3%). Seventy-five percent of the comments about awareness reflected a positive awareness of cultural issues regarding organ donation, and the rest reflected a lack of awareness or misconceptions. Almost every theme was mentioned in all six focus groups. Understanding a specific ethnic group's knowledge, attitudes, and cultural beliefs regarding organ donation is important in the development of educational campaigns to encourage organ donation in ethnic minority populations.

  13. 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…

  14. 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.

  15. 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.

  16. 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.

  17. Voluntary organ donation system adapted to Chinese cultural values and social reality.

    PubMed

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

    2015-04-01

    Organ donation and transplant systems have unique characteristics based on the local culture and socioeconomic context. China's transplant and organ donation systems developed without regulatory oversight until 2006 when regulation and policy were developed and then implemented over the next several years. Most recently, the pilot project of establishing a voluntary citizen-based deceased donor program was established. The pilot program addressed the legal, financial, and cultural barriers to organ donation in China. The pilot program has evolved into a national program. Significantly, it established a uniquely Chinese donor classification system. The Chinese donor classification system recognizes donation after brain death (category I), donation after circulatory death (category II), and donation after brain death followed by circulatory death (category III). Through August 2014, the system has identified 2326 donors and provided 6416 organs that have been allocated though a transparent organ allocation system. The estimated number of donors in 2014 is 1147. As China's attitudes toward organ donation have matured and evolved and as China, as a nation, is taking its place on the world stage, it is recognizing that its past practice of using organs from executed prisoners is not sustainable. It is time to recognize that the efforts to regulate transplantation and provide voluntary citizen-based deceased organ donation have been successful and that China should use this system to provide organs for all transplants in every province and hospital in China. At the national organ transplant congress on October 30, 2014, the Chairman of the China's national organ donation and transplantation committee, Jeifu Huang required all hospitals to stop using organs from executed prisoners immediately and the civilian organ donation will be sole source for organ transplant in China starting January 2015.

  18. 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…

  19. Financial compensation for deceased organ donation in China.

    PubMed

    Wu, Xiaoliang; Fang, Qiang

    2013-06-01

    In March 2010, China launched a pilot programme of deceased donor organ donation in 10 provinces and cities. However, the deceased donor donation rate in China remains significantly lower than in Spain and other Western countries. In order to provide incentive for deceased donor organ donation, five pilot provinces and cities have subsequently launched a financial compensation policy. Financial compensation can be considered to include two main forms, the 'thank you' form and the 'help' form. The 'thank you' form is an expression of gratitude on behalf of the Red Cross Society of China for consenting to donation. The 'help' form is social welfare support for needy families.

  20. 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…

  1. 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

  2. Potential law reform for Australia's organ donation system.

    PubMed

    Halls, Alexandra

    2012-12-01

    Australia's current organ donation rates are very low, particularly in comparison to several European countries such as Spain and Austria. Many Australians wait for many years to receive organs that they desperately need, and many die while waiting. Australia's current organ donation system is based on express consent, with intending donors registering that intent at the Australian Organ Donation Registry. However, given that organs can only be donated in certain circumstances, this system is proving to be inadequate. This article compares the current express consent (or "opt-in") system and the presumed consent (or "opt-out") system used in the European countries that have significantly higher donation rates. It suggests reforms to Australian legislation to change the current system to that of presumed consent, and considers whether it is likely to work in Australian society.

  3. [Latin program for organ donation: the intensivists are networking].

    PubMed

    Revelly, J-P; Heidegger, C-P; Eckert, P; Moretti, D; Chevrolet, J-C; Chioléro, R

    2008-12-10

    The new Swiss federal law on organ and transplantation strengthens the responsibilities of the intensive care units. In Italian and French speaking parts of Switzerland, the Programme Latin pour le Don d'Organe (PLDO) has been launched to foster a wider collaboration between intensivists and donation coordinators. The PLDO aims at optimising knowledge and expertise in organ donation through improvements in identification, notification and management of organ donors and their next of kin. The PLDO dispenses education to all professionals involved. Such organisation should allow increasing the number of organs available, while improving healthcare professionals experience and next of kin emotion throughout the donation process.

  4. 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.

  5. 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.

  6. "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…

  7. The impact of an organ donation registration information program for high school students in the Netherlands.

    PubMed

    Reubsaet, A; Brug, J; Nijkamp, M D; Candel, M J J M; van Hooff, J P; van den Borne, H W

    2005-04-01

    In 1998, a new organ donor registration system was implemented in the Netherlands to increase the number of potential donors. A high school education program was developed to prepare adolescents to make an informed decision about organ donation. A post-test only randomised controlled trial was conducted in 39 high schools including 2868 students. Students within schools were randomly allocated to either attend the organ donation education program or not. The impact of the program on students' intention to register their organ donation preference (and determinants thereof) were analysed using multivariate multileveling modelling (MlwiN). The results show that students who were exposed to the education program had more favourable registration intentions (B = .40), were more often willing to be donors (OR = 1.45), and had greater knowledge about (B = 3.84) and more positive social outcome expectations (B = .09) and self-efficacy regarding organ donation registration (B=.22). Lastly, they experienced significantly less negative outcome expectations related to organ donation registration (B = -.15). Students' evaluation of the school-based education program was favourable. The present organ donation registration program proved to be effective in changing determinants of organ donation registration, and a large-scale implementation in the Dutch high school curriculum is planned.

  8. Deceased Donor Organs: What Can Be Done to Raise Donation Rates Using Evidence From Malaysia?

    PubMed

    Rasiah, R; Manikam, R; Chandrasekaran, S K; Naghavi, N; Mubarik, S; Mustafa, R; Pushparajan, S

    2016-05-01

    Organ donation rates have continued to fall seriously short of needs worldwide, with the lowest rates recorded among developing economies. This study seeks to analyze evidence from a developing economy to explore the usefulness of social psychological theory to solve the problem. The study deployed a large survey (n = 10 412) using a convenience sampling procedure targeted at increasing the number of Malaysians registered with the Ministry of Health, Malaysia who are willing to donate organs upon death. Structural equation modeling was deployed to estimate simultaneously the relative influence of cognitive and noncognitive variables on willingness to donate deceased organs. The cognitive factors of donation perception, socioeconomic status and financial incentives, and the noncognitive factors of demography and fear showed a high statistically significant (1%) relationship with willingness to donate organs after death. While financial incentives were significant, cash rewards showed the least impact. Donation perception showed the highest impact, which shows that the development of effective pedagogic programs with simultaneous improvements to the quality of services provided by medical personnel engaged in retrieving and transplanting deceased donor organs can help raise organ donation rates.

  9. 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

  10. 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.

  11. A cross-validation study of nurses' attitudes and commitment to organ donation in Hong Kong.

    PubMed

    Boey, Kam Weng

    2002-01-01

    This study examined the attitudes and commitment to posthumous organ donation among a group of nurses (N=314) in a teaching hospital in Hong Kong. Attitude was operationally defined by a self-report measure of favorable or unfavorable feelings and beliefs about organ donation, whereas commitment was defined by having signed a donor card. Consistent with findings reported in the West, nurses who exhibited favorable attitudes towards organ donation were of greater proportion than those who had signed a donor card. Younger and unmarried nurses were more likely to commit to posthumous organ donation. More than half (55%) of the nurses were undecided about commitment to organ donation, but most of them were likely to sign a donor card. Principal component analysis confirmed the conceptual structure of the Organ Donation Attitude Scale developed by Parisi and Katz (Health Psychol. 5 (1986) 565-580). Reliability of the factor scores (Humanitarian and moral conviction, Fears of bodily mutilation, and Fears of medical neglect) was satisfactory (Cronbach alpha ranged from 0.80 to 0.86). Fears of bodily mutilation were most significantly related to unwillingness to commit to organ donation. Implications of the findings for nursing education are discussed and suggestions for future research made.

  12. 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

  13. Directed organ donation: is the donor the owner?

    PubMed

    Cronin, Antonia J; Price, David

    2008-09-01

    The issue of directed donation of organs from deceased donors for transplantation has recently risen to the fore, given greater significance by the relatively stagnant rate of deceased donor donation in the UK. Although its status and legitimacy is explicitly recognized across the USA, elsewhere a more cautious, if not entirely negative, stance has been taken. In England, Wales and Northern Ireland, the Human Tissue Act 2004, and in Scotland the Human Tissue (Scotland) Act 2006, are both silent in this regard. Although so-called conditional donation, donation to (or perhaps withheld from) a specific class, has been outlawed as a product of guidance issued by the Secretary of State for Health issued in the wake of the controversial incident occurring in the North of England in 1998, its intended application to 'directed' donation is less certain.Directed and conditional donations challenge the traditional construct of altruistic donation and impartial (equitable) allocation in a very immediate and striking fashion. They implicitly raise important questions as to whether the body or parts of the body are capable of being owned, and by whom. This paper attempts to explore the notion of donor ownership of body parts and its implications for both directed and conditional donation.

  14. Directed organ donation: is the donor the owner?

    PubMed Central

    Cronin, Antonia J; Price, David

    2010-01-01

    The issue of directed donation of organs from deceased donors for transplantation has recently risen to the fore, given greater significance by the relatively stagnant rate of deceased donor donation in the UK. Although its status and legitimacy is explicitly recognized across the USA, elsewhere a more cautious, if not entirely negative, stance has been taken. In England, Wales and Northern Ireland, the Human Tissue Act 2004, and in Scotland the Human Tissue (Scotland) Act 2006, are both silent in this regard. Although so-called conditional donation, donation to (or perhaps withheld from) a specific class, has been outlawed as a product of guidance issued by the Secretary of State for Health issued in the wake of the controversial incident occurring in the North of England in 1998, its intended application to ‘directed’ donation is less certain. Directed and conditional donations challenge the traditional construct of altruistic donation and impartial (equitable) allocation in a very immediate and striking fashion. They implicitly raise important questions as to whether the body or parts of the body are capable of being owned, and by whom. This paper attempts to explore the notion of donor ownership of body parts and its implications for both directed and conditional donation. PMID:20890462

  15. A proposal for an anonymous living organ donation in Germany.

    PubMed

    Rittner, Christian K; Besold, Andrea; Wandel, Evelyn

    2003-03-01

    In Germany, living organ donation of paired and usually not regenerating organs is restricted by law to related individuals, as well as persons who 'obviously entertain an especially intimate personal relationship'. When this law was adopted in 1997, the intention of the legislator was to guarantee the free will of the donor and to exclude any trade of organs. Since then the transplantation of cadaveric organs has not increased. Additional organs were donated from living donors. However, for a number of reasons only a limited array of transplantation centers use living organ donation as a supply facing a steadily increasing number of patients with chronic renal failure. Living organ donation raises a variety of medical, ethical and legal questions. Although transplantation is a generally accepted therapeutic approach for impaired organ function, doctors do not promote it actively. Prospective donor-recipient pairs use the information obtained via internet and other sources before they contact the clinician. Doctors are hesitant to operate a healthy individual for allowing her or him to profit from this organ loss only emotionally or in an altruistic sense. Often a complex relationship between donor and recipient, as well as tissue incompatibility (ABO, HLA) may be additional reasons to restrain from carrying out living organ transplantation. To improve the chances for good organ function and better life quality of the patients we here propose a model for anonymous living organ donation with special reference to kidney transplantation.

  16. Cadaveric & living organ donation. Natural limitations. Possible solutions. Singapore experience.

    PubMed

    Prabhakar, K S

    2004-01-01

    Singapore is a country with different cultures and beliefs. Over the last thirty eight years since independance, it has blossomed close to being a developed nation. Having performed the first cadaver donor renal transplantation in 1970, there has been a tremendous amount of health literacy injected into the Singaporeans, with the able support of the National Kidney Foundation. Never ending waiting list for organ donation has facilitated a march of events from Volunatary Organ Pledging under the Medical Therapy, Education and Research Act to passing the Human Organ Transplant Act to extension of the presumed consent law to include Heart, Liver and Cornea and non-accidental brain deaths. In the years to come, Singapore will certainly see an increase in the number of organ transplantations both Cadaveric and Living related.

  17. 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.

  18. 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

  19. 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.

  20. Thanking and reciprocating under the New Zealand organ donation system.

    PubMed

    Shaw, Rhonda

    2012-05-01

    Organ donation and transplantation has been extensively addressed in the biomedical and bioethics literature in relation to debates around organ allocation and procurement strategies, and concerns about consent, coercion and commodification. This article addresses the topic sociologically, drawing on data from face-to-face in-depth interviews undertaken between 2008 and 2010 with organ and tissue recipients, anonymous altruistic donors and donor family members to discuss questions of reciprocity and intercorporeality that arise in the course of tissue exchange. In particular, the article examines the place of anonymity protocol for organ donors and transplantation recipients in New Zealand and their responses to conventions and scripts surrounding this rule. The article concludes by calling for discussion to re-examine anonymity protocol and rituals around organ donation and transplantation, citing lessons from gamete donation policies and recent law in New Zealand as productive for thinking through matters of personhood and identity relating to organ transfer.

  1. Pilot explores organ donation in the ED--challenges raised.

    PubMed

    2010-06-01

    A pilot program for ED organ donation at University of Pittsburgh Medical Center (UPMC)--Presbyterian Hospital is seeking much-needed organs, while maintaining optimal medical care for the living and avoiding potential conflicts of interest. Separate teams are involved with organ donation and with patient care, creating a "firewall" to prevent conflicts of interest. After failed CPR, a minimum of two minutes of no-CPR time is allowed to pass after death is pronounced to be certain there is no occult cardiac activity. Infusions of cold fluids are used to give enough time for the transplant surgeon to arrive and determine if any organs can be procured.

  2. Normative consent and presumed consent for organ donation: a critique.

    PubMed

    Potts, Michael; Verheijde, Joseph L; Rady, Mohamed Y; Evans, David W

    2010-08-01

    Ben Saunders claims that actual consent is not necessary for organ donation due to 'normative consent', a concept he borrows from David Estlund. Combining normative consent with Peter Singer's 'greater moral evil principle', Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' arguments. First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of 'mandatory consent'. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society.

  3. Organ donation by capital prisoners in China: reflections in Confucian ethics.

    PubMed

    Wang, Mingxu; Wang, Xueliang

    2010-04-01

    This article discusses the practice and development of organ donation by capital prisoners in China. It analyzes the issue of informed consent regarding organ donation from capital prisoners in light of Confucian ethics and expounds the point that under the influence of Confucianism, China is a country that attaches great importance to the role of the family in practicing informed consent in various areas, the area of organ donation from capital prisoners included. It argues that a proper form of organ donation from capital prisoners can be justified within the Confucian moral context in which the proper interests of capital prisoners and their families, the benefit of organ receptors, and a rightful order of society should all be appropriately considered. From the Confucian perspective, the act of donating organs from a capital prisoner must be decided by both the prisoner and his/her family (i.e., each side should hold a veto power), whereas such donation, in the proper circumstance protected by a rightful procedure, should be appreciated as a morally praiseworthy act of the prisoner who is willing to make the final effort to repent and correct his/her evil conduct and to leave something good to the world.

  4. Family discussions about organ donation: how the media influences opinions about donation decisions.

    PubMed

    Morgan, Susan E; Harrison, Tyler R; Long, Shawn D; Afifi, Walid A; Stephenson, Michael T; Stephenson, Michael S; Reichert, Tom

    2005-10-01

    In this study, 78 family pair dyads (spouses, parent-child pairs, or siblings) were brought into an interaction laboratory set up like a living room. After being briefed on the study, family members discussed a series of eight questions about their thoughts and opinions about organ donation. Thematic analysis of the thousands of pages of transcripts revealed that family members believe that they receive important information about organ donation through the media. Unfortunately, the most influential information came from sensationalistic, negative media portrayals. The myths that seem to be the most actively referenced by the media include premature declaration of death, the transference of personality traits from donor to recipient, a US black market for organs, corruption in the medical community, and corruption in the organ allocation system (which allows celebrities to get transplants first). Although these are not the only myths that the generally public holds to be true, the media is a powerful source of support for these particular myths. Therefore, such myths must be countered effectively if greater consent for organ donation is to be attained.

  5. 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.

  6. 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.

  7. 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.

  8. Attitudes to Cadaveric Organ Donation in Irish Preclinical Medical Students

    ERIC Educational Resources Information Center

    Cahill, Kevin C.; Ettarh, Rajunor R.

    2011-01-01

    There is a worldwide shortage of organs for transplantation. It has been shown that the attitude of healthcare professionals can improve the rates of organ donation, and that educational programs aimed at improving both attitudes and knowledge base of professionals can have positive outcomes. Although there has been research carried out on this…

  9. Clinical skin banking: II. Stimulating sources for organ donation.

    PubMed

    Fisher, J C; Ninnemann, J L; Wachtel, T L; Frank, H A

    1980-12-01

    Donor source stimulation for a regional skin bank is discussed, emphasizing the importance of coordination with other organ donor programs, centralization of a public information and donor identifying communication system, exploitation of regional legislative precedents which facilitate organ donation, and finally, identification of health professional and related groups with a common interest in matters associated with rational planning for the time of death. The specific problem associated with skin donation, namely, a sensitive description of the technical details of skin harvest, is also considered.

  10. 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

  11. Organ Donation and Elective Ventilation: A Necessary Strategy

    PubMed Central

    2017-01-01

    Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation. To perform elective nontherapeutic ventilation (ENTV), a patient's anticipated willingness to donate organs and/or explicit acceptance by his/her relatives is required. This process should focus exclusively on those patients with catastrophic brain injuries and imminent risk of death which, due to its acute damage, are not considered treatable. This article defends ENTV as an effective strategy to improve donation rate, analyzing its ethical and legal basis. PMID:28182115

  12. Organ Donation and Elective Ventilation: A Necessary Strategy.

    PubMed

    Escudero, Dolores; Otero, Jesus; Menéndez de León, Begoña; Perez-Basterrechea, Marcos

    2017-01-01

    Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation. To perform elective nontherapeutic ventilation (ENTV), a patient's anticipated willingness to donate organs and/or explicit acceptance by his/her relatives is required. This process should focus exclusively on those patients with catastrophic brain injuries and imminent risk of death which, due to its acute damage, are not considered treatable. This article defends ENTV as an effective strategy to improve donation rate, analyzing its ethical and legal basis.

  13. Elective ventilation for organ donation: law, policy and public ethics.

    PubMed

    Coggon, John

    2013-03-01

    This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

  14. 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.

  15. 75 FR 873 - Extramural Support Reimbursement of Travel and Subsistence Expenses Toward Living Organ Donation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-06

    ... HUMAN SERVICES Health Resources and Services Administration Extramural Support Reimbursement of Travel... providing reimbursement of travel and subsistence expenses for certain individuals donating their organs... reimbursement for qualifying travel and subsistence expenses related to live organ donation. The...

  16. 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.

  17. Motivations for Deceased Organ Donation Among Volunteers in China: A Qualitative Research Study.

    PubMed

    Yin, Zhike; Liu, Shan; Yan, Jin; Liu, Jia

    2016-06-09

    BACKGROUND To align with guiding principles on human organ and tissue transplantation published by the World Health Organization (WHO), the Red Cross Society of China (RCSC) launched a new nationwide organ donation program in 2010 to recruit organ donation volunteers. Despite severe shortage of donated organs, there is a very low rate of volunteering for organ donation among the Chinese population (only 0.03 donors per million population) in the national program. Motivating organ donation is the key to the success of organ transplantation in China. MATERIAL AND METHODS Semi-structured 45- to 60-min interviews were conducted among 34 volunteers. Data analysis was performed with Nvivo 8.0 software. RESULTS Six motivations for organ donation were identified: helping others/altruism, fulfilling long-cherished wishes, reducing the burdens, making the best use of everything, giving back to society, and life extension. Factors affecting the motivation of organ donation among volunteers in China included traditional values, personal experiences, role model effect, family support, and problems in the donation system. Possible strategies to improve organ donation included fostering a scientific concept of the body and death, focusing donation promotion efforts on certain groups, and simplifying the process of organ donation. CONCLUSIONS There are multiple reasons for Chinese people to register for organ donation, with helping others as the central motivation.

  18. 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…

  19. Organ donation: the role of hospitals.

    PubMed

    Land, W; Schulz, C

    1990-11-01

    Three models of cooperation between hospitals and transplant centres are: (1) performance of brain death diagnosis, organ removal and preservation at the peripheral hospital; (2) performance of brain death diagnosis at the peripheral hospital and transportation of the dead body under ICU modalities to the transplant centre; (3) transport of a potential organ donor to the transplant centre. The key issues for success in cooperation between peripheral hospitals and transplant centres are: positive attitudes of hospital representatives; motivation and acceptance of ICU staff, supported by the whole community; and availability of adequate facilities to perform organ recovery in practice.

  20. Points mean prizes: priority points, preferential status and directed organ donation in Israel

    PubMed Central

    2014-01-01

    The introduction of Israel’s new Organ Transplantation Act in 2010 has enabled the development of a unique priority point system aimed at motivating individual’s to donate their organ. The priority point system rewards those who are willing to donate an organ with preferential status and an increased chance of receiving a donor organ, should they come to be in need of one. Preliminary evidence suggests it has considerable public support among Israelis, who appear willing to redress the challenge posed by those who are willing to accept an organ but not willing to donate. Since the Act’s introduction Israel has witnessed record numbers signing donor cards and there has been a significant increase in the actual numbers of transplants. One aspect of the new Israeli system that has hitherto not much been considered is its tendency towards a communitarian model of organ donation and the implications this change in emphasis may have for the existing ‘opt-in’ model based upon autonomy and consent. Gil Siegel draws our attention to this aspect when he sets out his defence of a proposal he refers to as ‘directed organ donation to other registered donors’, which encourages community responsibility without affecting the established commitment to consent and individual freedom. This commentary provides a brief overview of the new Act and its priority point system. It also examines Siegel’s proposal and considers the implications it may have for equity and justice, personal choice and dispositional authority. It is argued that although the proposal brings with it several inevitable hurdles for policy makers these are not insurmountable. Rather, its extraordinary potential to save life and avoid suffering should prompt urgent action at policy level. If such a scheme was successfully implemented in Israel it would represent a landmark change in organ donation and allocation policy, and set an example from which we all could learn. PMID:24565060

  1. Points mean prizes: priority points, preferential status and directed organ donation in Israel.

    PubMed

    Cronin, Antonia J

    2014-02-24

    The introduction of Israel's new Organ Transplantation Act in 2010 has enabled the development of a unique priority point system aimed at motivating individual's to donate their organ. The priority point system rewards those who are willing to donate an organ with preferential status and an increased chance of receiving a donor organ, should they come to be in need of one. Preliminary evidence suggests it has considerable public support among Israelis, who appear willing to redress the challenge posed by those who are willing to accept an organ but not willing to donate. Since the Act's introduction Israel has witnessed record numbers signing donor cards and there has been a significant increase in the actual numbers of transplants.One aspect of the new Israeli system that has hitherto not much been considered is its tendency towards a communitarian model of organ donation and the implications this change in emphasis may have for the existing 'opt-in' model based upon autonomy and consent. Gil Siegel draws our attention to this aspect when he sets out his defence of a proposal he refers to as 'directed organ donation to other registered donors', which encourages community responsibility without affecting the established commitment to consent and individual freedom.This commentary provides a brief overview of the new Act and its priority point system. It also examines Siegel's proposal and considers the implications it may have for equity and justice, personal choice and dispositional authority. It is argued that although the proposal brings with it several inevitable hurdles for policy makers these are not insurmountable. Rather, its extraordinary potential to save life and avoid suffering should prompt urgent action at policy level. If such a scheme was successfully implemented in Israel it would represent a landmark change in organ donation and allocation policy, and set an example from which we all could learn.

  2. Organ donation after assisted suicide: a potential solution to the organ scarcity problem.

    PubMed

    Shaw, David M

    2014-08-15

    Switzerland has low deceased organ donation rates. It is also one of the few countries where assisted suicide is decriminalized in some circumstances. If organs donated by Swiss and foreign citizens assisted in committing suicide in Switzerland were used for transplantation, the country could achieve a surplus of organs. There are several practical problems and ethical and legal objections to this proposal, all of which can be overcome. Organ donation after planned death is a potential solution to the organ scarcity problem in any country that permits assisted dying.

  3. [Living organ donation vs. cadaveric donation - study of liver transplanted children and their families].

    PubMed

    Schulz, K H; Hofmann, C; Sander, K; Edsen, S; Burdelski, M; Koch, U; Rogiers, X

    2001-12-01

    that if they were to be asked today, they would donate again, only one of the partners raised objections. In summary, as a retrospective pilot study, this study primarily generates hypotheses rather than testing them and helps to develop research tools for the field. Results suggest that a psychological support be made available both prior to and following the operation, not only for the children but also for their families, with particular attention to the partners of the living donors and the siblings of the affected children.

  4. Tacitly consenting to donate one's organs.

    PubMed

    den Hartogh, Govert

    2011-06-01

    The common objection to opt-out systems of postmortal organ procurement is that they allow removal of a deceased person's organs without their actual consent. However, under certain conditions it is possible for 'silence'--failure to register any objection--conventionally and/or legally to count as genuine consent. Prominent conditions are that the consenter should be fully informed about the meaning of his or her silence and that the costs of registering dissent should be insignificant. This paper explicates this thesis and discusses some possible objections to it: (1) it cannot possibly be guaranteed that each citizen is aware of the meaning of silence; and (2) the system is slightly manipulative because it exploits a common defect in autonomous decision-making.

  5. 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.

  6. The joint action MODE (Mutual Organ Donation and Transplantation Exchanges): a sound contribution to implementation of health policies in organ donation and transplantation

    PubMed Central

    2013-01-01

    Background The main objective of the joint action MODE is the transfer of best-practices in the field of organ donation and transplantation and the creation of positive synergies among participating European (EU) Member States (MS) apt to support authorities in possible decision-making and policy contexts. Methods The consortium has chosen to foster the exchange of best-practice through a series of exchange visits followed by the provision of a set of specialized trainings. Each participating MS has presented its strengths and weaknesses through a questionnaire based on the Organ Action Plan. Once the situation was clearer, countries with the strongest program organized and hosted the on-site visits and each country had the opportunity to perform five exchange visits on five selected topics. Specific courses for healthcare staff of organ coordinating and transplantation centres were organized. Based on evaluation of the results of the on-site visits and training needs indicated by the partners, the chosen topics were: • reporting on adverse events and reactions • quality assurance programme of the donation process in Spain • quality assurance of the transplantation process Results and conclusions The outcome is that within the EU, even among MS with well-developed services, the organ donation and transplantation activity has substantial differences so that all participating countries would benefit from investigating foreign donation and transplant systems. Collaboration at EU level can be beneficial for all systems and the joint action MODE indicated that in some countries the sharing of expertise across the EU Member States has already proved to be useful in starting a virtuous circle in organization and training that would allow to increase organ donor rates and improve overall performance. PMID:23421414

  7. Non-heart beating organ donation. A case study.

    PubMed

    Stirling, John

    2005-11-01

    The aim of this case study is to discuss the clinical management of a non-heart beating organ donor. This case study will concentrate in particular on the clinical assessment of the potential donor patient undertaken by the donor transplant coordinator (DTC) and the donation process up to the time of transplantation. The author will also describe the differences between heart beating and non-heart beating donors and discuss how transplantation can benefit renal recipient patients.

  8. 48 CFR 52.226-6 - Promoting excess food donation to nonprofit organizations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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...

  9. Psychiatric Aspects of Organ Transplantation and Donation

    PubMed Central

    Faeder, Sarah; Moschenross, Darcy; Rosenberger, Emily; Dew, Mary Amanda; DiMartini, Andrea

    2015-01-01

    Purpose of the review Psychiatrists and other mental health professionals typically assist with evaluating and treating psychiatric and behavioral issues in transplant candidates, recipients and living organ donors. In this review recent findings on specific psychiatric issues in adult solid organ transplant candidates and recipients, as well as living donors are discussed as well as their relevance to clinical practice. Recent findings Patients with complex mental health and addiction histories can have outcomes similar to patients without these disorders but may require specialized pre-transplant preparation or post-transplant interventions to optimize their outcomes. Specific attention to the preparation and wellbeing of living donors is needed. Summary As transplant programs increasingly consider patients with complex mental health histories, psychiatrists and mental health professionals evaluating and treating these patients need to consider plans for early identification and treatment. Psychiatric care provided across the pre- to post-operative periods will best address the longitudinal care needs of patients with mental health disorders. Abstinence from substances and complete adherence to medical directives provides the best chance for optimal outcomes. Treatment of depression may improve transplant outcomes. Research is needed to identify effective interventions and the best strategies to engage patients to improve adherence. PMID:26186069

  10. Lower Consent Rates for Organ Donation Found among Racial and Ethnic Minorities and Older Donors

    MedlinePlus

    ... Health Literacy and Cultural Competency Computers and Medical Informatics Children's Health Aging Women's Health Full Research Reports ... about the organ donation process, the definition of brain death, the potential for donation to help others, ...

  11. 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.

  12. 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.

  13. Religio-ethical discussions on organ donation among Muslims in Europe: an example of transnational Islamic bioethics.

    PubMed

    Ghaly, Mohammed

    2012-05-01

    This article analyzes the religio-ethical discussions of Muslim religious scholars, which took place in Europe specifically in the UK and the Netherlands, on organ donation. After introductory notes on fatwas (Islamic religious guidelines) relevant to biomedical ethics and the socio-political context in which discussions on organ donation took place, the article studies three specific fatwas issued in Europe whose analysis has escaped the attention of modern academic researchers. In 2000 the European Council for Fatwa and Research (ECFR) issued a fatwa on organ donation. Besides this "European" fatwa, two other fatwas were issued respectively in the UK by the Muslim Law (Shariah) Council in 1995 and in the Netherlands by the Moroccan religious scholar Mustafā Ben Hamza during a conference on "Islam and Organ Donation" held in March 2006. The three fatwas show that a great number of Muslim religious scholars permit organ donation and this holds true for donating organs to non-Muslims as well. Further, they demonstrate that transnationalism is one of the main characteristics of contemporary Islamic bioethics. In a bid to develop their own standpoints towards organ donation, Muslims living in the West rely heavily on fatwas imported from the Muslim world.

  14. Forced organ donation: the presumed consent to organ donation laws of the various states and the United States Constitution.

    PubMed

    Powhida, A

    1999-01-01

    The issues presented in this Comment pertain to whether there are substantive limits imposed by the Fourteenth Amendment upon the state legislatures which would defeat the recent, tentative steps of many states to pass laws authorizing presumed consent to organ donation. The final and perhaps least effective presumed consent law creates a presumption of consent to organ donation. The potential organ donor makes the choice whether to donate or not during his lifetime. This form of the presumed consent law would probably have the least impact on increasing the number of available donor organs. It permitted the coroner to harvest the eyes and corneas of deceased individuals if the coroner was unaware of objections from either the decedent or the family of the decedent. Presumed consent statutes should be found unconstitutional because they infringe upon a family's property interest in a deceased relative's corpse. However, due to the family's property interest in a relative's deceased body, as set forth in the next section, the result is that presumed consent statutes are unconstitutional. In order to find the presumed consent law unconstitutional, the Court would have to find that either: (a) the Fourteenth Amendment's liberty component included the family's right to determine what happens to a relative's body after death, or (b) that the property component included a vested state law property interest in the dead body.

  15. For and against Organ Donation and Transplantation: Intricate Facilitators and Barriers in Organ Donation Perceived by German Nurses and Doctors

    PubMed Central

    Mayr, Beate; Paal, Piret; Frick, Eckhard; Forsberg, Anna

    2016-01-01

    Background. Significant facilitators and barriers to organ donation and transplantation remain in the general public and even in health professionals. Negative attitudes of HPs have been identified as the most significant barrier to actual ODT. The purpose of this paper was hence to investigate to what extent HPs (physicians and nurses) experience such facilitators and barriers in ODT and to what extent they are intercorrelated. We thus combined single causes to circumscribed factors of respective barriers and facilitators and analyzed them for differences regarding profession, gender, spiritual/religious self-categorization, and self-estimated knowledge of ODT and their mutual interaction. Methods. By the use of questionnaires we investigated intricate facilitators and barriers to organ donation experienced by HPs (n = 175; 73% nurses, 27% physicians) in around ten wards at the University Hospital of Munich. Results. Our study confirms a general high agreement with the importance of ODT. Nevertheless, we identified both facilitators and barriers in the following fields: (1) knowledge of ODT and willingness to donate own organs, (2) ethical delicacies in ODT, (3) stressors to handle ODT in the hospital, and (4) individual beliefs and self-estimated religion/spirituality. Conclusion. Attention to the intricacy of stressors and barriers in HPs continues to be a high priority focus for the availability of donor organs. PMID:27597891

  16. 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.

  17. Attitudes toward organ donation among waitlisted transplant patients: results of a cross-sectional survey.

    PubMed

    Merola, Jonathan; Pei, Kevin Y; Rodriguez-Davalos, Manuel I; Gan, Geliang; Deng, Yanhong; Mulligan, David C; Davis, Kimberly A

    2016-11-01

    Organ shortage remains a major barrier to transplantation. While many efforts have focused on educating the general population regarding donation, few studies have examined knowledge regarding donation and donor registration rates among waitlisted candidates. We aimed to determine waitlisted patients' willingness to donate, elucidate attitudes surrounding organ allocation, and identify barriers to donation. A cross-sectional survey was distributed to assess demographics, knowledge regarding organ donation, and attitudes regarding the allocation process. Responses from 225 of 579 (39%) waitlisted patients were collected. Seventy-one respondents (32%) were registered donors, while 64 patients (28%) noted no interest in participating in donation. A total of 19% of respondents felt their medical treatment would change by being a donor, while 86 patients (38%) felt their condition precluded them from donation. Forty patients (18%) felt they should be prioritized on the waitlist if they agreed to donate. A minority of patients (28%) reported discussion of organ donation with their physician. Waitlisted candidates constitute a population of willing, although often unregistered, organ donors. Moreover, many endorse misconceptions regarding the allocation process and their donation eligibility. In a population for which transplantation is not always possible, education is needed regarding organ donation among waitlisted patients, as this may enhance donation rates.

  18. The current status and future perspectives of organ donation in Japan: learning from the systems in other countries.

    PubMed

    Soyama, Akihiko; Eguchi, Susumu

    2016-04-01

    The revised Organ Transplant Law came into effect in Japan in July 2010. The law allows for organ procurement from brain-dead individuals, including children, with family consent from subjects who had not previously rejected organ donation. Nevertheless, the number of cadaveric organ donations has not increased as expected. The Spanish Model is widely known as the most successful system in the field of organ donation. The system includes an earlier referral of possible donors to the transplant coordination teams, a new family-based approach and care methods, and the development of additional training courses aimed at specific groups of professionals, which are supported by their corresponding societies. South Korea, a country which neighbors Japan, has recently succeeded in increasing the rates of organ donation by introducing several systems, such as incentive programs, an organ procurement organization, a donor registry, and a system to facilitate potential donor referral. In this review, we present the current status of organ donation in Japan and also explore various factors that may help to improve the country's low donation rate based on the experiences of other developed countries.

  19. 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.

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

    PubMed

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

    2016-12-16

    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.

  1. Organ donation after circulatory death in a university teaching hospital.

    PubMed

    Sidiropoulos, S; Treasure, E; Silvester, W; Opdam, H; Warrillow, S J; Jones, D

    2016-07-01

    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; P<0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. Deceased organ donation for transplantation: Challenges and opportunities

    PubMed Central

    Girlanda, Raffaele

    2016-01-01

    Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the wait-list an increase in the number of donors is necessary. Patients with devastating irreversible brain injury, if medically suitable, are potential deceased donors and strategies are needed to successfully convert them into actual donors. Multiple steps in the process of deceased organ donation can be targeted to increase the number of organs suitable for transplant. In this review, after describing this process, we discuss current challenges and potential strategies to expand the pool of deceased donors. PMID:27683626

  9. 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.

  10. Islam and end-of-life organ donation. Asking the right questions.

    PubMed

    Rady, Mohamed Y; Verheijde, Joseph L

    2009-07-01

    Organ transplantation has become an established treatment option for end-stage organ disease. Both living and end-of-life (so called deceased) organ donation narrow the gap between supply and demand for transplantable organs. Advances in human biology prove that death occurs as a gradual process over time and not as a single discrete event. Declaring death with either neurological criteria (heart-beating organ donation) or circulatory criteria (non-heart-beating organ donation) enables the procurement of transplantable organs before human death is complete, namely, from the incipiently dying donor. Thus, surgical procurement of organs from the incipiently dying donor is the proximate cause of death, raising new questions on end-of-life organ donation. It is imperative to first and foremost care for the patient as a dying person. International Muslim scholars should reevaluate previous Islamic rulings and provide guidance about current practice of end-of-life organ donation.

  11. 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

  12. 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.

  13. The default option: Why a system of presumed consent may be effective at increasing rates of organ donation.

    PubMed

    Rockloff, Matthew; Hanley, Christine

    2014-01-01

    In Australia, general sentiment towards organ donation is somewhat positive, but actual donation rates languish amongst the poorest in the western world. Even for registered organ donors, the Australian system mandates obtaining family consent for posthumous donation; making non-donation the default option. A telephone survey in Central Queensland, Australia (n=1289), investigated people's confidence regarding their decision on whether to donate organs of a deceased family member; whether or not they had discussed donation with their family; and their support for an opt-out (presumed consent) system of donation. In accord with our expectations, each of these factors independently predicted the wishes of respondents to donate their own organs. The results suggest that promoting organ donation as the default option may improve rates of public acceptance for organ donations and consequently save lives.

  14. Ethical controversies in organ donation after circulatory death.

    PubMed

    2013-05-01

    The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be required to participate in DCD. Because the preparation for organ recovery in DCD begins before the declaration of death, there are potential conflicts between the donor's and recipient's interests. These conflicts can be managed in a variety of ways, including informed consent and separating the various participants' roles. For example, informed consent should be sought for premortem interventions to improve organ viability, and organ procurement organization personnel and members of the transplant team should not be involved in the discontinuation of life-sustaining treatment or the declaration of death. It is also important to emphasize that potential donors in cases of DCD should receive integrated interdisciplinary palliative care, including sedation and analgesia.

  15. Organ donation: Transplant Games, the "Island Effect," and other successful methods.

    PubMed

    Slapak, M

    1997-11-01

    We have alluded to data showing that effective organisation has a well-documented effect on organ donation. We have also presented data demonstrating the positive effect of the Transplant Games on public opinion and through positive media influence, producing a very marked increase in organ donation. Attention has also been drawn to the surprising phenomenon we call the "Island Effect," which may endorse the concept of decentralisation and close communication as an effective way of increasing organ donation. Finally, we conclude that, with professional help, both into the organisation of organ donation, and the creation of a positive media effect on public opinion, there is a great scope for increasing human organ donation to levels that are very much higher than that which we now experience. Both the Transplant Games and the "Island Effect" have indicated routes that we can and must explore and use to narrow the vital gap between organ need and organ supply for transplantation.

  16. Knowledge and Attitude towards Organ Donation among Males in Riyadh, Saudi Arabia.

    PubMed

    Altraif, I H; Al Sebayel, M I; Nondo, H

    1996-01-01

    Organ transplant programs are increasing in Saudi Arabia with the major barrier to transplantation being a shortage of organs. The majority of Saudi Nationals are reluctant and unwilling to donate or consent for donation. This study was undertaken to determine the knowledge and attitude towards organ donation among males in Riyadh, Saudi Arabia. A questionnaire was distributed to 223 men attending the out-patient department of the National Guard Hospital, Riyadh. A total of 205 (92%) individuals answered the questionnaire. Of them, 187 (91%) were Saudis and 18 (9%) were non-Saudis. A total of 187 (88%) had heard about organ donation of whom 80 (43%) each, had acquired this knowledge through television or radio, 16 (8%) through newspaper and magazines, seven (4%) through friends and relatives, and four (2%) through health-care workers. Of the 205 study subjects, 88 (43%) claimed they understood the concept of brain-death, 96 (47%) did not, and 19 (10%) did not respond to this question. One hundred and thirty-eight (67%) were willing to donate, and 156 (76%) were willing to receive an organ. One hundred and fifteen (56%) believed that Islam permits people to donate organs, five (2%) thought Islam does not permit organ donation, 64 (31%) gave a "don't know" answer and 21 (11%) did not attempt to answer the question. In addition, 41 (20%) thought organ donation disfigures the body. In conclusion although 67% of the respondents in this survey were willing to donate, there was a significant lack of knowledge and misconception with regard to Islamic support to, and the mutilating effects of, organ donation. Public educational programs and other measures addressing these issues may help in increasing the rate of organ donation among Saudis.

  17. Opportunities not taken: successes and shortcomings in the Institute of Medicine's report on organ donation.

    PubMed

    Das, K K; Lerner, B H

    2007-04-01

    The Institute of Medicine's recent report, Organ Donation: Opportunities for Action, studies the current problems facing organ donation in the USA, making suggestions for quality improvement and analyzing various proposals of incentivized donation and presumed consent (PC). Although the report deals with the donation of several solid organs, this mini review examines the findings from the perspective of kidney transplantation. The committee's recommendations to move from circulatory to neurologic criteria for cadaveric donation and to increase opportunities for donor decision making are prudent. We agree with the committee's arguments against providing incentives for donation because of the inherent distributional inequalities and imperfect information; the intrinsic difficulties in establishing market equilibrium for such heterogeneous and perishable goods; the implied commoditization of the human body; and the inadequate data regarding the long-term risks of living donation. However, we question the committee's firm opposition to PC, especially given recent data from 22 European countries showing a 25-30% increase in organ supply attributable to a PC policy. If this simple change in the default position on donation has the potential to increase organ supply, decrease the need for living donation, reduce the burden on grieving families, maintain familial authority over the deceased, and respect patient autonomy, at least a pilot program of PC seems warranted.

  18. Presuming consent, presuming refusal: organ donation and communal structure.

    PubMed

    Loewy, E H

    2000-01-01

    Donating, distributing and ultimately transplanting organs each has distinct ethical problems. In this paper I suggest that the first ethical question is not what should be done but what is a fair way in which each of these problems can be addressed. Experts--whether these be transplant surgeons, policy analysts, political scientists or ethicists--can help guide but cannot by themselves make such decisions. In making these decisions the difference between identified and non-identified lives is crucial. I suggest that an approach in which reason is tempered by compassion ("compassionate rationality") when dealing with unidentified lives and in which compassion is controlled by reason ("rational compassion") in dealing with identified lives must serve us well. Ultimately decisions of this sort are prone to sturdy democratic process which is possible only when the preconditions of person, economic and educational democracy are met.

  19. [Determination of brain death in organ donation: is EEG required?].

    PubMed

    Kompanje, Erwin J O; Epker, Jelle L; de Groot, Yorick J; Wijdicks, Eelco F M; van der Jagt, Mathieu

    2013-01-01

    The determination of brain death is a prerequisite of multiple organ donation in ventilated patients in the ICU. The criteria for brain death differ internationally. In some countries, brain stem death is equivalent to brain death. In others, including the Netherlands, in addition to the determination of brain stem death, an EEG must also be carried out to rule out cortex activity according to the criteria of "whole brain death". However, this does not prove that there is complete failure of all brain functions; indeed, EEG does not examine the subcortical brain. The Dutch Health Board has established that brain death is ruled out by rest activity in the cortex, but not by persistent subcortical activity. This is conceptually incorrect. The criteria for brain stem death fit better in practice than the criteria for whole brain death. Taking an EEG should therefore no longer be an obligation in establishing brain death, as is the case in many other countries.

  20. 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.

  1. Conductivity Modifications of Graphene by Electron Donative Organic Molecules

    NASA Astrophysics Data System (ADS)

    Masujima, Hiroaki; Mori, Takehiko; Hayamizu, Yuhei

    2017-03-01

    Graphene has been studied for the application of transparent electrodes in flexible electrical devices with semiconductor organics. Control of the charge carrier density in graphene is crucial to reduce the contact resistance between graphene and the active layer of organic semiconductor. Chemical doping of graphene is an approach to change the carrier density, where the adsorbed organic molecules donate or accept electrons form graphene. While various acceptor organic molecules have been demonstrated so far, investigation about donor molecules is still poor. In this work, we have investigated doping effect in graphene field-effect transistors functionalized by organic donor molecules such as dibenzotetrathiafulvalene (DBTTF), hexamethyltetrathiafulvalene (HMTTF), 1,5-diaminonaphthalene (DAN), and N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD). Based on conductivity measurements of graphene transistors, the former three molecules do not have any significant effect to graphene transistors. However, TMPD shows effective n-type doping. The doping effect has a correlation with the level of highest occupied molecular orbital (HOMO) of each molecule, where TMPD has the highest HOMO level.

  2. 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.…

  3. The principles of gift law and the regulation of organ donation.

    PubMed

    Glazier, Alexandra K

    2011-04-01

    The principles of gift law establish a consistent international legal understanding of consent to donation under a range of regulatory systems. Gift law as the primary legal principle is important to both the foundation of systems that prevent organ sales and the consideration of strategies to increase organ donation for transplantation.

  4. Effects of anonymous information about potential organ transplant recipients on attitudes toward organ transplantation and the willingness to donate organs.

    PubMed

    Singh, Michelle; Katz, Roger C; Beauchamp, Kenneth; Hannon, Roseann

    2002-10-01

    Two approaches for educating college students about the need for organ donors were compared. The experimental group (N = 162) watched a video-taped dramatization of an organ procurement coordinator asking the family members of a recently deceased loved one if they would donate their loved one's organs. Contained in this videotape was demographic information about three adults who needed an organ transplant. The control group (N = 169) saw the same videotape minus the demographic information. Extrapolating from research on altruism, we hypothesized that information about potential organ recipients would increase the viewer's willingness to donate a next-of-kin's organs and their own willingness to become an organ donor. Results supported this hypothesis. Compared to the control group, the experimental group was more willing to donate a next-of-kin's organs and take action to become an organ donor. We tentatively conclude that providing information about potential organ recipients increases the willingness of college students to become organ donors.

  5. NHSBT consideration to ignore family override of consent to organ donation.

    PubMed

    Griffith, Richard

    2016-02-01

    NHS Blood and Transplant (NHSBT), the agency responsible for allocating donated organs and maintaining the organ donor register, is considering proceeding with harvesting organs from a registered donor in spite of objections from the deceased's family, in order to raise the number of available organs. District nurses are witness to the need for an increase in the number of donated organs, given the care they provide to those waiting for transplant, and it is essential that district nurses inform this debate. In this article, the author discusses the NHSBT proposal and reviews the law of consent in relation to organ donation.

  6. Analysis of knowledge of the general population and health professionals on organ donation after cardiac death

    PubMed Central

    Bedenko, Ramon Correa; Nisihara, Renato; Yokoi, Douglas Shun; Candido, Vinícius de Mello; Galina, Ismael; Moriguchi, Rafael Massayuki; Ceulemans, Nico; Salvalaggio, Paolo

    2016-01-01

    Objective To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. Methods 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. Results 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). Conclusion 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. PMID:27626950

  7. UK Polish Migrant Attitudes Toward Deceased Organ Donation: Findings from a Pilot Study.

    PubMed

    Sharp, Chloe; Randhawa, Gurch

    2015-08-01

    There is a critical shortage of transplantable organs in the UK. At present, there is no literature on Polish migrants' (the fastest growing community in the UK) attitudes toward organ donation. This is the first study to explore the views of the Polish community towards organ donation in the UK. There were 31 participants that took part in semi-structured interviews or small focus groups to discuss organ donation for approximately 1½-2 h. Interviews were transcribed and analysed using grounded theory methods to elicit thematic categories and sub-categories. Overall, participants had a positive attitude towards organ donation but demonstrated a lack of knowledge about the organ donation systems and processes in the UK and wanted to learn more about these issues. As little detailed data on ethnicity is collected on the NHS Organ Donor Register and on the active transplant waiting list, it is currently unclear as to how organ donation affects the Polish community living in the UK. However, the findings of the study highlight the Polish community could benefit from tailored education for a clearer understanding of organ donation processes and systems in the UK and registering as an organ donor.

  8. Metaphors of organ donation, social representations of the body and the opt-out system.

    PubMed

    Lauri, Mary Anne

    2009-11-01

    Organ donation is the only available treatment for end-stage failure of organs such as liver, lung, and heart and therefore increasing the number of organ donors is a priority for most countries. One measure that could be taken by a country to increase the number of organ transplants is to introduce the opt-out system of organ donation. Public opinion is divided on this issue and policy makers need to tread with caution before introducing legislation. This paper proposes that understanding the social representations the public has of organ donation is important in taking the right policy decisions. We propose here that an in-depth study of the views held by people on the issue is essential in this regard and that this can best be done by investigating the metaphors people use to describe organ donation, interpreted within the theory of social representation. In this study, the social representations of organ donation were investigated through five focus groups with 57 participants living in Malta. Analysis of the transcriptions of these focus groups yielded pertinent issues related to organ donation. Moreover, metaphors of organ donations and how these were related to social representations of the body and attitudes towards the opt-out system are discussed. It is being suggested that these findings could be of relevance to the present discussion on the opt-out system in the UK and in other countries.

  9. Experience of nurses in the process of donation of organs and tissues for transplant1

    PubMed Central

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

    2014-01-01

    Objective to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. Method 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. Results 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. Final considerations 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. PMID:26107829

  10. Incentivizing Authorization for Deceased Organ Donation With Organ Allocation Priority: The First 5 Years.

    PubMed

    Stoler, A; Kessler, J B; Ashkenazi, T; Roth, A E; Lavee, J

    2016-09-01

    The allocation system of donor organs for transplantation may affect their scarcity. In 2008, Israel's Parliament passed the Organ Transplantation Law, which grants priority on waiting lists for transplants to candidates who are first-degree relatives of deceased organ donors or who previously registered as organ donors themselves. Several public campaigns have advertised the existence of the law since November 2010. We evaluated the effect of the law using all deceased donation requests made in Israel during the period 1998-2015. We use logistic regression to compare the authorization rates of the donors' next of kin in the periods before (1998-2010) and after (2011-2015) the public was made aware of the law. The authorization rate for donation in the period after awareness was substantially higher (55.1% vs. 45.0%, odds ratio [OR] 1.43, p = 0.0003) and reached an all-time high rate of 60.2% in 2015. This increase was mainly due to an increase in the authorization rate of next of kin of unregistered donors (51.1% vs. 42.2%). We also found that the likelihood of next-of-kin authorization for donation was approximately twice as high when the deceased relative was a registered donor rather than unregistered (89.4% vs. 44.6%, OR 14.27, p < 0.0001). We concluded that the priority law is associated with an increased authorization rate for organ donation.

  11. Organ donation and transplantation-the Chennai experience in India.

    PubMed

    Shroff, S; Rao, S; Kurian, G; Suresh, S

    2007-04-01

    evolve a model to take this program to the national level and more so as it recently has been granted 100% tax exemption on all donations to form a countrywide network for organ sharing.

  12. Identification of a Patient Population Previously Not Considered for Organ Donation.

    PubMed

    Barrois, Brad

    2016-09-26

    For the foreseeable future, more individuals will need a kidney than there are kidneys available for transplant. This is not a new issue, and it is one that will not likely be solved anytime soon. While recent initiatives have focused on efficiently allocating kidneys in order to maximize supply, a shortage will remain.  Currently, organs are made available for transplant through three different processes: donation after brain death declaration (BD), donation after circulatory death (DCD), and living donation (one healthy individual donates to a person in need). The objective of this article is to discuss the possibility of a fourth option in imminent death single kidney donation (IDSKD) and its potential effects on the future of donation and transplantation. During our study, IDSKD had the potential to increase the number of kidneys transplanted in our service area by approximately 5%.

  13. Changing Patterns of Organ Donation: Brain Dead Donors Are Not Being Lost by Donation After Circulatory Death.

    PubMed

    Nelson, Helen M; Glazier, Alexandra K; Delmonico, Francis L

    2016-02-01

    The clinical characteristics of all New England Organ Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June 30, 2014. During that 5-year period, there were 494 authorized medically suitable potential DCDs that the NEOB evaluated, constituting more than 30% of deceased donors coordinated annually by the NEOB. From the cohort of 494 authorized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) transitioned to an actual donor after brain death (DBD). Two hundred seventy-six organs were transplanted from the 81 donors that transitioned from DCD to actual DBD, including 24 heart, 70 liver, 12 single and 14 bilateral lung, and 12 pancreas transplants. When patients with devastating brain injury admitted to the intensive care units are registered donors, the Organ Procurement Organization staff should share the patient's donation decision with the health care team and the patient's family, as early as possible after the comfort measures only discussion has been initiated. The experience of the NEOB becomes an important reference of the successful implementation of DCD that enables an expansion of deceased donation (inclusive of DBD).

  14. Expanding the donor pool: regional variation in pediatric organ donation rates.

    PubMed

    Godown, Justin; McKane, Meghann; Wujcik, Kari; Mettler, Bret A; Dodd, Debra A

    2016-12-01

    There are limited published data on pediatric organ donation rates. The aim of this study was to describe the trends in pediatric organ donation over time and to assess the regional variation in pediatric deceased organ donation. OPTN data were utilized to assess the trends in pediatric organ donation over time. The number of deceased pediatric organ donors was indexed using regional mortality data obtained from the National Center for Health Statistics and compared across UNOS regions and two different eras. The number of pediatric deceased organ donors has declined in the recent era, largely driven by fewer adolescent donors. For all age groups, there is significant regional variation in organ donation rates, with identifiable high- and low-performing regions. Expansion of the donor pool may be possible by optimizing organ donation in regions demonstrating lower recruitment of pediatric donors. Using the region with the highest donation rate for each age group as the gold standard, we estimate a potential 24% increase in the number of donors if all regions performed comparably, equating to 215 new pediatric donors annually.

  15. Randomised, Double Blind, Controlled Trial of the Provision of Information about the Benefits of Organ Donation during a Family Donation Conversation

    PubMed Central

    Aranha, Sarah; Pilcher, David V.; Bailey, Michael

    2016-01-01

    Introduction It is unclear how much information should be provided to families of potential organ donors about the benefits of organ donation. Whilst this information is material to the donation decision, it may also be perceived as coercive. Methods Randomised, double blind, controlled trial in which community members watched one of two videos of a simulated organ donation conversation that differed only in the amount of information provided about the benefits of donation. Participants then completed a questionnaire about the adequacy of the information provided and the degree to which they felt the doctor was trying to convince the family member to say yes to donation. Results There was a wide variability in what participants considered was the “right” amount of information about organ donation. Those who watched the conversation that included information about the benefits of donation were more likely to feel that the information provided to the family was sufficient. They were more likely to report that the doctor was trying to convince the family member to say yes to donation, yet were no more likely to feel uncomfortable or to feel that the doctor was uncaring or cared more about transplant recipients than he did for the patient and their family. Conclusions This study suggests that community members are comfortable with health care staff providing information to family members that may be influential in supporting them to give consent for donation. PMID:27322832

  16. Attitude of healthcare professionals: a major limiting factor in organ donation from brain-dead donors.

    PubMed

    Kosieradzki, Maciej; Jakubowska-Winecka, Anna; Feliksiak, Michal; Kawalec, Ilona; Zawilinska, Ewa; Danielewicz, Roman; Czerwinski, Jaroslaw; Malkowski, Piotr; Rowiński, Wojciech

    2014-01-01

    Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P < 0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude.

  17. Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

    PubMed Central

    Kosieradzki, Maciej; Jakubowska-Winecka, Anna; Feliksiak, Michal; Kawalec, Ilona; Zawilinska, Ewa; Danielewicz, Roman; Czerwinski, Jaroslaw; Malkowski, Piotr; Rowiński, Wojciech

    2014-01-01

    Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P < 0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude. PMID:25349721

  18. 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

  19. 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

  20. 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.

  1. Factors influencing the family consent rate for organ donation in the UK.

    PubMed

    Hulme, W; Allen, J; Manara, A R; Murphy, P G; Gardiner, D; Poppitt, E

    2016-09-01

    The refusal rate for organ donation in the UK is 42%, among the highest in Europe. We extracted data on every family approach for donation in UK ICUs or Emergency Departments between 1st April 2012 and 30th September 2013, and performed multiple logistic regression to identify modifiable factors associated with consent. Complete data were available for 4703 of 4899 approaches during the study period. Consent for donation after brain death was 68.9%, and for donation after circulatory death 56.5% (p < 0.0001). Patient ethnicity, knowledge of a patient's wishes and involvement of a specialist nurse in organ donation in the approach were strongly associated with consent (p < 0.0001). The impact of the specialist nurse was stronger for donation after circulatory death than for donation after brain death, even after accounting for the impact of prior knowledge of patients' wishes. Involvement of the specialist nurse in the approach, encouraging family discussions about donation wishes and promotion of the organ donor register are key strategies to increase UK consent rates, and are supported by this study.

  2. Intensive care practices in brain death diagnosis and organ donation.

    PubMed

    Escudero, D; Valentín, M O; Escalante, J L; Sanmartín, A; Perez-Basterrechea, M; de Gea, J; Martín, M; Velasco, J; Pont, T; Masnou, N; de la Calle, B; Marcelo, B; Lebrón, M; Pérez, J M; Burgos, M; Gimeno, R; Kot, P; Yus, S; Sancho, I; Zabalegui, A; Arroyo, M; Miñambres, E; Elizalde, J; Montejo, J C; Domínguez-Gil, B; Matesanz, R

    2015-10-01

    We conducted a multicentre study of 1844 patients from 42 Spanish intensive care units, and analysed the clinical characteristics of brain death, the use of ancillary testing, and the clinical decisions taken after the diagnosis of brain death. The main cause of brain death was intracerebral haemorrhage (769/1844, 42%), followed by traumatic brain injury (343/1844, 19%) and subarachnoid haemorrhage (257/1844, 14%). The diagnosis of brain death was made rapidly (50% in the first 24 h). Of those patients who went on to die, the Glasgow Coma Scale on admission was ≤ 8/15 in 1146/1261 (91%) of patients with intracerebral haemorrhage, traumatic brain injury or anoxic encephalopathy; the Hunt and Hess Scale was 4-5 in 207/251 (83%) of patients following subarachnoid haemorrhage; and the National Institutes of Health Stroke Scale was ≥ 15 in 114/129 (89%) of patients with strokes. Brain death was diagnosed exclusively by clinical examination in 92/1844 (5%) of cases. Electroencephalography was the most frequently used ancillary test (1303/1752, 70.7%), followed by transcranial Doppler (652/1752, 37%). Organ donation took place in 70% of patients (1291/1844), with medical unsuitability (267/553, 48%) and family refusal (244/553, 13%) the main reasons for loss of potential donors. All life-sustaining measures were withdrawn in 413/553 of non-donors (75%).

  3. 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.

  4. Transplantation, multi-organ donation & presumed consent: a 3 year survey of university students.

    PubMed

    Healy, G; Sharma, K; Healy, D G

    2009-10-01

    We profile the practises and attitudes of university students in Ireland towards consent for organ donation. 1103 students were surveyed. Only 34.6% (382/1103) carried organ donor consent cards, although the majority were favourably disposed towards donation. Only 9% (96/1103) were against donation. In regard to presumed consent only 38% (177/470) were in favour of changing the current "opt-in" consent methodology to presumed consent. These findings show a favourable opinion towards donation among Irish university students. However this may result in few actual donations in the event of brain death, as the majority do not carry donor cards and do not want to change to a presumed consent regime. The most common answer for not carrying a card was that the individual had not formalised a decision. Mandated choice at a fixed point could significantly reduce this ambivalence.

  5. 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.

  6. 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

  7. Factors Associated with a Family's Delay of Decision for Organ Donation After Brain Death.

    PubMed

    Han, Sang Youb; Kim, Jae Il; Lee, Eun-Woo; Jang, Hye-Yeon; Han, Kum Hyun; Oh, Se Won; Roh, Young-Nam

    2017-01-17

    BACKGROUND This study aimed to explore the factors associated with a family's delay of decision for organ donation after brain death, and to investigate the effect of such a delay on organ donation. MATERIAL AND METHODS Medical records and data on counseling about organ donation with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed. RESULTS The final consent rate was 58% (62/107), and successful donation was performed in 40% (43/107). Ninety-two families (86%) made a decision within 48 hours, whereas 15 (14%) required more than 48 hours for a final decision. In univariate and multivariate analyses, the independent factors associated with a decision delay were mean arterial pressure ≤60 mm Hg and coma therapy. In the early decision group (<48 hours), the consent and successful donation rates were 55% (51/92) and 39% (36/92), respectively, whereas in the delayed decision group (≥48 hours), these rates were 73% (11/15) and 47% (7/15), respectively. The consent and successful donation rates were not inferior in the delayed decision group. CONCLUSIONS These findings justify continuous efforts to maintain organ viability and to extend counseling to encourage donation even if the family cannot decide immediately.

  8. Premortem interventions in dying children to optimise organ donation: an ethical analysis.

    PubMed

    Brierley, Joe; Shaw, David

    2016-07-01

    A range of interventions in dying patients can improve both the possibility of successful organ donation and the likely long-term success of transplantation. The ethical and legal issues surrounding such interventions, which most frequently occur in the context of donation after circulatory determination of death, are complex, controversial and many remain unresolved. This is true with adults, but even more so with children, where the issue of organ donation and premortem interventions to facilitate it, are highly sensitive. Essentially, such interventions are being undertaken in dying children who cannot medically benefit from them, though arguments have been advanced that becoming a donor might be in a child's extended best interest. However, certain interventions carry a potential risk, although small, of direct harm and of course overall objections to child donation after circulatory determination of death per se are still expressed in the literature. But, unlike the case in critically ill adults, those giving permission for such interventions are normally able to fully participate in decision-making, and indeed to consent, to both donation and premortem interventions. We review the issue of the use of premortem interventions in dying children to facilitate organ donation, including decision-making and ethical justification. Individual interventions are then considered, including an ethical analyse of their use. Finally, we recommend an approach using a combination of welfare checklist strategy, coupled with the establishment of an agreed zone of parental discretion about individual interventions which might be used in dying children to increase the possibility of successful organ donation.

  9. Organ donation in the Philippines: should the dead do more?

    PubMed

    de Castro, Leonardo D

    2014-01-01

    This paper asks whether the Philippines should focus on ways of dealing with end-stage renal disease by getting more transplantable kidneys from the dead. Would it be more ethical to put the burden to donate on the dead (who have already lost their chance to consent) than on the living (who can consent)? Given the risks involved in undergoing nephrectomy and the lack of benefits arising from the procedure to donors, the dead should be the first to put their kidneys on the line. In the Philippines, unfortunately, living donors have had to bear the greater burden in this regard. Starting with a brief account of developments surrounding the impact of the Declaration of Istanbul on the situation in the Philippines as well as in other countries, the paper examines what the living have been expected to do, what they have actually done, and what lessons the experience with living donors offers for the understanding of cadaver transplants. The paper then looks at possible ways of increasing the sources of kidneys for transplantation and asks if these ways could be implemented successfully and ethically in the Philippines.

  10. Partnerships for organizing blood donation camp: An experience from rural North India

    PubMed Central

    Kant, Shashi; Malhotra, Sumit; Ahamed, Farhad; Archana, S.; Pandav, Chandrakant S.

    2016-01-01

    Background: Rural areas pose challenges for motivating villagers to donate blood. We organized a blood donation camp in a rural setting by engaging multiple stakeholders. We examined the factors that influenced blood donation. Methods: Local level stakeholders were involved in planning of the camp. Mobilization of donors was attempted through intensive awareness generation activities utilizing multiple channels. A list of willing blood donors was prepared. Results: Out of 152 willing donors, 88 reported to donation camp, and after screening, 67 donated the blood. Most of the willing donors were males (89.8%), and the mean standard deviation age was 31.9 (9.4) years. Deferral rate was 23.8%. Involvement of local stakeholders can result in creating a pool of donors in rural area which can mitigate the existing gap between demand and supply of blood in India. PMID:28217590

  11. Distrust in the healthcare system and organ donation intentions among African Americans.

    PubMed

    Russell, Emily; Robinson, Dana H Z; Thompson, Nancy J; Perryman, Jennie P; Arriola, Kimberly R Jacob

    2012-02-01

    The purpose of this study is to further understanding of the association between distrust in the healthcare system and written and verbal expressions of donation intentions among African Americans. We hypothesize that distrust in the healthcare system will be significantly, positively associated with both verbal and written donation intentions. Five hundred and eighty five participants completed a 98-item survey that included scales on distrust in the healthcare system and donation intentions. Bivariate analyses (t-tests, ANOVA, chi-square tests and odds ratios) were used to explore the extent to which donation intentions and distrust in the healthcare system varied by demographic characteristics and the association between the distrust in the healthcare system scale and verbal and written donation intentions. Separate logistic regressions were performed with each of the dependent variables to see if significant associations remained while controlling for confounders. Findings based on the multiple regression indicate that when controlling the participant's education level, distrust in the healthcare system was not significantly related to written donation intentions (OR = 1.04; P = .12). When controlling for education level, health insurance status, Community Health Advocates group and marital status, distrust in the healthcare system was significantly associated with verbal donation intentions (OR = 1.08; P < 0.05). Our results suggest that distrust in the healthcare system varies in the way that it is associated with donation intentions. Future organ donation studies should be conducted to determine the pathways through which distrust in the healthcare system impacts different types of organ donation intentions.

  12. 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.

  13. 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.

  14. Partnership for transplantation: a new initiative to increase deceased organ donation in Poland.

    PubMed

    Kosieradzki, M; Czerwinski, J; Jakubowska-Winecka, A; Kubik, T; Zawilinska, E; Kobryn, A; Bohatyrewicz, R; Zieniewicz, K; Nyckowski, P; Becler, R; Snarska, J; Danielewicz, R; Rowinski, W

    2012-09-01

    Despite the long-standing history of transplantation, the shortage of organs has remained its most restrictive factor. In 2010, the number of actual deceased organ donors in Poland was 13.5/million population (pmp). However, a huge difference in organ recovery rates is evident between various regions, eg, 32 pmp, in western Pomerania compared with 1-3 pmp in southern districts. A substantial number of patients who die while awaiting organ transplantations could be saved were effective programs able to overcome barriers in deceased organ donation. Such programs, eg, the European Donor Hospital Education Program, Donor Action, European Training Program on Organ Donation, United States Collaborative in Donation were introduced several years ago, but after transient improvements there has not been real progress. A new comprehensive program-Regional Partnership for Transplantation-was initiated a year ago in 4 districts of southern Poland by the Polish Union for Transplantation Medicine. The letter of intent to activate the donation program was signed by the local administration, the president of the local medical school, president of the Physician's Chamber, transplant centers, the Polish Union for Transplantation, and the Polish Transplant Coordinating Center. The plan of action included training of in-hospital coordinators, visits to all regional hospitals in company of a representative of the hospital founding body, examination of the real donation pool and the need for participation in a donation program training and education of the hospital staff in legal and organizational aspects of donation, brain death recognition, and various aspects of donor care. In addition, the program included communication skills workshops for intensive care unit physicians (with participation of 2 actors, an experienced anesthesiologist, and a psychologist), lectures for high school and university students and for hospital chaplains as well as alumni of higher seminaries. The

  15. Effect of Interviews Done by Intensive Care Physicians on Organ Donation.

    PubMed

    Birtan, D; Arslantas, M K; Dincer, P C; Altun, G T; Bilgili, B; Ucar, F B; Bozoklar, C A; Ayanoglu, H O

    2017-04-01

    In this study, we examined the correspondence between intensive care unit physicians and the relatives of potential brain-dead donors regarding the decision to donate or the reasons for refusing organ donation. A total of 12 consecutive cases of potential brain-dead patients treated in intensive care units of Marmara University Pendik Education and Research Hospital in 2013 were evaluated. For each of the cases, the Potential Donor Questionnaire, and Family Notification, Brain Death Criteria Fulfilment and Organ Donation Conversation Questionnaires were used to collect the required data. Statistically, descriptive analyses were performed. We concluded that honestly, regularly, and sufficiently informed relatives of the potential brain-dead donor more readily donate organs, with a positive contribution from the intensive care physician.

  16. Organ donation after brain death in India: A trained intensivist is the key to success

    PubMed Central

    Palaniswamy, Vijayanand; Sadhasivam, Suganya; Selvakumaran, Cibi; Jayabal, Priyadharsan; Ananth, S. R.

    2016-01-01

    Organ donation after brain death in India is gaining momentum but only in a few states. Tamil Nadu is leading in the country in this regard. Certain cities have performed well compared to Chennai's results. A single tertiary hospital performed 28 donations in a 17 months period with a team of an intensivist and a transplant coordinator. An intensivist needs training and interest in this noble cause. There is no formal training program in this noble cause for doctors in India. A structured formal training needs to be introduced and made mandatory for the doctors in intensive care to make this donation process a successful program. PMID:27829715

  17. 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…

  18. Knowledge and attitude towards organ donation among adult population in Al-Kharj, Saudi Arabia.

    PubMed

    Agrawal, Sandeep; Binsaleem, Saud; Al-Homrani, Mohammed; Al-Juhayim, Abdullaziz; Al-Harbi, Abdullah

    2017-01-01

    Organ transplantation is a lifesaving treatment for patients with end-stage organ failure. Despite the advanced medical science and technology, shortage of organs had led to a growing gap between the demand for organs and the number of donors. With a limited number of studies on the subject and based on those findings, the public knowledge and attitudes must be assessed to understand more clearly that why many people are opposing donating their organs in Saudi Arabia. The objective of our study was to assess the knowledge and attitude of the adult population toward organ donation in Saudi Arabia. This was a hospital-based cross-sectional study where the information was collected using a self-administered questionnaire in Al-Kharj, Saudi Arabia. The questionnaire was distributed in both King Khalid Hospital and Prince Sattam Bin Abdulaziz University Hospital, and data gathered analyzed by Statistical Package for Social Sciences (SPSS version 20.0). There were a total of 403 respondents. Nearly 35.6% did not have the knowledge that organ donation is legal in the KSA. Almost 97% did not know where to go if they want to become donors. All of who were willing to donate, the most common reason was to save someone's life (92.7%). Body distortion (39%) and fear of health complications (35%) were the most common causes people opposed donation. It was suggested that, in order to increase the awareness for organ donation, the important role of health workers and hospital displays should be immediately addressed and public lectures should be held on regular basis. Information regarding organ donation should be incorporated with clear messages in various mass media.

  19. Attitudes and behaviours of students from the faculty of theology regarding organ donation: a study from Turkey.

    PubMed

    Naçar, M; Cetinkaya, F; Baykan, Z; Poyrazoğlu, S

    2009-12-01

    The aim of this study was to investigate the knowledge and attitude of students from the Faculty of Theology of Erciyes University regarding organ donation. This study comprising all students (n = 264) showed that 51.6% of subjects to the kidney is an organ that may be donated; other organs were less known. 16.5% of the students thought that organ donation is not in accord with Islamic beliefs; 22.0% thought that it is permitted in Islam for Muslims to donate to non-Muslims, and 23.6% were willing to accept organs from non-Muslims. 23.6% of the students were willing to donate their organs, whereas 57.3% were undecided. None of the students had an organ donation card. Among students who did not consider donation or were undecided, 16.5% stated that it was "religiously inappropriate" and 13.3% stated that they did not "approve the loss of body integrity." Students declared that they had little knowledge regarding organ/tissue donation: 67.9% about the religious aspect, 78.9% about the legal aspect, and 80.5% about the scientific aspect. Only 24.6% of the group noted school education as their source of information, with 51.2% stating that they had been questioned about organ donation by society. With this study, we concluded that the student's knowledge regarding organ donation was not sufficient.

  20. New organ transplant policies in Japan, including the family-oriented priority donation clause.

    PubMed

    Aita, Kaoruko

    2011-03-15

    The revised Organ Transplant Law in Japan that took effect in July 2010 allows organ procurement from brain-dead individuals, including children, only with family consent. The amended law also allows individuals to prioritize family members to receive their donated organs after death. This policy differs from the prioritization policy in Israel, which provides incentives to individuals who agree to help each other in society and rectifies the problem of free riders, individuals who are willing to accept an organ but refuse to donate. Despite these differences, however, the Japanese and Israeli policies have revealed new ethical dilemmas, including the fear of compromising fairness in organ allocation.

  1. 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.

  2. Helping With All Your Heart: Realistic Heart Stimulus and Compliance With an Organ Donation Request.

    PubMed

    Jacob, Céline; Guéguen, Nicolas

    2015-01-01

    Pictures and images are important aspects in fundraising advertising and could generate more donations. In two experimental studies, we examined the effect of various pictures of hearts on compliance with a request for organ donations. The solicitor wore a white tee shirt where various forms of hearts were printed: symbolic versus realistic (first experiment), none versus symbolic versus realistic (second experiment). Results showed that more compliance was found in the realistic heart experimental condition whereas the symbolic heart form had no significant effect.

  3. 38 CFR 1.485a - Eye, organ and tissue donation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health...

  4. 38 CFR 1.485a - Eye, organ and tissue donation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health...

  5. 38 CFR 1.485a - Eye, organ and tissue donation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health...

  6. 38 CFR 1.485a - Eye, organ and tissue donation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health...

  7. 38 CFR 1.485a - Eye, organ and tissue donation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health...

  8. 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.

  9. 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

    2016-06-28

    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.

  10. Egalitarian and maximin theories of justice: directed donation of organs for transplant.

    PubMed

    Veatch, R M

    1998-08-01

    It is common to interpret Rawls's maximin theory of justice as egalitarian. Compared to utilitarian theories, this may be true. However, in special cases practices that distribute resources so as to benefit the worst off actually increase the inequality between the worst off and some who are better off. In these cases the Rawlsian maximin parts company with what is here called true egalitarianism. A policy question requiring a distinction between maximin and "true egalitarian" allocations has arisen in the arena of organ transplantation. This case is examined here as a venue for differentiating maximin and true egalitarian theories. Directed donation is the name given to donations of organs restricted to a particular social group. For example, the family of a member of the Ku Klux Klan donated his organs on the provision that they go only to members of the Caucasian race. While such donations appear to be discriminatory, if certain plausible assumptions are made, they satisfy the maximin criterion. They selectively advantage the recipient of the organs without harming anyone (assuming the organs would otherwise go unused). Moreover, everyone who is lower on the waiting list (who, thereby, could be considered worse off) is advantaged by moving up on the waiting list. This paper examines how maximin and more truly egalitarian theories handle this case arguing that, to the extent that directed donation is unethical, the best account of that conclusion is that an egalitarian principle of justice is to be preferred to the maximin.

  11. Use of social media and college student organizations to increase support for organ donation and advocacy: a case report.

    PubMed

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

    2012-12-01

    This report focuses on the University of Wisconsin Hospital and Clinics organ procurement organization's efforts to increase deceased organ and tissue donation by using social media and personalized messages targeting members of university student organizations, their families, and their friends. A grant from the US Department of Health and Human Services funded a 2-year study to (1) identify barriers/opportunities for increasing awareness, attitudes, and behaviors related to organ and tissue donation; (2) implement an intervention using social media and personalized message to increase knowledge, support, and donor registrations; (3) measure impact on awareness and attitudinal and behavioral changes within the organization; and (4) assess behavioral measures across a host of social media analytics and organ donor registrations. The results show increases in knowledge about and support for organ donation, including a 20% increase in donor registration. As a result, funding was secured to continue the project for an additional 2 years.

  12. Current knowledge and attitudes about organ donation and transplantation among Chinese university students.

    PubMed

    Chen, J X; Zhang, T M; Lim, F L; Wu, H C; Lei, T F; Yeong, P K; Xia, S J

    2006-11-01

    Current attitudes toward organ donation among university students in mainland China and the differences in attitudes between Chinese students in mainland China versus overseas are unknown. To address these issues, we conducted a cross-sectional survey using questionnaires among 922 Chinese undergraduates from mainland China and overseas regions of the world. Data were analyzed by descriptive statistics, Student t tests, chi-square tests, and a logistic regression analysis. We found that blood donors showed significantly better awareness of heart, liver, lung, skin, and tendon donation among commonly transplanted organs/tissues. As to the willingness for cadaveric organ donation, 61.3% of respondents consented, 8.5% objected, and 30.3% answered "not sure." The percentage holding an organ donor card was 15.7% among students from Hong Kong; 3.0%, mainland China; 2.8%, Macau; 2.6%, Taiwan, and 4.0%, other regions of the world. In a logistic regression analysis, female students (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.35 to 3.72) and blood donors (OR, 1.91; 95% CI, 1.10 to 3.32) did, but age and study specialty (medical vs nonmedical) did not show significantly more positive attitudes toward cadaveric organ donation. Compared with students from mainland China, overseas Chinese students from various regions did not show significantly different attitudes toward cadaveric organ donation. In summary, blood donors among university students have a greater knowledge of transplantation and a more positive attitude toward organ donation. Since university students are an important source of blood donors in China, they will be a potential pool of organ donors in the future.

  13. From hesitation to appreciation: the transformation of a single, local donation-nurse project into an established organ-donation service.

    PubMed

    Gyllström Krekula, Linda; Malenicka, Silvia; Nydahl, Anders; Tibell, Annika

    2015-03-01

    This study evaluates the transition from a local project to promote organ donation to a permanent county-based donation service inspired by the Spanish model. To address the problem of declining donation rates, a project with one donation-specialized nurse (DOSS) was initiated at a single neuro-intensive care unit. This project was later expanded into a permanent on-call service consisting of seven DOSSes, covering a large urban county. During the different periods (before, during project and during permanent service), the DOSS function's effect on donation rates was significant, and the number of eligible donors that became actual donors increased from 37% to 73% and 74%, respectively. The effect on family vetoes was as prominent with a decrease from 34% to 8% and 14%. The staff appreciation of the DOSS function was also evident during the periods; all areas included in the questionnaire (family care, donor care and staff support) have improved greatly owing to the DOSS. The transition from a single, local donation-nurse project, to an on-call service with several DOSSes covering a large urban county was a success considering the donation rates as well as the staff's appreciation. Hence, organizational models from abroad can be adjusted and successfully adopted.

  14. Attitudes, knowledge, and proficiency in relation to organ donation: a questionnaire-based analysis in donor hospitals in northern Denmark.

    PubMed

    Bøgh, L; Madsen, M

    2005-10-01

    The aim of this study was to assess knowledge, attitudes, and proficiency in relation to organ donation among staff members of intensive care units (ICUs) in donor hospitals, and possibly identify areas for improvement. The investigation was carried out as a collaboration between the transplant center and appointed key persons in all 17 ICUs in 15 hospitals in northern Denmark. A total of 1168 structured questionnaires were distributed to the health care professionals in the ICUs in the region; 689 were returned, giving a response rate of 59%. In general, there is a positive attitude among health care professionals toward organ donation. However, a considerable fraction of 11% declares to be against organ donation. Only 49% of the ICU health care professionals are willing to donate their own organs after death. By comparison, 74% of the general Danish population are willing to donate organs after death. Doctors are more positive toward organ donation than the nursing staff. Thus, 95% of the doctors are positive to organ donation compared to 81% of the nurses; 70% of the doctors will donate own organs after death compared to 45% of the nurses. Further, the survey demonstrates as expected a significant lack of experience in organ donation. Our data show a considerable need for more education and training, especially on how to inform and support the donor relatives and how to identify potential donors. The survey also discloses a substantial need for information regarding the results of transplantation.

  15. Ethical problems in ex vivo or cadaver organ transplantation: should the donation be paid?

    PubMed

    Bruzzone, Paolo

    2015-01-01

    Financial incentives for organ donation (from living or cadaveric donors) have been considered ethically acceptable by some bioethicists, and recently, according to the media, by Prof. Gary Becker, Nobel Laureate for Economy. However, the only countries to have approved a law allowing financial incentives for organ donation are Iran in 1988 and, in some way and much later, Singapore and Saudi Arabia. In Europe financial incentives for donors are prohibited, except maybe in Austria. In Germany, it is forbidden to purchase organs not only in the home country, but all over the world. The author was involved, as peer reviewer of a major international Transplant journal, in the evaluation of some papers concerning paid kidney living donors in Iran, and therefore made an extensive literature search on this topic and more generally on paid kidney living donation all over the world. The situation in Italy will also be reported and analysed.

  16. Family communication patterns moderate the relationship between psychological reactance and willingness to talk about organ donation.

    PubMed

    Scott, Allison M; Quick, Brian L

    2012-01-01

    Considerable research has investigated how psychological reactance affects individuals' responses to health promotion messages, but little is known about how family processes might moderate the reactance process. In this study, 301 participants were exposed to a persuasive message about organ donation. The moderating role of family communication patterns in the reactance process was tested using hierarchical regression. We found that family conversation orientation had a direct effect on willingness to talk with family members about being an organ donor and that family conformity orientation and family conversation orientation each interacted with reactance to predict willingness to communicate with family about donation. Theoretically, these results extend psychological reactance theory by considering how interpersonal factors affect the reactance process. Practically, the findings suggest that for optimal impact, family processes should be considered in the design of messages promoting organ donation.

  17. 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

  18. 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.

  19. 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

  20. Organ and tissue donation in migrants: advanced course for cross-cultural mediators.

    PubMed

    Potenza, R; Guermani, A; Grosso, M; Fossarello, L; Fontaneto, C; Casciola, A; Donadio, P P

    2013-09-01

    Between 2004 and 2010 in Piedmont (Italy Northern Region) 1556 brain-death situations were reported, including 113 (7.3%) in migrants as potential organ and tissue donors. The health staff often has to face migrants, who show great cultural differences and language difficulties. The Molinette Hospital Customer Care Service, the Piedmont Regional Tissue and Organ Procurement Coordination Agency (RPC), and the Cross-Cultural Mediators Association (CMA) organized a special course for intercultural mediators, to decrease misunderstandings between the health staff and the migrants' families and to improve professional communication. In 2011, 28 cultural-linguistic mediators representing different groups of migrants in Piemonte took part in a specific course. Over a 5 month period they were informed about emotional and communicative aspects, proper to the moment of death, as well as organ donation as an intercultural field, the professional role of the mediator, the clinical and forensic aspects of brain death and donation, and the psychological aspects of organ donation. The course was organized by cultural-linguistic mediators of the CMA, the staff of the RPC and the teachers at Turin University. The list of the 21 mediators who passed the final exam was given to organ and tissue donation hospital co-ordinators in Piedmont, so that if necessary, they could obtain the cooperation of these qualified people.

  1. A Revised Iranian Model of Organ Donation as an Answer to the Current Organ Shortage Crisis.

    PubMed

    Hamidian Jahromi, Alireza; Fry-Revere, Sigrid; Bastani, Bahar

    2015-09-01

    Kidney transplantation has become the treatment of choice for patients with end-stage renal disease. Six decades of success in the field of transplantation have made it possible to save thousands of lives every year. Unfortunately, in recent years success has been overshadowed by an ever-growing shortage of organs. In the United States, there are currently more than 100 000 patients waiting for kidneys. However, the supply of kidneys (combined cadaveric and live donations) has stagnated around 17 000 per year. The ever-widening gap between demand and supply has resulted in an illegal black market and unethical transplant tourism of global proportions. While we believe there is much room to improve the Iranian model of regulated incentivized live kidney donation, with some significant revisions, the Iranian Model could serve as an example for how other countries could make significant strides to lessening their own organ shortage crises.

  2. 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

  3. Opinion Toward Living Liver Donation of Hospital Personnel From Units Related to Organ Donation and Transplantation: A Multicenter Study From Spain and Latin-America

    PubMed Central

    Rios, Antonio; Lopez Navas, Ana; Ayala Garcia, Marco Antonio; Sebastian, Jose; Abdo Cuza, Anselmo; Martinez Alarcon, Laura; Ramirez, Ector Jaime; Munoz, Gerardo; Palacios, Gerardo; Suarez Lopez, Juliette; Castellanos, Ricardo; Gonzalez, Beatriz; Martinez, Miguel Angel; Diaz, Ernesto; Ramirez, Pablo; Parrilla, Pascual

    2014-01-01

    Background: Hospital personnel of services related to donation and transplantation process play a fundamental role in the development of transplantation. Objectives: The aim of this study was to investigate the attitude toward living liver donation (LLD) among hospital personnel from services related to donation and transplantation in hospital centers in Spain and Latin America. Materials and Methods: Eight hospitals within the “International Donor Collaborative Project” were selected, three in Spain, three in Mexico and two in Cuba. The study was performed in transplant-related services, using a randomized sample, which was stratified by the type of service and job category. Results: In total, 878 workers were surveyed of which 82% (n = 720) were in favor of related LLD, 10% (n = 90) were against and 8% (n = 68) undecided. Attitudes toward related LLD were more favorable in the following groups: the Latin Americans (86% in favor vs. 77% among the Spanish; P = 0.007); younger people (37 vs. 40 years, P = 0.002); those in favor of either deceased donation (P < 0.001) or living kidney donation (P < 0.001); those who believed that they might need a transplant in the future (P < 0.001); those who would accept a liver from a living donor (P < 0.001); those who discussed the subject of donation and transplantation with their families (P = 0.040); and those whose partner was in favor of donation and transplantation (P = 0.044). Conclusions: Personnel from donation and transplantation-related units had a favorable attitude toward LLD. This attitude was not affected by psychosocial factors, although it was influenced by factors directly and indirectly related to the donation and transplantation process. PMID:25737727

  4. Limiting financial disincentives in live organ donation: a rational solution to the kidney shortage.

    PubMed

    Gaston, R S; Danovitch, G M; Epstein, R A; Kahn, J P; Matas, A J; Schnitzler, M A

    2006-11-01

    Availability of kidney transplantation is limited by an inadequate supply of organs, with no apparent remedy on the immediate horizon and increasing reliance on living donors (LDs). While some have advocated financial remuneration to stimulate donation, the National Organ Transplant Act (NOTA) of 1984 expressly forbids the offer of 'valuable consideration.' However, recent developments indicate some fluidity in the definition of valuable consideration while evolving international standards highlight deficiencies (particularly regarding long-term care and follow-up) in the current American system. Recognizing that substantial financial and physical disincentives exist for LDs, we propose a policy change that offers the potential to enhance organ availability as well as address concerns regarding long-term care. Donors assume much greater risk than is widely acknowledged, risk that can be approximated for the purpose of determining appropriate compensation. Our proposal offsets donor risk via a package of specific benefits (life insurance, health insurance and a small amount of cash) to minimize hazard and ensure donor interests are protected after as well as before nephrectomy. It will fund medical follow-up and enable data collection so that long-term risk can be accurately assessed. The proposal should be cost effective with only a small increase in the number of LDs, and the net benefit will become greater if removal of disincentives stimulates even further growth. As importantly, by directly linking compensation to risk, we believe it preserves the essence of kidney donation as a gift, consistent with NOTA and implementable in the United States without altering current legal statutes.

  5. 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.

  6. 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

  7. 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…

  8. Knowledge, Attitude and Practice Regarding Organ Donation among Indian Dental Students

    PubMed Central

    Chakradhar, K.; Doshi, D.; Srikanth Reddy, B.; Kulkarni, S.; Padma Reddy, M.; Sruthi Reddy, S.

    2016-01-01

    Background: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process. Objective: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students. Methods: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1–13), positive attitude (Q14–24) and practice habits (Q25–27) regarding organ donation with dichotomous scale (Yes/No). Results: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p<0.001). While second year dental students had higher scores for their knowledge (8.55±1.56) and practice (1.02±0.44) compared to other year of training, third year students showed a significant higher mean attitude score (1.73±1.17) (p=0.02). Hindus and Muslims scored significantly lower mean knowledge, attitude and practice habits compared to others (Christians, Jains and Athesists) (p<0.001). There was a positive correlation between mean knowledge, attitude, and practice habits. Conclusion: There are an average level of knowledge and low levels of positive attitude and practice habits among studied dental students towards organ donation and transplantation. PMID:26889371

  9. Expanding the role of pharmacists and pharmacy students in the promotion of organ donation awareness.

    PubMed

    Descourouez, Jillian L; Richards, Katelyn R; Sam, Teena; Crowther, Barrett

    2014-06-01

    The gap between supply and demand for available organs has resulted in numerous deaths of patients on the transplant waiting list each year. Given the substantial public health impact of the organ shortage crisis, efforts have been focused on the use of educational interventions aimed both at the public and health care professionals to spread awareness of the disparity in organ supply and demand and ultimately improve organ donation rates. Transplant pharmacists are fundamental members of transplant multidisciplinary teams and are expected to promote organ and tissue awareness in an effort to decrease the morbidity and mortality of patients on the transplant waiting list. The role of pharmacists and pharmacy students in the promotion of organ donation awareness is expanding.

  10. Recommendations for further improvement of the deceased organ donation process in Belgium.

    PubMed

    Hoste, Pieter; Ferdinande, Patrick; Hoste, Eric; Vanhaecht, Kris; Rogiers, Xavier; Eeckloo, Kristof; Van Deynse, Dominique; Ledoux, Didier; Vandewoude, Koenraad; Vogelaers, Dirk

    2016-10-01

    Belgium has achieved high deceased organ donation rates but according to the medical record data in the Donor Action database, deceased potential donors are still missed along the pathway. Between 2010 and 2014, 12.9 ± 3.3% of the potential donors after brain death (DBD) and 24.6 ± 1.8% of the potential donors after circulatory (DCD) death were not identified. Conversion rates of 41.7 ± 2.1% for DBD and 7.9 ± 0.9% for DCD indicate room for further improvement. We identify and discuss different issues in the monitoring of donation activities, practices and outcomes; donor pool; legislation on deceased organ donation; registration; financial reimbursement; educational and training programs; donor detection and practice clinical guidance. The overall aim of this position paper, elaborated by a Belgian expert panel, is to provide recommendations for further improvement of the deceased organ donation process up to organ procurement in Belgium.

  11. A Televised Entertainment-Education Drama to Promote Positive Discussion about Organ Donation

    ERIC Educational Resources Information Center

    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…

  12. Willingness to Participate in Organ Donation among Black Seventh-Day Adventist College Students

    ERIC Educational Resources Information Center

    Cort, Malcolm; Cort, David

    2008-01-01

    Objective and Participants: The authors studied a group of black and white Seventh-Day Adventist (SDA) college students (N = 334) to compare the power of religious socialization with racial socialization. Methods: The authors compared the levels of willingness to donate organs between black and nonblack students in an availability sample. Results:…

  13. Potential donor families' experiences of organ and tissue donation-related communication, processes and outcome.

    PubMed

    Marck, C H; Neate, S L; Skinner, M; Dwyer, B; Hickey, B B; Radford, S T; Weiland, T J; Jelinek, G A

    2016-01-01

    We aimed to describe the experiences of families of potential organ and tissue donors eligible for donation after circulatory death or brain death. Forty-nine family members of potential donors from four Melbourne hospitals were interviewed to assess their experiences of communication, processes and the outcomes of donation. Interviews were recorded, transcribed verbatim and analysed thematically. Families expressed a range of perspectives on themes of communication, hospital processes and care, the processes of consent and donation and reflected on decisions and outcomes. They expressed satisfaction overall with communication when receiving bad news, discussing death and donation. Honest and frank communication and being kept up-to-date and prepared for potential outcomes were important aspects for families, especially those of post circulatory death donors. Participants reported high levels of trust in healthcare professionals and satisfaction with the level of care received. Many donor families indicated the process was lengthy and stressful, but not significantly enough to adversely affect their satisfaction with the outcome. Both the decision itself and knowing others' lives had been saved provided them with consolation. No consenting families, and only some non-consenting families, regretted their decisions. Many expressed they would benefit from a follow-up opportunity to ask questions and clarify possible misunderstandings. Overall, while experiences varied, Australian families valued frank communication, trusted health professionals, were satisfied with the care their family member received and with donation processes, despite some apparent difficulties. Family satisfaction, infrequently assessed, is an important outcome and these findings may assist education for Australian organ donation professionals.

  14. 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.

  15. How I manage the adult potential organ donor: donation after cardiac death (part 2).

    PubMed

    Frontera, Jennifer A

    2010-02-01

    To address the gap between organs available for transplant and the number of patients on the transplant waiting list, the Joint Commission on the Accreditation of Healthcare Organizations, Institute of Medicine, United Network for Organ Sharing and the federal government have recommended the increased used of donation after cardiac death (DCD) (JCAHOnline http://www.jointcommission.org/Library/JCAHOnline/jo_06.06.htm ; UNOS, Highlights of the June Board Meeting, 2006). DCD is defined as organ donation once death is declared after irreversible cessation of circulatory and respiratory functions, as opposed to brain death (donation after neurological death). Though DCD is one of the fastest growing categories of organ donors, it comprises only 8% of all deceased donors (Steinbrook in N Engl J Med 357:209-213, 2007). Prior to 1968, when the Ad Hoc Committee of Harvard Medical School proposed a neurological definition of death based on brain-death criteria, organs from deceased donors came from patients who had suffered cardio-pulmonary demise (IOM, Non-heart-beating organ transplantation: practice and protocols, 2000). Early transplantation from DCD donors met with limited success and most transplant surgeons turned to brain-dead donors. Consequently, DCD fell out of vogue and, until recently, has not been the focus of transplant initiatives.

  16. Should we allow organ donation euthanasia? Alternatives for maximizing the number and quality of organs for transplantation.

    PubMed

    Wilkinson, Dominic; Savulescu, Julian

    2012-01-01

    There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is one currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste. In this paper we consider and evaluate a range of ways to improve the number and quality of organs available from this group of patients. Changes to consent arrangements (for example conscription of organs after death) or changes to organ donation practice could dramatically increase the numbers of organs available, though they would conflict with currently accepted norms governing transplantation. We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support. It would give individuals the greatest chance of being able to help others with their organs after death. It would increase patient autonomy. It would reduce the chance of suffering during the dying process. We argue that patients should be given the choice of whether and how they would like to donate their organs in the event of withdrawal of life support in intensive care. Continuing current transplantation practice comes at the cost of death and prolonged organ failure. We should seriously consider all of the alternatives.

  17. Do new drivers equal new donors? An examination of factors influencing organ donation attitudes and behaviors in adolescents.

    PubMed

    Sirois, Brian C; Sears, Samuel F; Marhefka, Stephanie

    2005-04-01

    Adolescent and parent organ donation attitudes, knowledge, communications, and donor card signing rates were assessed. Parent-adolescent dyads (N = 137) were recruited at a Department of Motor Vehicles (DMV). Using discriminant analysis, attitude, knowledge, and communication variables adequately classified adolescent donor status. Overall, adolescent positive attitude toward donation was the most powerful variable discriminating between donors and nondonors. Examining only participants who had discussed donation with parents, the nature of parent-adolescent discussions about organ donation became the most important variable in donor classification. Adolescent donors reported significantly more positive and less negative attitudes, had parents with more positive and less negative attitudes, and had engaged in more frequent and more positive communications with parents about organ donation.

  18. The history of organ donation and transplantation in Iran.

    PubMed

    Ghods, Ahad J

    2014-03-01

    The first kidney transplant in Iran was performed in 1967, and this was the first organ transplant in countries that are current members of the Middle East Society for Organ Transplantation. In 1988, in response to the long waiting list at the Iranian Ministry of Health for kidney transplant, a state-regulated living-unrelated donor kidney transplant program was adopted. By 1999, the kidney transplant waiting list in Iran was eliminated. In 1989, a fatwa (religious approval) from the Supreme Religious Leader was obtained that recognized brain death and allowed deceased-donor organ transplant. Subsequently, transplant centers began performing deceased-donor kidney, liver, and heart transplants. In 2000, the Brain Death and Organ Transplantation Act was passed by the Iranian parliament, legalizing deceased-donor organ transplant. The transplant team at Shiraz began performing more deceased-donor kidney and liver transplants and became a successful deceased-donor organ transplant model in the country. By the end of 2012, there were 34166 kidney (including 4436 deceased-donor) and 2021 liver (including 1788 deceased-donor), 482 heart, 147 pancreas, 63 lung, and several intestine and multiorgan transplants performed in Iran. In 2011, there were 2771 solid-organ transplants performed in Iran (37 transplants per million population), and Iran ranked as number 33 among the 50 most active countries worldwide. In 2011 and 2012, Iran was ahead of all country members of the Middle East Society for Organ Transplantation in performing deceased-donor kidney and liver transplants.

  19. Transparency and accountability in mass media campaigns about organ donation: a response to Morgan and Feeley.

    PubMed

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

    2013-11-01

    We respond to Morgan and Feeley's critique on our article "Mass Media in Organ Donation: Managing Conflicting Messages and Interests." We noted that Morgan and Feeley agree with the position that the primary aims of media campaigns are: "to educate the general public about organ donation process" and "help individuals make informed decisions" about organ donation. For those reasons, the educational messages in media campaigns should not be restricted to "information from pilot work or focus groups" but should include evidence-based facts resulting from a comprehensive literature research. We consider the controversial aspects about organ donation to be relevant, if not necessary, educational materials that must be disclosed in media campaigns to comply with the legal and moral requirements of informed consent. With that perspective in mind, we address the validity of Morgan and Feeley's claim that media campaigns have no need for informing the public about the controversial nature of death determination in organ donation. Scientific evidence has proven that the criteria for death determination are inconsistent with the Uniform Determination of Death Act and therefore potentially harmful to donors. The decision by campaign designers to use the statutory definition of death without disclosing the current controversies surrounding that definition does not contribute to improved informed decision making. We argue that if Morgan and Feeley accept the important role of media campaigns to enhance informed decision making, then critical controversies should be disclosed. In support of that premise, we will outline: (1) the wide-spread scientific challenges to brain death as a concept of death; (2) the influence of the donor registry and team-huddling on the medical care of potential donors; (3) the use of authorization rather than informed consent for donor registration; (4) the contemporary religious controversy; and (5) the effects of training desk clerks as organ

  20. The donor organ as an 'object a': a Lacanian perspective on organ donation and transplantation medicine.

    PubMed

    Zwart, Hub

    2014-11-01

    Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to 'transplant tourism' and 'organ trade'. This paper presents a 'depth ethics' approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body (as something which constitutes a whole, while at the same time being a set of replaceable elements or parts). These will be addressed from a psychoanalytical (Lacanian) angle. First, I will outline Lacan's view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers to as an object a, the 'partial object' of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient's body an empty space emerges, a kind of 'vacuole', once occupied by a faltering organ (now removed). This space can only be filled by a 'gift' from the other, by an object a. Once implanted, however, this implant becomes an 'extimate' object: something both 'external' and 'intimate', both 'embedded' and 'foreign', and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the 'fragmented body' of Frankenstein's 'monster'--as an aggregate of replaceable parts--and the multiple organ recipients (the 'puzzle people') of today.

  1. International indicators of donation and solid organ transplantation.

    PubMed

    Perez-Protto, S; Mizraji, R; Alvarez, I

    2009-10-01

    The main goal of any organ procurement organization (OPO) is to offer the greatest number of organs achievable with the goal of reducing mortality and the waiting list time of patients. Evaluation of OPO activity is mandatory to identify causes of missed potential donors seeking to implement changes in steps susceptible of improvement. In this review, we have presented the classical indicators of brain death along with new indicators. We observed that when the donor generation capacity is adjusted to the deaths, the indicator is more reliable for comparisons of countries with different mortality rates. We concluded that the indicators are complementary, because they measure different aspects of the process. To have a better understanding of the situation, country, institution, or hospital, one should simultaneously use all of the indicators.

  2. The influence of socioeconomic and demographic variables on willingness to donate cadaveric human organs in Malaysia.

    PubMed

    Rasiah, Rajah; Manikam, Rishya; Chandarsekaran, Sankara K; Thangiah, Govindamal; Puspharajan, Saravanan; Swaminathan, Dasan

    2014-11-01

    The growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents' willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above.A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents' willingness to become cadaveric organ donors controlling for age.About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively.Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of Malaysians willing to become

  3. The Influence of Socioeconomic and Demographic Variables on Willingness to Donate Cadaveric Human Organs in Malaysia

    PubMed Central

    Rasiah, Rajah; Manikam, Rishya; Chandarsekaran, Sankara K.; Thangiah, Govindamal; Puspharajan, Saravanan; Swaminathan, Dasan

    2014-01-01

    Abstract The growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents’ willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above. A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents’ willingness to become cadaveric organ donors controlling for age. About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively. Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of

  4. Intra-hospital organ and tissue donation coordination project: cost-effectiveness and social benefits

    PubMed Central

    Silva, Vanessa Silva e; Moura, Luciana Carvalho; Leite, Renata Fabiana; de Oliveira, Priscilla Caroliny; Schirmer, Janine; Roza, Bartira De’ Aguiar

    2015-01-01

    OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation. METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so. RESULTS Following the nursing specialist commencement on the committee, brain death referrals and the number of actual donors increased at hospital 2 (4.17 and 1.52, respectively). At hospital 7, the number of actual donors also increased from 0.005 to 1.54. In addition, after the nurse started working, hospital revenues increased by 190.0% (ranging 40.0% to 1.955%). The monthly cost for the nurse working 20 hours was US$397.97 while the doctor would cost US$3,526.67. The return on investment was 275% over the short term (0.36 years). CONCLUSIONS This paper showed that including a professional specialist in intra-hospital committees for organ and tissue donation for transplantation proved to be cost-effective. Further economic research in the area could contribute to the efficient public policy implementation of this organ and tissue harvesting model. PMID:26487290

  5. Death, dying and donation: organ transplantation and the diagnosis of death.

    PubMed

    Kerridge, I H; Saul, P; Lowe, M; McPhee, J; Williams, D

    2002-04-01

    Refusal of organ donation is common, and becoming more frequent. In Australia refusal by families occurred in 56% of cases in 1995 in New South Wales, and had risen to 82% in 1999, becoming the most important determinant of the country's very low organ donation rate (8.9/million in 1999). Leading causes of refusal, identified in many studies, include the lack of understanding by families of brain death and its implications, and subsequent reluctance to relegate the body to purely instrumental status. It is an interesting paradox that surveys of the public continue to show considerable support for organ donation programmes--in theory we will, in practice we won't (and don't). In this paper we propose that the Australian community may, for good reason, distrust the concept of and criteria for "whole brain death", and the equation of this new concept with death of the human being. We suggest that irreversible loss of circulation should be reinstated as the major defining characteristic of death, but that brain-dead, heart-beating entities remain suitable organ donors despite being alive by this criterion. This presents a major challenge to the "dead donor rule", and would require review of current transplantation legislation. Brain dead entities are suitable donors because of irreversible loss of personhood, accurately and robustly defined by the current brain stem criteria. Even the dead are not terminally ill any more.

  6. Platelet Donation

    MedlinePlus

    ... donating platelets, can I still donate blood? What blood types should donate platelets? Can I donate plasma at ... Community Learn About Blood Blood Facts and Statistics Blood Types Blood Components What Happens to Donated Blood Blood ...

  7. 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.

  8. 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.

  9. Theoretical implications addressing rural college students' organ donation behaviors.

    PubMed

    Britt, Rebecca K; Britt, Brian C; Anderson, Jennifer

    2015-11-19

    The current study used the theory of planned behavior to examine rural college students' attitudes, normative beliefs, and perceived behavioral control regarding intent to register as organ donors. This effort is done in light of a need to increase intervention efforts among college students, particularly those in rural areas where these undertakings may need to be tailored in grassroots approaches. The study made use of perceived behavioral control as a moderator and found partial support for the model. Findings offer results that scholars, practitioners, and educators can utilize for interventions.

  10. How to face organ shortage in liver transplantation in an area with low rate of deceased donation.

    PubMed

    Gruttadauria, Salvatore; Pagano, Duilio; Echeverri, Gabriel J; Cintorino, Davide; Spada, Marco; Gridelli, Bruno G

    2010-12-01

    Despite advances in patient selection, surgical technique, immunosuppression, and peri-operative management, the need for liver replacement exceeds organ availability. Moreover, in Italy, where the overall rate of cadaver donation is 21 donors per million per year, there are areas of the country, such as Sicily, where the rate of cadaver donation is 9.3 donors per million per year. In fact, this ongoing shortage of organs has led surgeons to develop innovative techniques in an attempt to expand the donor pool, and clinicians are continually modifying criteria to accept organs, particularly the previously defined expanded or marginal donor organs, which are now defined as extended criteria donor. Rarely, in certain specific settings alternative strategies based on the appropriate donor-recipient match allowed the use of grafts that otherwise would have been discarded due to anatomic anomalies. The organ shortage becomes more problematic in the scenario of re-transplantation where the use of a limited resource such as a liver graft must be weighed against the risk of a more difficult surgery.

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

    PubMed Central

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

    2016-01-01

    Introduction: Transplantation of organs is the treatment of choice for severe organ failure worldwide. Aim: The aims of the present study were to determine the influence of religion on attitudes towards organ donation among staff at schools in Tuzla. Material and Methods: 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. Results: 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). Conclusion: 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. PMID:27999488

  12. An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD) on donation rates after brain death (DBD) and transplantation rates.

    PubMed

    Bendorf, Aric; Kelly, Patrick J; Kerridge, Ian H; McCaughan, Geoffrey W; Myerson, Brian; Stewart, Cameron; Pussell, Bruce A

    2013-01-01

    During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD) in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD) donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD) and DBD rates, we analyzed deceased donation rates from 82 countries from 2000-2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01). Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp) increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; p<0.0001). We also found that the number of organs transplanted per donor was significantly lower in DCD when compared to DBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; p<0.001). Whilst the results do not infer a causal relationship between increased DCD and decreased DBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed.

  13. Mass media campaigns and organ donation: managing conflicting messages and interests.

    PubMed

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

    2012-05-01

    Mass media campaigns are widely and successfully used to change health decisions and behaviors for better or for worse in society. In the United States, media campaigns have been launched at local offices of the states' department of motor vehicles to promote citizens' willingness to organ donation and donor registration. We analyze interventional studies of multimedia communication campaigns to encourage organ-donor registration at local offices of states' department of motor vehicles. The media campaigns include the use of multifaceted communication tools and provide training to desk clerks in the use of scripted messages for the purpose of optimizing enrollment in organ-donor registries. Scripted messages are communicated to customers through mass audiovisual entertainment media, print materials and interpersonal interaction at the offices of departments of motor vehicles. These campaigns give rise to three serious concerns: (1) bias in communicating information with scripted messages without verification of the scientific accuracy of information, (2) the provision of misinformation to future donors that may result in them suffering unintended consequences from consenting to medical procedures before death (e.g, organ preservation and suitability for transplantation), and (3) the unmanaged conflict of interests for organizations charged with implementing these campaigns, (i.e, dual advocacy for transplant recipients and donors). We conclude the following: (1) media campaigns about healthcare should communicate accurate information to the general public and disclose factual materials with the least amount of bias; (2) conflicting interests in media campaigns should be managed with full public transparency; (3) media campaigns should disclose the practical implications of procurement as well as acknowledge the medical, legal, and religious controversies of determining death in organ donation; (4) organ-donor registration must satisfy the criteria of informed

  14. 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

    2016-11-22

    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.

  15. Clarifications on mass media campaigns promoting organ donation: a response to Rady, McGregor, & Verheijde (2012).

    PubMed

    Morgan, Susan E; Feeley, Thomas Hugh

    2013-11-01

    The current paper provides readers some clarifications on the nature and goals of mass media campaigns designed to promote organ donation. These clarifications were necessitated by an earlier essay by Rady et al. (Med Health Care Philos 15:229-241, 2012) who present erroneous claims that media promotion campaigns in this health context represent propaganda that seek to misrepresent the transplantation process. Information is also provided on the nature and relative power of media campaigns in organ donation promotion.

  16. The thin flat line: redefining who is legally dead in organ donation after cardiac death.

    PubMed

    Harrington, Maxine M

    2009-01-01

    The debate over whether donation after cardiac death (DCD) donors are truly dead is not new but has surfaced mostly in the academic community. In 2008, widespread publicity was given to the indictment of a transplant surgeon in California in connectionwith the alleged administration of excessive and inappropriate medications to a potential donor awaiting cardiac death after removal from a ventilator. This and other reports in the lay press mirror the expanding use of DCD to boost the supply of organs. This article explains the practice of donation after cardiac death, examines whether DCD donors are legally dead under the UDDA, explores whether it is appropriate to apply DCD as it is currently practiced, addresses the concern that DCD is causing the death of donors, and suggests several approaches to resolve the controversy over the determination of death in DCD donors. The author concludes with a call for this debate to move beyond scholarly journals into the public arena.

  17. Attitudes of the medical profession to whole body and organ donation.

    PubMed

    Green, Connor; Bowden, Dermot; Molony, Diarmuid; Burke, Neil; Felle, Patrick; Dudeney, Sean

    2014-04-01

    Cadaveric dissection remains an important part of undergraduate medical education in anatomy. In a concerted effort to rise the number of doctors in practice in Ireland the amount of medical school placements has been increased steadily since 1995. This poses a problem as the number of cadavers has remained unchanged despite an overall increase in the population Ireland over the last twenty years. The medical profession plays a central part in raising public awareness of living and post-mortem organ donation. Previous studies have examined the attitudes of medical students to whole body donation, however to our knowledge this is the first study that evaluates the attitudes of medical professionals. We assess the opinions of junior and senior doctors at the time of their dissection experience and in their current practice. We show that their attitudes have changed as their clinical experience grows.

  18. The negative impact of death anxiety on self-efficacy and willingness to donate organs among Chinese adults.

    PubMed

    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 plus or minus 25 years), a higher level of death anxiety was associated with a greater expectation of medical neglect and a lower level of self-efficacy. Moreover, a higher level of death anxiety was also correlated with a lower likelihood of donor card signing and discussion of organ donation. The results of regression analyses suggested a mediating role of self-efficacy on the relationship between death anxiety and these behaviors. That is, death anxiety, by lowering one's perceived self-efficacy, reduces his/her likelihood to sign the donor card or to tell his/her donation decision. Findings suggest that death education program should be included in promotion campaigns for Chinese adults.

  19. Inhaled nitric oxide for the brain dead donor with neurogenic pulmonary edema during anesthesia for organ donation: a case report

    PubMed Central

    Park, Eun Sun; Lee, A-Ran; Lee, Sang Hyun; Kim, An Suk; Park, Soon Eun; Cho, Young Woo

    2014-01-01

    Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation. PMID:25237451

  20. "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.

  1. Exchanging spare parts or becoming a new person? People's attitudes toward receiving and donating organs.

    PubMed

    Sanner, M A

    2001-05-01

    The present study explored the public's feelings and ideas about receiving organs, and how this influenced their attitudes toward accepting a transplant themselves. Also the willingness to donate was examined in order to provide a complementary perspective. The main aim was to identify consistent attitude patterns that would include attitudes toward both receiving and donating organs and the motives behind this. Sixty-nine individuals with varying socio-demographic background, selected from samples who had responded to a questionnaire on receiving and donating organs and tissues, were interviewed in-depth. The approach to analyse the interviews was hermeneutic. Seven typical attitude patterns emerged. By an 'attitude pattern' was meant a specific set of attitudes and motives, that formed a consistent picture that was logical and psychologically meaningful. In the discussion, two different conceptions of the body were focused. One of them meant that the body was easily objectified and conceived as machine-like, and did not represent the self. This machine model paved the way for the understanding that body parts needed to be replaced by spare parts. The other conception meant that a new organ would transfer the donor's qualities, i.e. influence the identity of the recipient with regard to behaviour, appearance, and personality. This belief may be explained by 'analogy thinking' based on our everday experience of how mixed entities take on the qualities of all components. Another explanation would be a kind of magical thinking and 'the law of contagion', which is often connected to oral incorporation. The consequences of these conceptions when patients are confronted with the factual situation of a transplantation, were discussed.

  2. Ethical and legal issues in non-heart-beating organ donation.

    PubMed

    Bos, Michael A

    2005-05-15

    Procurement of kidneys and livers from non-heart-beating donors (NHBD) raises ethical and legal issues that need to be considered before wider use of these donors is undertaken. Although NHBDs were used in kidney transplantation as early as the 1960s, retrieval of these organs is not universally accepted today. From a medical point of view, these organs were considered "marginal" because the majority showed delayed or impaired function early after implantation. Legal problems relate to determination of death on cardiopulmonary criteria, the issue of valid consent, and the use of preservation measures. Among ethical issues involved are observance of the dead-donor rule, decisions with respect to resuscitation and withdrawal of life-sustaining treatment, respect for the dying patient and the dead body, and proper guidance of the family. In The Netherlands NHB donation was pioneered by the Maastricht Centre as early as 1981. Today, all seven transplant centers procure and transplant these organs, and NHBDs have become an important source of transplantable kidneys and livers. Recent legislation in The Netherlands also supports NHB donation by allowing the use of organ-preserving measures, even in the absence of family consent. As a result, one of every three kidneys transplanted in The Netherlands in 2004 derives from a NHBD. This article explores Dutch NHBD practice, protocols, and results and compares these data internationally.

  3. Is an opt-out organ donation system desirable? Comments on a new law.

    PubMed

    Petrini, C

    2016-01-01

    A law that introduces an opt-out system for organ donation has recently come into force in Wales. The debate surrounding the effectiveness and ethical acceptability of an opt-out system continues, though the available data have still not provided definitive proof that an opt-out system is more efficient than an opt-in system. Systems based on implied consent but with specific safeguards would appear more suitable and more respectful of ethical principles than those based on a more aggressive form of presumed consent.

  4. Making a case for controlled organ donation after cardiac death: the story of Italy's first experience.

    PubMed

    Vergano, Marco; Magavern, Emma; Baroncelli, Francesca; Frisenda, Valeria; Fonsato, Alessia; Artusio, Diego; Castioni, Carlo Alberto; De Piero, Maria Elena; Abelli, Massimo; Ticozzelli, Elena; Livigni, Sergio

    2017-04-01

    Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process. In our case, the death of the patient subsequent to the withdrawal of life-sustaining therapies was consistent with the patient's wishes, showing respect for his dignity and honoring his autonomy, as expressed to his family previously. By making donation possible, the medical team was able to fulfill the family's last request on behalf of the patient. This case should stimulate deliberation regarding the potential to shorten the 20-minute no-touch period currently in place in Italy. Such an action would not have injured this patient and would certainly have increased the quality of the procured organs.

  5. 'You have to die first': Exploring the thoughts and feelings on organ donation of British women who have not signed up to be donors.

    PubMed

    Nizza, Isabella E; Britton, Heather P; Smith, Jonathan A

    2016-05-01

    Four White British women who had not signed up to be organ donors were interviewed in depth to investigate their feelings on organ donation. Transcripts were analysed using Interpretative Phenomenological Analysis to reveal how the ability to detach from the body affects the acceptance of organ donation, how organ donation can trigger difficult thoughts and how the family can be used to explain not having signed up. The findings confirm previous empirical evidence but also offer original insight on the discrepancy between attitudes and behaviours, how fears can inhibit action and the importance of communicating organ donation wishes to family.

  6. Effectiveness of Organ Donation Information Campaigns in Germany: A Facebook Based Online Survey

    PubMed Central

    Settmacher, Utz; Wurst, Christine; Dirsch, Olaf

    2015-01-01

    Background The German transplantation system is in a crisis due to a lack of donor organs. Information campaigns are one of the main approaches to increase organ donation rates. Since 2012, German health insurance funds are obliged by law to inform their members about organ donation. We raised the hypothesis: The willingness to sign a donor card rises due to the subsequent increase of specific knowledge by receiving the information material of the health insurance funds. Objective The objective of the study was to assess the influence of information campaigns on the specific knowledge and the willingness to donate organs. Methods We conducted an online survey based on recruitment via Facebook groups, advertisements using the snowball effect, and on mailing lists of medical faculties in Germany. Besides the demographic data, the willingness to hold an organ donor card was investigated. Specific knowledge regarding transplantation was explored using five factual questions resulting in a specific knowledge score. Results We recruited a total of 2484 participants, of which 32.7% (300/917) had received information material. Mean age was 29.9 (SD 11.0, median 26.0). There were 65.81% (1594/2422) of the participants that were female. The mean knowledge score was 3.28 of a possible 5.00 (SD 1.1, median 3.0). Holding a donor card was associated with specific knowledge (P<.001), but not with the general education level (P=.155). Receiving information material was related to holding a donor card (P<.001), but not to a relevant increase in specific knowledge (difference in mean knowledge score 3.20 to 3.48, P=.006). The specific knowledge score and the percentage of organ donor card holders showed a linear association (P<.001). Conclusions The information campaign was not associated with a relevant increase in specific knowledge, but with an increased rate in organ donor card holders. This effect is most likely related to the feeling of being informed, together with an easy

  7. Organ and tissue donation in clinical settings: a systematic review of the impact of interventions aimed at health professionals

    PubMed Central

    2014-01-01

    In countries where presumed consent for organ donation does not apply, health professionals (HP) are key players for identifying donors and obtaining their consent. This systematic review was designed to verify the efficacy of interventions aimed at HPs to promote organ and tissue donation in clinical settings. CINAHL (1982 to 2012), COCHRANE LIBRARY, EMBASE (1974 to 2012), MEDLINE (1966 to 2012), PsycINFO (1960 to 2012), and ProQuest Dissertations and Theses were searched for papers published in French or English until September 2012. Studies were considered if they met the following criteria: aimed at improving HPs’ practices regarding the donation process or at increasing donation rates; HPs working in clinical settings; and interventions with a control group or pre-post assessments. Intervention behavioral change techniques were analyzed using a validated taxonomy. A risk ratio was computed for each study having a control group. A total of 15 studies were identified, of which only 5 had a control group. Interventions were either educational, organizational or a combination of both, and had a weak theoretical basis. The most common behavior change technique was providing instruction. Two sets of interventions showed a significant risk ratio. However, most studies did not report the information needed to compute their efficacy. Therefore, interventions aimed at improving the donation process or at increasing donation rates should be based on sound theoretical frameworks. They would benefit from more rigorous evaluation methods to ensure good knowledge translation and appropriate organizational decisions to improve professional practices. PMID:24628967

  8. Fear, ambivalence, and liminality: key concepts in refusal to donate an organ after brain death.

    PubMed

    Rassin, Michal; Lowenthal, Miri; Silner, Dina

    2005-01-01

    The refusal to donate an organ is a phenomenon in need of exploration and explanation. This article refers to the major fear of becoming an organ donor in relation to a global culture perspective and to the Halacha (Jewish law). A theoretical critique about the ambivalence demonstrated by health care providers and families will discuss these concepts in relation to brain death, from the stages of hospitalization, through the period prior to the assertion of brain death, ending with brain death, and its perspective as a liminal situation.Finally, we conclude that nursing practices during the care of the "brain dead" patient, and toward the patient's family, should convey an unequivocal message. That is, brain death describes irreversible cessation of all brain function, and therefore, the patient becomes a dead body and can be treated as a potential organ donor.

  9. Differences between white Americans and Asian Americans for social responsibility, individual right and intentions regarding organ donation.

    PubMed

    Hee Sun Park; Yoon Sook Shin; Yun, Doshik

    2009-07-01

    This study examined factors affecting intention to enroll in an organ donor registry and intention to talk to family about organ donation. Participants indicated their views about maintaining body integrity as an individual right and donating organs as a social responsibility. Results showed that the influence of social responsibility on intention to enroll was stronger for white Americans than for Asian Americans. Individual right was negatively associated with intention to enroll among Asian Americans, but not among white Americans. Social responsibility was significant for intention to talk among both white Americans and Asian Americans, but individual right was not significant.

  10. A student leadership model for promoting educational programs in organ donation and transplantation.

    PubMed

    Reville, P; Zhao, C; Perez, T; Nowacki, A S; Phillips, D; Bowen, G; Starling, N; Pflaum, B; Strickland, R; Fung, J; Askar, M

    2013-05-01

    The global organ shortage is the strongest factor for the increase in transplant wait time and deaths on waitlists. Here we describe a model for involving high school students in education research around organ donation and transplantation and capitalize on the strength of a pre-existing educational program offered by the local organ procurement organization (OPO). While training in education research at Cleveland Clinic, a high school student embarked on a collaborative project with the local OPO. The project involved evaluating three educational programs, selecting the most appropriate program for administration at her school, coordinating with the student's school administration and teachers, administering an assessment tool for the effectiveness of the program, and analyzing the results. The local OPO program that was selected for implementation consisted of a video presentation entitled "Share your life, share your decision" prepared by the United States Health Resources and Services Administration (HRSA), lectures by invited speakers and an educational assessment (pre- and post-education). The assessment survey included 3 multiple choice and 7 true/false questions. Compared to the over 2500 programs administered in the last 5 years by the local OPO, this program had a higher volume of participation (n = 353 compared to an average of 150 students/day). Students correctly classified transplantation status of more organ and tissues post-education (P < .0001 for both). For 5 out of the 7 true/false questions, students correctly answered questions more frequently post-education (P ≤ .002 for all). This experience included for the first time a formal assessment of the program which will be utilized to address targeted areas for specific improvements. This student collaborative model of involving students in organ donation and transplantation related education research has the potential to promote and maximize the effectiveness of educational programs targeting

  11. Educational Web-Based Intervention for High School Students to Increase Knowledge and Promote Positive Attitudes toward Organ Donation

    ERIC Educational Resources Information Center

    Vinokur, Amiram D.; Merion, Robert M.; Couper, Mick P.; Jones, Eleanor G.; Dong, Yihui

    2006-01-01

    A sample of 490 high school students from 81 schools in Michigan participated in an experiment in which they were randomly assigned to either a control or an experimental Web site. The experimental Web site provided exposure to educational material about the process of organ donation and organ transplantation. The control Web site provided…

  12. Donor designation: racial and ethnic differences in US nondesignators' preferred methods for disclosing intent to donate organs.

    PubMed

    Purnell, Tanjala S; Powe, Neil R; Troll, Misty U; Wang, Nae-Yuh; LaVeist, Thomas A; Boulware, L Ebony

    2011-10-01

    Little is known about racial/ethnic differences in preferred methods of disclosing deceased organ donation intentions among persons not previously designating their organ donation preferences publicly or the association of medical mistrust with preferences. We surveyed 307 United States (US) adults who had not yet designated their donation intentions via drivers' licenses or organ donor cards (nondesignators) to identify their preferred disclosure methods (personal discussions with family, physicians, or religious representatives or public registration via mail/telephone/computer, workplace, place of religious worship, or grocery store/bank/post office) and to assess the association of mistrust with preferences. In multivariable models, we assessed racial/ethnic differences in preferences and the influence of medical mistrust on preferences. Nondesignators most preferred discussions with physicians (65%) or family members (63%). After adjustment, African Americans (AAs) were more likely than Whites to prefer discussion with religious representatives. In contrast, AAs and Hispanics were less likely than Whites to prefer registration at a workplace or through mail/telephone/computer. Medical mistrust was common and associated with less willingness to disclose via several methods. Encouraging donation intention disclosure via discussions with physicians, family, and religious representatives and addressing medical mistrust could enhance strategies to improve nondesignators' donation rates.

  13. Donor Designation: Racial and Ethnic Differences in United States Non-Designators’ Preferred Methods for Disclosing Intent to Donate Organs

    PubMed Central

    Purnell, Tanjala S.; Powe, Neil R.; Troll, Misty U.; Wang, Nae-Yuh; LaVeist, Thomas A.; Boulware, L. Ebony

    2011-01-01

    Main Problem Little is known about racial/ethnic differences in preferred methods of disclosing deceased organ donation intentions among persons not previously designating their organ donation preferences publicly or the association of medical mistrust with preferences. Methods We surveyed 307 United States (US) adults who had not yet designated their donation intentions via drivers’ licenses or organ donor cards (non-designators) to identify their preferred disclosure methods (personal discussions with family, physicians, or religious representatives or public registration via mail/telephone/computer, workplace, place of religious worship, or grocery store/bank/post office) and to assess the association of mistrust with preferences. In multivariable models, we assessed racial/ethnic differences in preferences and the influence of medical mistrust on preferences. Results Non-designators most preferred discussions with physicians (65%) or family members (63%). After adjustment, African Americans (AAs) were more likely than Whites to prefer discussion with religious representatives. In contrast, AAs and Hispanics were less likely than Whites to prefer registration at a workplace or through mail/telephone/computer. Medical mistrust was common and associated with less willingness to disclose via several methods. Conclusions Encouraging donation intention disclosure via discussions with physicians, family, and religious representatives and addressing medical mistrust could enhance strategies to improve non-designators’ donation rates. PMID:21777299

  14. The dissection room experience: A factor in the choice of organ and whole body donation--a Nigerian survey.

    PubMed

    Anyanwu, Emeka G; Obikili, Emmanuel N; Agu, Augustine U

    2014-01-01

    The psychosocial impact of human dissection on the lives of medical and health science students has been noted. To assess the impact of the dissection room experience on one's willingness to become a whole body and organ donor, the attitudes of 1,350 students and professionals from the medical, health, and non-health related disciplines to body and organ donation were studied. The participants were broken into categories according to degree of exposure to human dissection. Participants who were never exposed to the dissection experience showed more willingness to donate their bodies than those who were exposed. With the exception of the physiotherapy department, the students and professionals from the health science departments who were exposed to the dissection room but never engaged in dissection showed the most unwillingness to donate their bodies (P < 0.001). An unwillingness to donate oneself was noted as one of the negative impacts associated with exposure to the dissection room. Willingness to donate an organ correlated positively with the level of exposure to the dissection room (P < 0.001). Most of the reasons for unwillingness were traceable to negative perceptions of the dissection room as a result of poor and disrespectful management of the human cadavers.

  15. Time trends in organ donation after neurologic determination of death: a cohort study

    PubMed Central

    Kramer, Andreas H.; Baht, Ryan; Doig, Christopher J.

    2017-01-01

    Background: The cause of brain injury may influence the number of organs that can be procured and transplanted with donation following neurologic determination of death. We investigated whether the distribution of causes responsible for neurologic death has changed over time and, if so, whether this has had an impact on organ quality, transplantation rates and recipient outcomes. Methods: We performed a cohort study involving consecutive brain-dead organ donors in southern Alberta between 2003 and 2014. For each donor, we determined last available measures of organ injury and number of organs transplanted, and compared these variables for various causes of neurologic death. We compared trends to national Canadian data for 2000-2013 (2000-2011 for Quebec). Results: There were 226 brain-dead organ donors over the study period, of whom 100 (44.2%) had anoxic brain injury, 63 (27.9%) had stroke, and 51 (22.6%) had traumatic brain injury. The relative proportion of donors with traumatic brain injury decreased over time (> 30% in 2003-2005 v. 6%-23% in 2012-2014) (p = 0.004), whereas that with anoxic brain injury increased (14%-37% v. 46%-80%, respectively) (p < 0.001). Nationally, the annual number of brain-dead donors with traumatic brain injury decreased from 4.4 to less than 3 per million population between 2000 and 2013, and that with anoxic brain injury increased from 1.1 to 3.1 per million. Donors with anoxic brain injury had higher concentrations of creatinine, alanine aminotransferase and troponin T, and lower PaO2/FIO2 and urine output than donors with other diagnoses. The average number of organs transplanted per donor was 3.6 with anoxic brain injury versus 4.5 with traumatic brain injury or stroke (p = 0.002). Interpretation: Anoxic brain injury has become a leading cause of organ donation after neurologic determination of death in Canada. Organs from donors with anoxic brain injury have a greater degree of injury, and fewer are transplanted. These findings

  16. Individual and family consent to organ and tissue donation: is the current position coherent?

    PubMed

    Wilkinson, T M

    2005-10-01

    The current position on the deceased's consent and the family's consent to organ and tissue donation from the dead is a double veto-each has the power to withhold and override the other's desire to donate. This paper raises, and to some extent answers, questions about the coherence of the double veto. It can be coherently defended in two ways: if it has the best effects and if the deceased has only negative rights of veto. Whether the double veto has better effects than other policies requires empirical investigation, which is not undertaken here. As for rights, the paper shows that it is entirely possible that individuals have a negative right of veto but no positive right to compel acceptance of their offers. Thus if intensivists and transplant teams turn down the deceased's offer, they do not thereby violate the deceased's right. This leaves it open whether non-rights based reasons-such as avoiding bad publicity or distress -require intensivists and transplant teams to turn down or accept the deceased's offer. This, however, is beyond the scope of this paper. The current position may or may not be wrong, but it is at least coherent.

  17. Cultural carrying capacity: Organ donation advocacy, discursive framing, and social media engagement.

    PubMed

    Bail, Christopher A

    2016-09-01

    Social media sites such as Facebook have become a powerful tool for public health outreach because they enable advocacy organizations to influence the rapidly increasing number of people who frequent these forums. Yet the very open-ness of social media sites creates fierce competition for public attention. The vast majority of social media messages provoke little or no reaction because of the sheer volume of information that confronts the typical social media user each day. In this article, I present a theory of the "cultural carrying capacity" of social media messaging campaigns. I argue that advocacy organizations inspire more endorsements, comments, and shares by social media users if they diversify the discursive content of their messages. Yet too much diversification creates large, disconnected audiences that lack the sense of shared purpose necessary to sustain an online movement. To evaluate this theory, I created a Facebook application that collects social media posts produced by forty-two organ donation advocacy organizations over 1.5 years, as well as supplemental information about the organization, its audience, and the broader social context in which they interact. Time series models provide strong evidence for my theory net of demographic characteristics of social media users, the resources and tactics of each organization, and broader external factors. I conclude by discussing the implications of these findings for public health, cultural sociology, and the nascent field of computational social science.

  18. Changing pattern of organ donation at a single center: are potential brain dead donors being lost to donation after cardiac death?

    PubMed

    Saidi, R F; Bradley, J; Greer, D; Luskin, R; O'Connor, K; Delmonico, F; Kennealey, P; Pathan, F; Schuetz, C; Elias, N; Ko, D S C; Kawai, T; Hertl, M; Cosimi, A B; Markmann, J F

    2010-11-01

    Donation after cardiac death (DCD) has proven effective at increasing the availability of organs for transplantation.We performed a retrospective examination of Massachusetts General Hospital (MGH) records of all 201 donors from 1/1/98 to the 11/2008, including 54 DCD, 115 DBD and 32 DCD candidates that did not progress to donation (DCD-dnp). Comparing three time periods, era 1 (01/98-12/02), era 2 (01/03-12/05) and era 3 (01/06-11/08), DCD’s comprised 14.8,48.4% and 60% of donors, respectively (p = 0.002). A significant increase in the incidence of cardiovascular/cerebrovascular as cause of death was evident in era 3 versus eras 1 and 2; 74% versus 57.1% (p<0.001),as was a corresponding decrease in the incidence of traumatic death. Interestingly, we noted an increase in utilization of aggressive neurological management over time, especially in the DCD group.We detected significant changes in the make-up of the donor pool over the past decade. That the changes in diagnosis over time did not differ between DCD and DBD groups suggests this difference is not responsible for the increase in DCD rates. Instead, we suggest that changes in clinical practice, especially in management of patients with severe brain injury may account for the increased proportion of DCD.

  19. The Impact and Evaluation of Two School-Based Interventions on Intention to Register an Organ Donation Preference

    ERIC Educational Resources Information Center

    Reubsaet, A.; Brug, J.; Kitslaar, J.; Van Hooff, J. P.; van den Borne, H. W.

    2004-01-01

    The present paper describes the impact and evaluation of two intervention components--a video with group discussion and an interactive computer-tailored program--in order to encourage adolescents to register their organ donation preference. Studies were conducted in school during regular school hours. The video with group discussion in class had a…

  20. Process Evaluation of a School-Based Education Program about Organ Donation and Registration, and the Intention for Continuance

    ERIC Educational Resources Information Center

    Reubsaet, A.; Reinaerts, E. B. M.; Brug, J.; van Hooff, J. P.; van den Borne, H. W.

    2004-01-01

    This paper describes the process evaluation of an organ donation education program for high school students aged 15-18 years of which the effectiveness was established. The program consisted of three components: a video with group discussion, an interactive computer-tailored program and a registration training session. A cross-sectional survey was…

  1. Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief?

    ERIC Educational Resources Information Center

    Bellali, Thalia; Papadatou, Danai

    2006-01-01

    The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

  2. Effects of Ethnicity on Deceased Organ Donation in a Minority-Majority State

    PubMed Central

    Moore, S. Annie; Myers, Orrin; Comfort, Dave; Lu, Stephen W.; Tawil, Isaac; West, Sonlee D.

    2014-01-01

    OBJECTIVE To define how ethnicity affects donation rates in New Mexico as compared to the United States. We hypothesized that deceased donation rates in NM would reflect the ethnic rates of the population. DESIGN We performed a retrospective review of the Organ Procurement Database for NM from 2009 to June 2012. MEASUREMENTS Rates for donors and transplant candidates were calculated relative to 2010 census population estimates by ethnicity for Non-Hispanic Whites, Hispanics and American Indians. Poisson regression analyses were used to test whether US and NM rates differed. Rates were scaled to 100,000 patient-years for reporting. RESULTS Non-Hispanic White age-adjusted donor rates per 100,000 patient years were 2.58 in NM vs. 2.60 in US, Hispanic donor rates were 1.98 in NM vs 2.03 nationwide, and American Indian donor rates in NM were 0.26 vs. 1.23 nationwide (Rate Ratio = 0.21, 95% CI 0.05,0.86) American Indians have significantly lower donor rates in NM compared to Non-Hispanic Whites (Rate ratio = 0.11) and Hispanics (RR = 0.13) and nationally (Non-Hispanic Whites: RR = 0.32 and Hispanics: 0.43). Hispanics and Non-Hispanic Whites had similar donor rates regardless of geographic strata (Hispanics vs Non-Hispanic Whites NM: 0.83; US: 0.75). In NM Hispanic patients were 1.43 times more likely to be listed as transplant candidates than Non-Hispanic Whites and American Indians were 3.32 times more likely to be listed than Non-Hispanic Whites. In the US Hispanic patients were 1.90 times more likely to be listed as transplant candidates than Non-Hispanic Whites and American Indians were 1.55 times more likely to be listed than Non-Hispanic Whites. CONCLUSIONS Donor and transplant candidate rates did not show strong differences by geographic strata. These findings suggest that further work is needed to elucidate the causes for ethnic differences in rates of consent and donation, particularly in the American Indian population. PMID:24557419

  3. Development of a preclinical model of donation after circulatory determination of death for translational application

    PubMed Central

    2014-01-01

    Background Extracorporeal membranous oxygenation is proposed for abdominal organ procurement from donation after circulatory determination of death (DCD). In France, the national Agency of Biomedicine supervises the procurement of kidneys from DCD, specifying the durations of tolerated warm and cold ischemia. However, no study has determined the optimal conditions of this technique. The aim of this work was to develop a preclinical model of DCD using abdominal normothermic oxygenated recirculation (ANOR). In short, our objectives are to characterize the mechanisms involved during ANOR and its impact on abdominal organs. Methods We used Large White pigs weighing between 45 and 55 kg. After 30 minutes of potassium-induced cardiac arrest, the descending thoracic aorta was clamped and ANOR set up between the inferior vena cava and the abdominal aorta for 4 hours. Hemodynamic, respiratory and biochemical parameters were collected. Blood gasometry and biochemistry analysis were performed during the ANOR procedure. Results Six ANOR procedures were performed. The surgical procedure is described and intraoperative parameters and biological data are presented. Pump flow rates were between 2.5 and 3 l/min. Hemodynamic, respiratory, and biochemical objectives were achieved under reproducible conditions. Interestingly, animals remained hemodynamically stable following the targeted protocol. Arterial pH was controlled, and natremia and renal function remained stable 4 hours after the procedure was started. Decreased hemoglobin and serum proteins levels, concomitant with increased lactate dehydrogenase activity, were observed as a consequence of the surgery. The serum potassium level was increased, owing to the extracorporeal circulation circuit. Conclusions Our ANOR model is the closest to clinical conditions reported in the literature and will allow the study of the systemic and abdominal organ impact of this technique. The translational relevance of the pig will permit

  4. [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.

  5. What is the limiting factor for organ procurement in Belgium: donation or detection ? What can be done to improve organ procurement rates?

    PubMed

    Van Gelder, E; de Roey, J; Desschans, B; Van Hees, D; Aerts, R; Monbaliu, D; De Pauw, L; Coosemans, W; Pirenne, J

    2008-01-01

    In trying to overcome the growing gap between demand and offer of organs for transplantation, solutions are usually searched for by comparing successful and unsuccessful models in different countries. In particular, one element in the more successful countries such as for instance presumed consent, or one element in the less successful countries such as for instance refusal by relatives, are seen as possible reasons for these differences. This article tackles the problem of organ donor shortage through a new multi-level approach. Organ donation can indeed be analyzed on three different levels: the macro-level, the meso-level and the micro-level. The macro-level refers to the governmental structure where legislation, policies and funding are three essential elements necessary to make donation possible. The meso-level refers to the health care organization and the professionals who surround the process of organ donation and transplantation. Facilitating this process through standardized protocols and improving detection of organ donors are the two major elements. The micro-level refers to the individual believes and personal attitudes towards organ donation. This new multi-level approach gives a thorough and complete analysis of problems and allows to propose potential solutions to try to overcome the chronic organ shortage.

  6. 11 CFR 300.11 - Prohibitions on fundraising for and donating to certain tax-exempt organizations (2 U.S.C 441i(d)).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Prohibitions on fundraising for and donating to certain tax-exempt organizations (2 U.S.C 441i(d)). 300.11 Section 300.11 Federal Elections FEDERAL... Party Committees § 300.11 Prohibitions on fundraising for and donating to certain...

  7. 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

  8. Attitudes and beliefs within the Sikh community regarding organ donation: a pilot study.

    PubMed

    Exley, C; Sim, J; Reid, N; Jackson, S; West, N

    1996-07-01

    The current shortage of organs for transplantation is a matter of considerable concern in the United Kingdom (U.K.). Whilst issues of histocompatibility create particular problems in this respect for the Asian population in the U.K., it is sometimes suggested that there is also a resistance to the idea of organ transplantation among this community. To explore this issue, a small-scale interview study was conducted in Coventry among members of the Sikh community. A judgemental sample of 22 individuals, from different strata of the local Sikh community, were interviewed either in one-to-one interviews or in a focus group. These interviews had two broad aims: to determine the prevailing attitudes towards organ transplantation, and to gauge the impact and acceptability of the current Department of Health campaign literature. It was found that, whilst there were a number of misgivings to do with notions of mutilation and reincarnation, and anxieties as to technical or clinical aspects of the transplantation process, the prevailing view was supportive of transplantation, and organ donation was seen as a highly appropriate means of exhibiting the altruistic tradition within Sikhism. Such barriers that exist to the idea of transplantation seem to have more to do with knowledge and understanding than with cultural or religious factors. Concerning the campaign literature, informants identified a number of shortcomings, and indicated ways in which the impact of the leaflets and posters might be enhanced. Although the generalizability of these findings is limited, and despite possible threats to the validity of the data collected, this study has produced findings with significant implications for future policy in this area.

  9. Communication as a predictor of willingness to donate one's organs: an addition to the Theory of Reasoned Action.

    PubMed

    Jeffres, Leo W; Carroll, Jeanine A; Rubenking, Bridget E; Amschlinger, Joe

    2008-12-01

    Fishbein and Ajzen's theory of reasoned action has been used by many researchers, particularly in regard to health communication, to predict behavioral intentions and behavior. According to that theory, one's intention is the best predictor that one will engage in a behavior, and attitudes and social norms predict behavioral intentions. Other researchers have added different variables to the postulates of attitudes and social norms that Fishbein and Ajzen maintain are the best predictors of behavioral intention. Here we draw on data from a 2006 telephone survey (N = 420) gauging the awareness of an organ donation campaign in Northeast Ohio to examine the impact of communication on people's intentions. The current study supports the hypothesis that those who communicate with others are more likely to express a greater willingness to become an organ donor, but it expands the range of communication contexts. With demographics and attitudes toward organ donation controlled for, this study shows that communication with others about organ donation increases the willingness of individuals to have favorable attitudes about being an organ donor.

  10. Guidelines for drug donations.

    PubMed Central

    Hogerzeil, H. V.; Couper, M. R.; Gray, R.

    1997-01-01

    Drug donations are usually given in response to acute emergencies, but they can also be part of development aid. Donations may be given directly by governments, by non-governmental organisations, as corporate donations (direct or through private voluntary organisations), or as private donations to single health facilities. Although there are legitimate differences between these donations, basic rules should apply to them all. This common core of "good donation practice" is the basis for new guidelines which have recently been issued by the World Health Organisation after consultation with all relevant United Nations agencies, the Red Cross, and other major international agencies active in humanitarian emergency relief. This article summarises the need for such guidelines, the development process, the core principles, and the guidelines themselves and gives practical advice to recipients and donor agencies. PMID:9116555

  11. Organ donation and transplantation in the UK-the last decade: a report from the UK national transplant registry.

    PubMed

    Johnson, Rachel J; Bradbury, Lisa L; Martin, Kate; Neuberger, James

    2014-01-15

    Over the decade between 2003 and 2012, the UK has seen major changes in how organ donation and transplantation is delivered. The number of deceased organ donors has increased from 709 (12.0 per million population [pmp]) to 1,164 (18.3 pmp); this increase has been predominantly a result of an increase in donors after circulatory death (DCD) (from 1.1 pmp to 7.9 pmp) while the numbers of donors after brain death (DBD) has remained broadly stable (around 10.5 pmp). The donor population has become older (from 14% 60 years or over to 35%) and heavier (from 14% with body mass index >=30 kg/m2 to 23%). Despite these changes in demographic factors, the number of organs retrieved from DBD donors has risen from a mean of 3.6 to 4.0 per donor and for DCD donors from 2.2 to 2.6. The number of transplants in adults in 2012 was 2,709 (967 DBD, 708 DCD, and 1,034 living) for kidney alone, 246 pancreas (including 172 kidney and pancreas), 792 (611 DBD, 142 DCD, 36 living, and 3 domino) for liver, 136 for heart only, and 179 (145 DBD and 34 DCD) for lung only. Median waiting times to transplant for adult patients were 1,167, 339, 141, 293, and 311 days, respectively. The proportion of adult non-urgent registrants in 2009 (2007 for kidneys) who were removed from the waiting list or died awaiting a graft within 1 year was 3% for kidneys, 6% for pancreas, 19% for liver, 27% for heart, and 24% for lung. Outcomes after solid organ transplants are improving; for adult patients grafted between 2003 and 2005, 5-year graft survival for kidney is 84% (DBD), 87% (DCD), and 92% (living donor), for simultaneous kidney and pancreas 72%, and for pancreas alone 50% (DBD). Five-year patient survival for liver is 77% (DBD) and 68% (DCD), heart 67%, and lung 52% (DBD). Although rates of organ donation and transplantation have increased in the UK, this has been almost solely because of a rise in DCD donation. Although donor age and weight is increasing, graft survival has generally improved. Despite a

  12. Decision solution, data manipulation and trust: The (un-)willingness to donate organs in Germany in critical times.

    PubMed

    Schwettmann, Lars

    2015-07-01

    In 2011 and 2012 a change of rules and a data-manipulation scandal focused German public attention on organ donation. This increased citizens' background knowledge as well as their willingness to respond to surveys. The present study is an effort to seize this research opportunity and to create evidence on which policy recommendations can be conceivably based. It uses data from two major representative surveys from 2011 to 2012 to address four central questions: Which characteristics, experiences and attitudes correlate with the written or unwritten willingness of individuals to donate (WTD) their own organs post-mortem? How has the WTD changed over time? To what extent does the WTD depend on normative trust? Which factors correlate with trust? The data is analyzed through summary statistics and regression models. Several hypotheses regarding factors connected with the WTD are confirmed in the survey results. Altruistic motives, relevant knowledge and trust are decisive. The special role of trust is corroborated by the data. As current German politics prevents the introduction of post-mortem donation incentives, potential policy making proposals are restricted to institutional changes to regain trust including the implementation of an organ donor registry and the advancement of counselling talks with general practitioners.

  13. 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

  14. Donation FAQs (Bone and Tissue Allografts)

    MedlinePlus

    ... Is there a difference between tissue and organ donation? In general, organ donors must be brain dead, which is defined ... very limited cases (approximately 20,000 per year), organ donation occurs when mechanical support (i.e., ventilators) can ...

  15. Transplant recipients' conceptions of three key phenomena in transplantation: the organ donation, the organ donor, and the organ transplant.

    PubMed

    Sanner, Margareta A

    2003-08-01

    Thirty-five heart and kidney transplant patients were interviewed on five separate occasions during the first 2 yr after transplantation. The aim was to explore their experiences of phenomena that distinguish the transplantation from other kinds of medical treatment. The selection of informants was designed to permit comparisons between recipients with heart and kidney transplants and with living and necro-transplants. The qualitative analysis of the informants' reactions was focused on three themes; nine categories emerged. The first theme concerned general aspects of the donation and the donor and was differentiated in four categories: joy and sorrow, gratefulness and indebtedness, guilt, and inequity. The second theme related to the donor as a unique individual and included three categories: recognition and identification with the donor, influences of the donor, and relationship to the living donor. The third theme pertained to incorporation of the transplant and included two categories related to the naturalness of having a transplant, and the benevolent transplant. The informants' reactions were discussed in terms of primary and secondary processes. All informants were in an emotionally charged situation after transplantation and warded off anxiety-provoking impulses, most intensively during the first 6 months. Avoidance, suppression, and denial were the most common defence mechanisms, all of which seemed to be supported by the medical context. Other, more constructive strategies are suggested. The recipients' own interpretations of causes to possible personality changes are discussed. There were few differences between heart and necro-kidney patients concerning the reactions to the donation, the donor, and the transplant; the dividing line was more prominent between recipients with living and necro-transplants.

  16. Organizing the Donation of Convalescent Plasma for a Therapeutic Clinical Trial on Ebola Virus Disease: The Experience in Guinea

    PubMed Central

    Delamou, Alexandre; Haba, Nyankoye Yves; Mari-Saez, Almudena; Gallian, Pierre; Ronse, Maya; Jacobs, Jan; Camara, Bienvenu Salim; Kadio, Kadio Jean-Jacques Olivier; Guemou, Achille; Kolie, Jean Pe; De Crop, Maaike; Chavarin, Patricia; Jacquot, Chantal; Lazaygues, Catherine; De Weggheleire, Anja; Lynen, Lutgarde; van Griensven, Johan

    2016-01-01

    Although convalescent plasma (CP) transfusion was prioritized among potential Ebola treatments by the World Health Organization, there were concerns on the feasibility of its implementation. We report on the successful organization of donor mobilization and plasma collection as part of the Ebola-Tx clinical trial from November 2014 to July 2015 in Conakry, Guinea. Project implementation registers, tools and reports, mission reports, and minutes of research team meetings were used to reconstruct the sequence of events on how donor mobilization was organized, plasmapheresis was set up, and how effective this approach was in collecting CP. An initial needs assessment of the Guinean National Blood Transfusion Center resulted in targeted training of staff on site, resulting in autonomy and independent production of CP within 3 months. The Conakry Ebola Survivors Association played a direct role in donor mobilization and organization of CP donations. A total of 98 Ebola survivors were screened for plasma donation, of which 84 were found eligible for plasmapheresis. Of these, 26 (30.9%) were excluded. The remaining 58 donors made a total of 90 donations, corresponding to 50.9 L of CP. This sufficed to treat the 99 eligible patients enrolled in the trial. Within a poor resource emergency context, transfusion capacity could be rapidly improved through the strengthening of local capacities and gradual transfer of skills coupled with active involvement of Ebola survivors. However, large-scale plasma collection or multisite studies may require further adaptations of both strategy and logistics. The Ebola-Tx trial was funded by the European Union and others. PMID:27430546

  17. Survey of clinical engineering effectiveness in developing world hospitals: equipment resources, procurement and donations.

    PubMed

    Mullally, Shauna; Frize, Monique

    2008-01-01

    This paper presents preliminary findings of a study of clinical engineering effectiveness within developing world hospitals. To date, 169 responses have been collected from 43 countries, primarily from Africa, Latin America and Asia, with some representation from the Middle East and Eastern Europe as well. Data is presented on: 1) hospital and clinical engineering department profiles; 2) human and equipment resources; and 3) equipment procurement and donation processes, with a focus on the role of the clinical engineering department. This is the first study to collect and analyze data on the complexity and state of hospital equipment across the developing world; additionally it is the first to collect significant responses from Africa. Prior to this study, only 10 developing countries had been profiled in international studies.

  18. 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

  19. 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

  20. The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives

    PubMed Central

    2014-01-01

    End-of-life organ donation is controversial in Islam. The controversy stems from: (1) scientifically flawed medical criteria of death determination; (2) invasive perimortem procedures for preserving transplantable organs; and (3) incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: (1) reinterpreting religious scriptures, (2) reeducating faith leaders, and (3) utilizing media campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life. PMID:24888748

  1. The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives.

    PubMed

    Rady, Mohamed Y; Verheijde, Joseph L

    2014-06-02

    End-of-life organ donation is controversial in Islam. The controversy stems from: (1) scientifically flawed medical criteria of death determination; (2) invasive perimortem procedures for preserving transplantable organs; and (3) incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: (1) reinterpreting religious scriptures, (2) reeducating faith leaders, and (3) utilizing media campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life.

  2. The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor.

    PubMed

    Fan, Xiaoli; Chen, Zhiquan; Nasralla, David; Zeng, Xianpeng; Yang, Jing; Ye, Shaojun; Zhang, Yi; Peng, Guizhu; Wang, Yanfeng; Ye, Qifa

    2016-10-01

    Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes. A total of 19 brain death donors were supported by ECMO. The incidence rate of post-transplant liver primary non-function (PNF) was 10% (two of 20) in DBD-drug group and zero in DBD-ECMO group. Kidney function indicators, including creatinine clearance and urine production, were significantly better in DBD-ECMO group, as well as the kidney delayed graft function (DGF) rate was found to be decreased by the use of ECMO in our study. Donation success rate increased steadily from 47.8% in 2011 to 84.6% in 2014 after the ECMO intervention. The use of ECMO in assisting circulatory and respiratory function of DBD can reduce liver and kidney injury from vasoactive drugs, thereby improving organ quality and reducing the organ discard rates.

  3. Quantitative versus Qualitative Dimensions of Prosocial Development: Age-Related Contributors to Children's Donating Behavior.

    ERIC Educational Resources Information Center

    Roush, Cheri L.; Hudson, Lynne M.

    1985-01-01

    Sixty second-, fourth-, and sixth-grade children were given opportunities to donate money to other children in order to establish age-related differences and demand characteristics contributing to variability in donating behavior. Discussion focuses on necessity of incorporating both qualitative and quantitative dimensions in general models of the…

  4. Early liver transplantation for patients with acute alcoholic hepatitis: public views and the effects on organ donation.

    PubMed

    Stroh, G; Rosell, T; Dong, F; Forster, J

    2015-06-01

    Patients with severe acute alcoholic hepatitis may not survive to fulfill the standard 6 months of abstinence and counseling prior to transplantation. A prospective study demonstrated that early liver transplantation in such patients improved 2 year survival from 23% to 71% and only 3 of 26 patients returned to drinking after 1140 days; graft function was unaffected. Nonetheless, this treatment protocol may raise public concerns and affect organ donation rates. A total of 503 participants took a survey made available at an online crowdsourcing marketplace. The survey measured attitudes on liver transplantation generally and early transplantation for this patient population, in addition to measuring responses to nine vignettes describing fictional candidates. The majority of respondents (81.5%, n = 410) was at least neutral toward early transplantation for these patients; only a minority (26.3%) indicated that transplantation in any vignette would make them hesitant to donate their organs. Middle-aged patients with good social support and financial stability were viewed most favorably (p < 0.001). Age was considered the most important selection factor and financial stability the least important factor (each p < 0.001). Results indicate early transplantation for carefully selected patients with acute alcoholic hepatitis may not be as controversial to the public as previously thought.

  5. 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

  6. Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context.

    PubMed

    Allard, Julie; Fortin, Marie-Chantal

    2016-12-28

    In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death. The donation is subsequent to the decision to withdraw life-sustaining treatment (LST). Cases where patients are conscious prior to the withdrawal of LST are unusual, and have raised doubts as to the acceptability of removing organs from individuals who are not neurologically impaired and who have voluntarily chosen to die. These cases can be compared with likely scenarios in which patients will request both MAID and organ donation. In both instances, patients will be conscious and competent. Organ donation in such contexts raises ethical issues regarding respect for autonomy, societal pressure, conscientious objections and the dead-donor rule. In this article, we look at relevant policies in other countries and examine the ethical issues associated with cDCD in conscious patients who choose to die.

  7. 11 CFR 300.37 - Prohibitions on fundraising for and donating to certain tax-exempt organizations (2 U.S.C. 441i(d)).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Prohibitions on fundraising for and donating to certain tax-exempt organizations (2 U.S.C. 441i(d)). 300.37 Section 300.37 Federal Elections FEDERAL..., District, and Local Party Committees and Organizations § 300.37 Prohibitions on fundraising for...

  8. Principles and concepts of brain death and organ donation: the Jewish perspective.

    PubMed

    Rappaport, Z H; Rappaport, I T

    1998-08-01

    The harvesting of organs for transplantation is dependent on a stringent definition of brain death. Different societies have had to struggle with their cultural heritage, adapting their traditional attitudes to conform to the advances in medical science and the needs of the sick. In this article, the development of the concept of brain death as it applies to organ transplantation in Judaism is outlined. The ability of traditional Jewish values to address themselves to the challenges of modern medicine can serve as a basis for cultural cross-fertilization and comparison in modern societies.

  9. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

    PubMed

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

    2017-01-31

    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved.

  10. Donating Blood

    MedlinePlus

    ... blood transfusion. Blood donors — especially donors with certain blood types — are always in demand. Who Can Donate Blood? ... Natural Disasters: How to Help Blood Blood Transfusions Blood Types Contact Us Print Resources Send to a Friend ...

  11. The transplantable organ shortage in Singapore: has implementation of presumed consent to organ donation made a difference?

    PubMed

    Kwek, Tong Kiat; Lew, Thomas W K; Tan, Hui Ling; Kong, Sally

    2009-04-01

    The success of solid organ transplantation in the treatment of end-stage organ failure has fuelled a growing demand for transplantable organs worldwide that has far outstripped the supply from brain dead heart-beating donors. In Singapore, this has resulted in long waiting lists of patients for transplantable organs, especially kidneys. The Human Organ Transplant Act, introduced in 1987, is an opt-out scheme that presumes consent to removal of certain organs for transplantation upon death. Despite this legislation, the number of deceased organ donors in Singapore, at 7 to 9 per million population per year, remains low compared to many other developed countries. In this paper, we reviewed the clinical challenges and ethical dilemmas encountered in managing and identifying potential donors in the neurological intensive care unit (ICU) of a major general hospital in Singapore. The large variance in donor actualisation rates among local restructured hospitals, at 0% to 56.6% (median 8.8%), suggests that considerable room still exists for improvement. To address this, local hospitals need to review their processes and adopt changes and best practices that will ensure earlier identification of potential donors, avoid undue delays in diagnosing brain death, and provide optimal care of multi-organ donors to reduce donor loss from medical failures.

  12. Development and validation of a questionnaire to assess fear of kidney failure following living donation.

    PubMed

    Rodrigue, James R; Fleishman, Aaron; Vishnevsky, Tanya; Whiting, James; Vella, John P; Garrison, Krista; Moore, Deonna; Kayler, Liise; Baliga, Prabhakar; Chavin, Kenneth D; Karp, Seth; Mandelbrot, Didier A

    2014-06-01

    Living kidney donors (LKDs) may feel more anxious about kidney failure now that they have only one kidney and the security of a second kidney is gone. The aim of this cross-sectional study was to develop and empirically validate a self-report scale for assessing fear of kidney failure in former LKDs. Participants were 364 former LKDs within the past 10 years at five US transplant centers and 219 healthy nondonor controls recruited through Mechanical Turk who completed several questionnaires. Analyses revealed a unidimensional factor structure, excellent internal consistency (α = 0.88), and good convergent validity for the Fear of Kidney Failure questionnaire. Only 13% of former donors reported moderate to high fear of kidney failure. Nonwhite race (OR = 2.9, P = 0.01), genetic relationship with the recipient (OR = 2.46, P = 0.04), and low satisfaction with the donation experience (OR = 0.49, P = 0.002) were significant predictors of higher fear of kidney failure. We conclude that while mild anxiety about kidney failure is common, high anxiety about future renal failure among former LKDs is uncommon. The Fear of Kidney Failure questionnaire is reliable, valid, and easy to use in the clinical setting.

  13. "Bones of Contention". The donation of temporal bones for dissection after the organ-retention scandals.

    PubMed

    Morris, D P; Benbow, E W; Ramsden, R T

    2001-09-01

    It is essential for the Otologist in training to become familiar with the anatomy of the temporal bone. Generations of trainees have acquired this knowledge, together with basic surgical skills and techniques by dissection of cadaver temporal bones. In recent years, however, the supply of temporal bones for dissection has become a contentious issue in many British hospitals. Media and public attention has recently focused on issues surrounding the retention of human tissues following post-mortem examinations. In response, the Chief Medical Officer, the Royal College of Pathologists in the UK, the Faculty of Pathology of the Royal College of Physicians in Ireland, the British Medical Association, and other bodies have issued new guidelines that are of relevance to the Otolaryngologist. This paper gives details of some of the UK guidelines and where they can be accessed. A copy of the Royal College of Pathologists preferred post-mortem consent form is presented. The authors' experience in Manchester is discussed and details of an information leaflet on the subject of temporal bone donation are given. It is concluded that, with knowledge of the existing guidelines and good communication with other hospital colleagues, as well as families of the deceased, it is still possible legally to obtain temporal bones for dissection.

  14. Exploring the Needs and Perceptions of Iranian Families Faced with Brain Death News and Request to Donate Organ: A Qualitative Study

    PubMed Central

    Manzari, Z. S.; Mohammadi, E.; Heydari, A.; Aghamohammadian Shearbaff, H. R.; Modabber Azizi, M. J.; Khaleghi, E.

    2012-01-01

    Background: Learning that one of your beloved ones is passing away and you have to decide on organ donation is a very stressful experience. Objective: To explore the specific needs of families with a brain-dead patient during organ donation process. Methods: A qualitative research using content analysis was used to obtain data from 26 purposely selected families in a transplantation center in Mashhad, northeastern Iran, regarding how they would face organ donation decisions. Results: Data saturation was reached after 38 unstructured in-depth interviews and field notes, once data was transcribed and tabulated. Four major themes emerged as 1) family needs for emotional support, 2) empathy and compassion, 3) team efforts to assure family, and 4) shouldering grief. Conclusion: Study results highlighted the essential need for an expert team with specialized training to help families in despair deciding in favor or against organ donation. Moreover, discovering and explaining these specific needs help policy makers and administrators to plan interventions in relation to condition-building to facilitate safe passing of the families through this difficult situation. PMID:25013629

  15. Knowledge Levels and Attitudes of People Living in the City Centre of Nevşehir on Organ Donation and Transplantation

    PubMed Central

    Yazar, Mehmet Akif; Açıkgöz, Mehmet Barış

    2016-01-01

    Objective The purpose of this descriptive study was to determine the knowledge levels and attitudes of people living in Nevşehir on organ donation (OD) and transplantation. Methods Data were collected using a questionnaire administered to 414 people residing in Nevşehir between February and May 2016. The primary and secondary endpoints of the present study were to determine the attitudes and knowledge levels of participants on OD and transplantation, respectively. Results Four hundred and fourteen people between the ages 20 and 65 years participated. In total, 8.9% of the participants correctly answered the question ‘What is necessary for donating an organ?’ and 31.4% of them correctly answered the question ‘What is brain death?’ Moreover, 53.1% of the participants stated that they wanted to receive reliable information on OD from OD centres. There was a close relationship between high education level and the willingness to donate organs (p<0.05). Further, 94.7% of the participants stated that they did not want to donate organs: 22.9% of them explained that their decision was because of their religious beliefs and 19.6% stated that their families did not allow it. It was observed that people who accepted organs from others were more willing to donate organs to their relatives (p<0.05). Conclusion People living in Nevşehir do not have sufficient knowledge on OD; they had various concerns on the issue and wanted to receive information from OD centres. Exemplification and internalisation methods can be used in educational schedules to increase the OD. PMID:27909606

  16. Types of Blood Donations

    MedlinePlus

    ... Double Red Cell Plasma Platelets Red Cells What blood donation type is best for me? **If you do not ... blood type, a whole blood donation is recommended** Blood Donation Types: Volunteer Donations The standard or most common type ...

  17. Limitations of cadaveric organ donation on judicial cases and problems confronted in autopsy: Istanbul data in comparative perspective.

    PubMed

    Arslan, M N; Esen Melez, I; Melez, D O; Cavlak, M; Gur, A

    2014-04-01

    Organ transplantation is one of the most important services of modern medicine to the humanity. In judicial death cases the interaction between judicial needs and transplantation needs is inevitable and both should be provided in a short time before the decomposition of the body. Thus, the description of this interaction and the algorithm which should be carried out to manage these cases are important. Aim of this study is to determine the problems confronted in forensic autopsies and to determine what to do for both judicial processes' and cadaveric organ donations' not becoming limited due to each other. With these aims, autopsy case archive of the Council of Forensic Medicine Istanbul Morgue Department was reviewed, between the years 2009 and 2011, to reveal the number of organ donors among autopsy cases and also to find out the judicial problems confronted during autopsies. Among 12,016 judicial death cases referred to Istanbul Morgue Department in 3 years, 35 cases were found to have undergone cadaveric solid organ harvesting procedure and 307 cases cornea-only harvesting procedure. Manner of deaths for organ donor cases were blunt trauma due to traffic accident in 20 cases, firearm injury in 3 cases, stabbing in 2 cases, suspicious criminal battery in 4 cases and fatal falls in 5 cases. Only 1 case was suspected to have died due to high dose insulin administration. Through the whole data presented in this study, it can be concluded that consulting with the Forensic Medicine Expert not only for the autopsies but also during the clinical process of a judicial case, who is a candidate to be an organ donor, is absolutely important. The early contribution of the Forensic Medicine Expert would provide help to plan both the judicial process and the transplantation process which needs urgent decisions. A Forensic Medicine Expert may be an organ harvest team member performing initial investigations on the cause of death and collecting some of the toxicological

  18. a statistical model based on serological parameters for predicting occult HBV infection: implications for organ/ blood donations.

    PubMed

    Coen, Sabrina; Angeletti, Claudio; Piselli, Pierluca; Tronchin, Michele; Vincenti, Donatella; Capobianchi, Maria Rosaria; Galli, Claudio; Menzo, Stefano

    2015-01-01

    The transmission of hepatitis B virus by donors with occult HBV infection (OBI) is a threat for blood transfusion and organ/tissue transplantation. The risk of carrying HBV DNA is currently not predictable by simple serologic markers, while HBV DNA testing is not universally deployed. This study evaluated an integrated serologic approach for assessing this risk. Anti-HBc positive subjects (461 HIV-negative, 262 HIV-positive) were selected for the study. Serology was analyzed by a commercial CMIA technique. HBV DNA was analyzed by both commercial and home-brew real-time amplification assays. A penalized maximum likelihood logistic approach was used to analyze the data. In HBsAg-negative subjects (HIV-negative), anti-HBc signal/cut off values, the presence of anti-HBc IgM, the absence of anti-HBsAg, and the absence of anti-HCV were correlated to the probability of finding circulating HBV DNA. A model for predicting HBV DNA presence by 4 serological parameters is therefore proposed. The predictive value of the logistic model based on simple serologic markers may represent a reasonable tool for the assessment of HBV transmission risk by transfusion or organ/tissue donation in the context of limited resources and where nucleic acid testing is not performed. In addition, it may be helpful for assessing the risk of reactivation in immunosuppressed OBI patients.

  19. Organ Donation and Transplantation: A Dialogue with American Indian Healers and Western Health-Care Providers

    ERIC Educational Resources Information Center

    Hodge, Felicia Schanche; Bellanger, Patricia; Norman, Connie

    2011-01-01

    Surgically replacing organs in the human body has become an acceptable and successful procedure in Western medicine. In more recent years, replacing major organs in the human body with those procured from deceased or living donors has become commonplace. Disparities exist at the earliest stages in the donor and transplantation process in that…

  20. Can I Donate My Organs If I've Had Cancer?

    MedlinePlus

    ... NS, Watt C, Hadjiliadis D, et al. Donor transmission of malignant melanoma in a lung transplant recipient ... Watson CJ, et al. Estimated risk of cancer transmission from organ donor to graft recipient in a ...

  1. Legal requirements for donating and retaining organs: the Human Tissue Act.

    PubMed

    Griffith, Richard

    2006-10-01

    The Human Tissue Act 2004 came into force on 1 September 2006 and introduced significant changes in the way human body parts, tissue and organs are removed, stored and used. The Act seeks to remedy the poor availability of organs for transplant caused in part by laws that date back to the 17th Century and to right the concerns raised by the Liverpool Children's Inquiry that revealed widespread retention of organs by hospitals without permission. In this article Richard Griffith describes how consent is now the driving force underpinning such activity and how the wishes of the patient remain paramount even after death. He also outlines how the Human Tissue Authority will licence and inspect activities involving human tissue under the Act and discuss how the new law will affect district nurse practice.

  2. [Pregnancy following oocyte donation].

    PubMed

    Boks, D E; Braat, D D

    1997-08-23

    Five women, aged 31, 26, 31, 34, and 28 years, became pregnant after oocyte donation and in-vitro fertilization. One was a carrier of Leber's optical atrophy, three had had an early menopause (in two because of chromosomal abnormalities), and one had had bilateral ovarian extirpation because of a cystadenoma and endometriosis. Three developed (pre-)eclampsia during pregnancy and one had a serious fluxus post partum. One twin died in utero, the other children were healthy. In the Netherlands in-vitro fertilization (with or without egg-donation) takes place up to the age of about 40. Regarding the high incidence of obstetrical complications in women under 40, raising the age limit could lead to even more pregnancy problems. Candidates for oocyte donation should be informed about these risks, furthermore they should not deliver at home.

  3. Uncontrolled organ donation following prehospital cardiac arrest: a potential solution to the shortage of organ donors in the United Kingdom?

    PubMed

    Roberts, Keith J; Bramhall, Simon; Mayer, David; Muiesan, Paolo

    2011-05-01

    Uncontrolled donation after cardiac death (DCD) could increase the donor pool in the UK. Air ambulance (AA) teams may be well placed to recruit these donors. They cover large geographical areas, have short transfer times and tasked predominantly to life-threatening cases. The potential to recruit from this pool of donors was reviewed. Seventy-five month activity of an AA unit was analysed identifying patients who entered prehospital cardiac arrest (PHCA). Patients over 70 years of age were excluded as were those whose cardiac arrest was unwitnessed. A minimum potential donor pool was estimated based upon patients dying of medical causes. Rates of bystander resuscitation, mechanism of death and patient demographic data were observed. During 10,022 missions 534 patients entered PHCA. A total of 106 patients met inclusion criteria. There were 12 paediatric cases; 39 cases of 17-50 year olds and 55 cases of 50-70 year olds. Medical and traumatic causes of death accounted for 60 and 46 cases respectively. Bystander resuscitation efforts were provided in 47% of cases. A regional AA could contribute to a national uncontrolled DCD programme. Given that there are 31 AA's in England and Wales, we estimate that there could be a minimum of 300 additional potential donors annually.

  4. Amyotrophic Lateral Sclerosis and Organ Donation: Is There Risk of Disease Transmission?

    PubMed Central

    Holmes, Brandon B.; Diamond, Marc I.

    2013-01-01

    A new protocol suggests that patients with amyotrophic lateral sclerosis (ALS) are a viable source of tissue for organ transplantation. However, multiple lines of evidence suggest that many neurodegenerative diseases, including ALS, might progress due to transcellular propagation of protein aggregation among neurons. Transmission of the disease state from donor to host thus may be possible under the permissive circumstances of graft transplantation. We argue for careful patient selection and close longitudinal follow-up of recipients when harvesting organs from individuals with neurodegenerative disease, especially dominantly inherited forms. PMID:23280834

  5. When organ donation from living donors serves as the main source of organ procurement: a critical examination of the ethical and legal challenges to Turkey's recent efforts to overcome organ shortage.

    PubMed

    Sert, G; Guven, T; Gorkey, S

    2013-01-01

    Despite the fact that Turkey has implemented a number of legislative and regulatory efforts to increase cadaveric donations, live donors still serve as the main source of organ procurement in this country. To address this problem, Turkey's regulatory authorities have sought to increase the number of brain death declarations. A new regulation issued in 2012 repeats the criteria for brain death that were first issued in 1993. This paper argues that these efforts are far from adequate owing to a number of complicated, ethical, and legal challenges that must be addressed to increase cadaveric organ donations. After examining these factors, which are completely neglected in current policies, we conclude that Turkey needs a realistic ethically justifiable organ procurement policy that must be supported by a framework of patient rights to implement the concept of patient autonomy and respect for human dignity in health care services as the primary goal.

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... organizations that provide assistance to food-insecure people in the United States. (c) Costs. (1) The... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Promoting excess food... tier, who will perform, under this contract, the provision, service, or sale of food in the...

  7. Spontaneous decision of organ donation in patients signing informed consent for liver transplantation.

    PubMed

    Heits, N; Guenther, R; Kuechler, T; Becker, T; Braun, F

    2013-05-01

    The shortage of postmortem donor organs is a well-known problem in Germany. Willingness in the general population is 80%, but less than 14% have an organ donor card. We evaluated the free decision of liver transplant candidates who filled out a donor card before signing the informed consent for the transplant procedure. We analyzed 122 patients of mean age 55.9 years (range, 15.4-74.1) who signed an informed consent for liver transplantation between January 10, 2007, and January 24, 2012. The patients received the original text of the German organ donor card with tick boxes on the informed consent form for liver transplantation. All patients were informed that their decision had no impact on further management. Patients were able to choose between (1) becoming a donor, (2) refusal, (3) transfer of the decision to another person, or (4) no decision. All patients signed the informed consent to be listed for liver transplantation: 73.8% (n = 90) chose to become a donor; 5.7% (n = 7) refused; 5.7% (n = 7) transferred the decision to another person; and 14.8% (n = 18) did not come to a decision. Interestingly, not all candidates for liver transplantation were willing to become an organ donor in the time of expressed consent. However, willingness to sign the donor card was much higher among liver transplant candidates compared with the general population.

  8. Impact of Introducing Full-time In-house Coordinators on Referral and Organ Donation Rates in Rio de Janeiro Public Hospitals: A Health Care Innovation Practice.

    PubMed

    Sarlo, R; Pereira, G; Surica, M; Almeida, D; Araújo, C; Figueiredo, O; Rocha, E; Vargas, E

    2016-09-01

    Establishing an organization to promote organ donation and a good organ procurement team assure quality and improve performance on organ donation rates. Brazil's organ procurement structure is based on 2 models disseminated worldwide: the "Spanish model," based on in-house coordinators, and the "American organ procurement organization (OPO) model," with extra-hospital coordinators. In 2006, Brazil's Federal Government had formally introduced the in-house coordination model for every hospital equipped with a mechanical ventilator bed. In January 2012, the Rio de Janeiro State OPO, Programa Estadual de Transplantes, introduced an innovation in the organization of the in-house coordination model in 4 selected public hospitals with high organ donation potential. It consisted in launching full-time in-house coordination teams, with ≥1 physician and 2 nurses per hospital fully dedicated to organ procurement. The objectives were to observe the impact of this innovation in referral and organ donor conversion rates and to analyze the importance of middle managers in health care innovation implementation. Comparing the year before implementation (2011) and the year of 2014 showed that this innovation led to an overall increase in referrals-from 131 to 305 per year (+132%) and conversion rates-from 20% to 42% per year-resulting in an increase in number of donors from 26 to 128 per year (+390%). Despite wide variations among hospitals in the outcomes, our results seem very encouraging and express a positive impact of this model, suggesting that dissemination to other hospitals may increase the number of donors and transplants in our region.

  9. The role of nurses in the risk management of organ and tissue donation.

    PubMed

    Saviozzi, A

    2010-01-01

    In the setting of organ and tissue procurement, lack of transplantation and the resulting missed opportunity for wait-listed patients might be considered as an untoward effect, since it results in longer wait-list times, higher mortality rates for potential candidates, and harm to the entire society. Beyond the classical definition holding that an adverse event is the inadvertent transmission of disease from a donor to a recipient, we advocate it should also include nonreporting of potential deceased donors; unsuccessful donor management; failure in organ/tissue procurement as the result of impossibility to assess brain death, lack of clinical data, or technical problems during surgical procedures. Based on their education, experience, and competencies, nurses share the responsibility to participate in the evaluation of risks and in the implementation of appropriate strategies for error prevention during the entire procurement process.

  10. Pediatric Deceased Donation-A Report of the Transplantation Society Meeting in Geneva.

    PubMed

    Martin, Dominique E; Nakagawa, Thomas A; Siebelink, Marion J; Bramstedt, Katrina A; Brierley, Joe; Dobbels, Fabienne; Rodrigue, James R; Sarwal, Minnie; Shapiro, Ron; Dominguez-Gil, Beatriz; Danovitch, Gabriel; Sweet, Stuart C; Trompeter, Richard S; Moazam, Farhat; Bos, Michael A; Delmonico, Francis L

    2015-07-01

    The Ethics Committee of The Transplantation Society convened a meeting on pediatric deceased donation of organs in Geneva, Switzerland, on March 21 to 22, 2014. Thirty-four participants from Africa, Asia, the Middle East, Oceania, Europe, and North and South America explored the practical and ethical issues pertaining to pediatric deceased donation and developed recommendations for policy and practice. Their expertise was inclusive of pediatric intensive care, internal medicine, and surgery, nursing, ethics, organ donation and procurement, psychology, law, and sociology. The report of the meeting advocates the routine provision of opportunities for deceased donation by pediatric patients and conveys an international call for the development of evidence-based resources needed to inform provision of best practice care in deceased donation for neonates and children.

  11. Rational Design of Diketopyrrolopyrrole-Based Small Moleculesas Donating Materials for Organic Solar Cells.

    PubMed

    Jin, Ruifa; Wang, Kai

    2015-08-27

    A series of diketopyrrolopyrrole-based small molecules have been designed to explore their optical, electronic, and charge transport properties as organic solar cell(OSCs) materials. The calculation results showed that the designed molecules can lower the band gap and extend the absorption spectrum towards longer wavelengths.The designed molecules own the large longest wavelength of absorption spectra,the oscillator strength, and absorption region values. The optical, electronic, and charge transport properties of the designed molecules are affected by the introduction of different π-bridges and end groups. We have also predicted the mobility of the designed molecule with the lowest total energies. Our results reveal that the designed molecules are expected to be promising candidates for OSC materials. Additionally, the designed molecules are expected to be promising candidates for electron and/or hole transport materials. On the basis of our results, we suggest that molecules under investigation are suitable donors for[6,6]-phenyl-C61-butyric acid methyl ester (PCBM) and its derivatives as acceptors of OSCs.

  12. Demographic and Socioeconomic Factors Influencing Public Attitudes Toward a Presumed Consent System for Organ Donation Without and With a Priority Allocation Scheme

    PubMed Central

    Tumin, Makmor; Tafran, Khaled; Mutalib, Muzalwana Abdul Talib @ Abdul; Satar, NurulHuda Mohd; Said, Saad Mohd; Adnan, Wan Ahmad Hafiz Wan Md; Lu, Yong Sook

    2015-01-01

    Abstract The influence of demographic and socioeconomic factors on the public's attitude towards a presumed consent system (PCS) of organ donation was estimated in 2 scenarios: without and with a priority allocation scheme (PAS). Self-administered questionnaires were completed by 775 respondents. Using multiple logistic regressions, respondents’ objections to donating organs in both scenarios were estimated. In total, 63.9% of respondents would object to donating under a PCS, whereas 54.6% would object under a PCS with a PAS. Respondents with pretertiary education were more likely to object than were respondents with tertiary education, in both the first (adjusted odds ratio [AOR] = 1.615) and second (AOR = 1.728) scenarios. Young respondents were less likely to object than were middle-aged respondents, in both the first (AOR = 0.648) and second (AOR = 0.572) scenarios. Respondents with mid-ranged personal monthly income were more likely to object than were respondents with low income, in both the first (AOR = 1.994) and second (AOR = 1.519) scenarios. It does not seem that Malaysia is ready to implement a PCS. The educational level, age, and income of the broader public should be considered if a PCS, without or with a PAS, is planned for implementation in Malaysia. PMID:26496282

  13. Specific unwillingness to donate eyes: the impact of disfigurement, knowledge and procurement on corneal donation.

    PubMed

    Lawlor, M; Kerridge, I; Ankeny, R; Dobbins, T A; Billson, F

    2010-03-01

    Although willingness, attitudes and beliefs surrounding solid-organ donation have been extensively investigated, much less is known about corneal donation. Despite evidence that a substantial number of families who agree to multiorgan donation also specifically refuse corneal donation, it is unclear why this occurs and what can be done to increase rates of corneal donation. We conducted a survey of 371 Australian adults regarding their views on corneal donation. Although willingness to donate corneas generally reflected a person's willingness to donate all of one's organs, unwillingness to donate corneas appeared to be due to other factors. Specifically, decisions not to donate appear to be driven by a range of concerns surrounding disfigurement. The survey also provides eye banks with reassurance about the acceptability of whole globe procurement, and recognition that research into blindness is a highly valued part of corneal donation. Finally, the survey identifies that many individuals see benefit in having their family engaged in the decision-making process, suggesting that decisions about donation are more complex than a simple appeal to the autonomy of the deceased.

  14. 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).

  15. Developments in addressing the organ donor shortage.

    PubMed

    Clayton, Michelle; Parker, Andrea; Willis, Sean

    Non-heartbeating donation is not a new concept but it is one that has been out of vogue for many years. However, increasing shortage of organs for transplantation has led to its increased use as a viable source of organs. This article outlines the rationale for its re-emergence and the challenges it poses for health care professionals.

  16. Socioeconomic implications of donation distributions

    NASA Astrophysics Data System (ADS)

    Wu, Yajing; Guo, Jinzhong; Chen, Qinghua; Wang, Yougui

    2011-11-01

    Individual donation depends on personal wealth and individual willingness to donate. On the basis of a donation model proposed in our previous study, a simplified version of an individual donation model is derived by relaxing the restrictions of the maximum wealth in the economy. Thus, the whole distribution is determined by only two parameters. One of them relates to the exponent of the distribution of society wealth and the other refers to the donation amount of the kindest poorest person. The parameters reflect the degree of wealth inequality and the charitable enthusiasm of society, respectively. Using actual donation data, we develop a specific parameter estimation method combining linear regression and the Kolmogorov-Smirnov (KS) statistic to get the value of two socioeconomic indicators. Applications to Chinese individual donations in response to the 2004 Indian Ocean tsunami and the 2008 Wenchuan earthquake indicate a rising inequality in social wealth distribution in China. Also, more charitable enthusiasm is observed in the response to the 2008 Wenchuan earthquake.

  17. Organization Development. Symposium.

    ERIC Educational Resources Information Center

    2002

    This document contains four papers on organization development and human resources. "Identification of Key Predictors of Rapid Change Adaptation in a Service Organization" (Constantine Kontoghiorghes, Carol Hansen) reports on the results of an exploratory study, which suggests that rapid change adaptation will be more likely to occur in…

  18. Collagen in organ development

    NASA Technical Reports Server (NTRS)

    Hardman, P.; Spooner, B. S.

    1992-01-01

    It is important to know whether microgravity will adversely affect developmental processes. Collagens are macromolecular structural components of the extracellular matrix (ECM) which may be altered by perturbations in gravity. Interstitial collagens have been shown to be necessary for normal growth and morphogenesis in some embryonic organs, and in the mouse salivary gland, the biosynthetic pattern of these molecules changes during development. Determination of the effects of microgravity on epithelial organ development must be preceded by crucial ground-based studies. These will define control of normal synthesis, secretion, and deposition of ECM macromolecules and the relationship of these processes to morphogenesis.

  19. An Interactive, Bilingual, Culturally Targeted Website About Living Kidney Donation and Transplantation for Hispanics: Development and Formative Evaluation

    PubMed Central

    Feinglass, Joe; Carney, Paula; Ramirez, Daney; Olivero, Maria; O'Connor, Kate; MacLean, Jessica; Brucker, James; Caicedo, Juan Carlos

    2015-01-01

    Background As the kidney shortage continues to grow, patients on the waitlist are increasingly turning to live kidney donors for transplantation. Despite having a disproportionately higher prevalence of end-stage kidney disease (ESKD), fewer waitlisted Hispanic patients received living donor kidney transplants (LDKTs) than non-Hispanic whites in 2014. Although lack of knowledge has been identified as a barrier to living kidney donation (LKD) among Hispanics, little is known about information needs, and few bilingual educational resources provide transplant-related information addressing Hispanics’ specific concerns. Objective This paper describes the process of developing a bilingual website targeted to the Hispanic community. The website was designed to increase knowledge about LKD among Hispanic patients with ESKD, their families, and the public, and was inspired by educational sessions targeted to Hispanic transplant patients provided by Northwestern University’s Hispanic Kidney Transplant Program. Methods Northwestern faculty partnered with the National Kidney Foundation of Illinois for expertise in ESKD and Hispanic community partners across the Chicago area. We established a Community Advisory Board (CAB) of 10 Chicago-area Hispanic community leaders to provide insight into cultural concerns and community and patients’ needs. Website content development was informed by 9 focus groups with 76 adult Hispanic kidney transplant recipients, living kidney donors, dialysis patients, and the general Hispanic public. The website development effort was guided by community input on images, telenovela scripts, and messages. After initial development, formal usability testing was conducted with 18 adult Hispanic kidney transplant recipients, dialysis patients, and living kidney donors to identify ways to improve navigability, design, content, comprehension, and cultural sensitivity. Usability testing revealed consistently high ratings as “easy to navigate”,

  20. 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.

  1. The authority of next-of-kin in explicit and presumed consent systems for deceased organ donation: an analysis of 54 nations

    PubMed Central

    Rosenblum, Amanda M.; Horvat, Lucy D.; Siminoff, Laura A.; Prakash, Versha; Beitel, Janice

    2012-01-01

    Background. The degree of involvement by the next-of-kin in deceased organ procurement worldwide is unclear. We investigated the next-of-kin’s authority in the procurement process in nations with either explicit or presumed consent. Methods. We collected data from 54 nations, 25 with presumed consent and 29 with explicit consent. We characterized the authority of the next-of-kin in the decision to donate deceased organs. Specifically, we examined whether the next-of-kin’s consent to procure organs was always required and whether the next-of-kin were able to veto procurement when the deceased had expressed a wish to donate. Results. The next-of-kin are involved in the organ procurement process in most nations regardless of the consent principle and whether the wishes of the deceased to be a donor were expressed or unknown. Nineteen of the 25 nations with presumed consent provide a method for individuals to express a wish to be a donor. However, health professionals in only four of these nations responded that they do not override a deceased’s expressed wish because of a family’s objection. Similarly, health professionals in only four of the 29 nations with explicit consent proceed with a deceased’s pre-existing wish to be a donor and do not require next-of-kin’s consent, but caveats still remain for when this is done. Conclusions. The next-of-kin have a considerable influence on the organ procurement process in both presumed and explicit consent nations. PMID:22121233

  2. Blood donation before surgery

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000367.htm Blood donation before surgery To use the sharing features ... vessels. Several sources of blood are described here. Blood From the Public (Volunteer Blood Donation) The most ...

  3. [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.

  4. 12 CFR 701.25 - Charitable contributions and donations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Charitable contributions and donations. 701.25... ORGANIZATION AND OPERATION OF FEDERAL CREDIT UNIONS § 701.25 Charitable contributions and donations. (a) A... directors must approve charitable contributions and/or donations, and the approval must be based on...

  5. 48 CFR 31.205-8 - Contributions or donations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 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...

  6. 78 FR 20217 - National Donate Life Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... Documents#0;#0; ] Proclamation 8950 of March 29, 2013 National Donate Life Month, 2013 By the President of... commitment to one another. During National Donate Life Month, we renew the call for organ and tissue donation... patients from getting life-saving care. Let us mark this month by rededicating ourselves to that...

  7. Alternative Living Kidney Donation Programs Boost Genetically Unrelated Donation

    PubMed Central

    Poldervaart, Rosalie A.; Laging, Mirjam; Royaards, Tessa; Kal-van Gestel, Judith A.; van Agteren, Madelon; de Klerk, Marry; Zuidema, Willij; Betjes, Michiel G. H.; Roodnat, Joke I.

    2015-01-01

    Donor-recipient ABO and/or HLA incompatibility used to lead to donor decline. Development of alternative transplantation programs enabled transplantation of incompatible couples. How did that influence couple characteristics? Between 2000 and 2014, 1232 living donor transplantations have been performed. In conventional and ABO-incompatible transplantation the willing donor becomes an actual donor for the intended recipient. In kidney-exchange and domino-donation the donor donates indirectly to the intended recipient. The relationship between the donor and intended recipient was studied. There were 935 conventional and 297 alternative program transplantations. There were 66 ABO-incompatible, 68 domino-paired, 62 kidney-exchange, and 104 altruistic donor transplantations. Waiting list recipients (n = 101) were excluded as they did not bring a living donor. 1131 couples remained of whom 196 participated in alternative programs. Genetically unrelated donors (486) were primarily partners. Genetically related donors (645) were siblings, parents, children, and others. Compared to genetically related couples, almost three times as many genetically unrelated couples were incompatible and participated in alternative programs (P < 0.001). 62% of couples were genetically related in the conventional donation program versus 32% in alternative programs (P < 0.001). Patient and graft survival were not significantly different between recipient programs. Alternative donation programs increase the number of transplantations by enabling genetically unrelated donors to donate. PMID:26421181

  8. In-hospital logistics: what are the key aspects for succeeding in each of the steps of the process of controlled donation after circulatory death?

    PubMed

    Murphy, Paul; Boffa, Catherine; Manara, Alex; Ysebaert, Dirk; de Jongh, Wim

    2016-07-01

    Donation after circulatory death (DCD) donors are becoming an increasingly important population of organ donors in Europe and worldwide. We report the state of the art regarding controlled DCD donation describing the organizational and technical aspects of establishing a controlled DCD programme and provide recommendations regarding the introduction and development of this type of programme.

  9. Body donation in India: social awareness, willingness, and associated factors.

    PubMed

    Rokade, Shrikant A; Gaikawad, Anjana P

    2012-01-01

    With the attendant rise of the number of medical colleges in India over past few decades, the demand for cadavers used in medical education and research is growing. However, there is an insufficient supply of donated cadavers available for dissection. This study was undertaken to assess the general population's awareness of body donation programs and willingness to donate in the State of Maharashtra, India. The willingness of participants to donate was compared with age, gender, and education of the respondents. A total of 625 adult individuals from the State of Maharashtra participated in a survey composed of questions about age, sex, education, awareness of body donation programs, and willingness to donate. It was found that 90.9% of the medical colleges surveyed reported an inadequate supply of cadavers. Of the general population, 32.1% of respondents were aware of body donation, compared to 95.83% of health care professionals. However, only 19.5% of the general population and 44.9% of health care professionals were willing to donate their bodies for anatomical education. Younger age groups, males, graduates, and postgraduates were found more willing to donate their bodies. Organ donation was preferred over body donation. A lack of awareness about body donation was the main factor responsible for respondents' "no body donation" response in the general population, along with firm religious beliefs and customs, the fear that the donated body will not be treated with respect and dignity, and the unacceptability of the dissection of one's own body. To overcome the current shortage of donated cadavers, efforts should be undertaken to change the mindset of the wider Indian society toward body donation. The authors believe this is possible through awareness campaigns and that prospective donors' concerns should be addressed appropriately. Proper guidance and assistance regarding body donation should be easily available for potential donors.

  10. [Blood donation: a marketing perspective].

    PubMed

    Ludwig, Silvia Terra; Rodrigues, Alziro César de Morais

    2005-01-01

    This paper emphasizes how marketing can make a difference in repeat donations by volunteer blood donors, since the greatest challenge for health institutions is to maintain and increase blood donation. In this context, understanding volunteer donors' motivations is highly important, and the studies reported here demonstrate that several variables are relevant to blood donation. The huge number of patients in need of blood transfusions and the lack of sufficient blood and blood products justify the interest in this study, considering both donors' and blood banks' perspectives. Moreover, recognition of the importance of actions and orientation for donors is fundamental for developing a marketing strategy. It is thus relevant for health institutions to identify donors' actual needs and wishes.

  11. Paid Living Donation and Growth of Deceased Donor Programs.

    PubMed

    Ghahramani, Nasrollah

    2016-06-01

    Limited organ availability in all countries has stimulated discussion about incentives to increase donation. Since 1988, Iran has operated the only government-sponsored paid living donor (LD) kidney transplant program. This article reviews aspects of the Living Unrelated Donor program and development of deceased donation in Iran. Available evidence indicates that in the partially regulated Iranian Model, the direct negotiation between donors and recipients fosters direct monetary relationship with no safeguards against mutual exploitation. Brokers, the black market and transplant tourism exist, and the waiting list has not been eliminated. Through comparison between the large deceased donor program in Shiraz and other centers in Iran, this article explores the association between paid donation and the development of a deceased donor program. Shiraz progressively eliminated paid donor transplants such that by 2011, 85% of kidney transplants in Shiraz compared with 27% across the rest of Iran's other centers were from deceased donors. Among 26 centers, Shiraz undertakes the largest number of deceased donor kidney transplants, most liver transplants, and all pancreas transplants. In conclusion, although many patients with end stage renal disease have received transplants through the paid living donation, the Iranian Model now has serious flaws and is potentially inhibiting substantial growth in deceased donor organ transplants in Iran.

  12. Crises in EFL Proficiency and Teacher Development in the Context of International Donation and Transformation Discourses

    ERIC Educational Resources Information Center

    Birbirso, Dereje Tadesse

    2014-01-01

    Since 2000, Ethiopia has been working to come out of social crises, modernise itself and achieve the Millennium Development Goals. Although provided with billions of dollars by the West and their international agents, little has been changed and the crises seem never to abate, especially in the educational system. This study, thus, critically…

  13. Willingness to Consider Non-Directed Kidney Donation.

    PubMed

    Bonfiglio, Diane B V; Kuntz, Kristin K

    2014-01-01

    The purpose of the study was to determine whether factors, including knowledge about living kidney donation or acquaintance with a donor or recipient, are related to willingness to consider donating a kidney. Participants were randomly assigned to read (n = 78) or not read (n = 71) educational materials regarding living donation. All participants then completed a living donation knowledge quiz, indicated whether they knew a donor or recipient, and indicated their support for living donation. Knowledge was not related to willingness to consider donation. Acquaintance with a living donor predicated greater willingness to act as a non-directed living donor, as did acquaintance with a transplant recipient. Decisions regarding whether to consider acting as a living organ donor may be related to whether a person is acquainted with an organ donor or a recipient. Emphasizing personal connections to transplant may lead to increased acceptance of living donation.

  14. Mild hypothermia during global cardiac ischemia opens a window of opportunity to develop heart donation after cardiac death.

    PubMed

    Stadelmann, Mathieu; Dornbierer, Monika; Clément, David; Gahl, Brigitta; Dick, Florian; Carrel, Thierry P; Tevaearai, Hendrik T; Longnus, Sarah

    2013-03-01

    Although heart donation after cardiac death (DCD) could greatly improve graft availability, concerns regarding warm ischemic damage typically preclude transplantation. Improving tolerance to warm ischemia may thus open a window of opportunity for DCD hearts. We investigated the hypothesis that, compared with normothermia, mild hypothermia (32° C) initiated after ischemic onset improves cardiac functional recovery upon reperfusion. Isolated, working hearts from adult, male Wistar rats underwent global, no-flow ischemia, and reperfusion (n = 28). After ischemic onset, temperature was maintained at either 37° C for 20 or 30 min or reduced to 32° C for 40, 50, or 60 min. Recovery was measured after 60-min reperfusion. Following normothermic ischemia, recovery of rate-pressure product (RPP; per cent of preischemic value) was almost complete after 20-min ischemia (97 ± 9%), whereas no recovery was detectable after 30-min ischemia. After mildly hypothermic ischemia (32° C), RPP also recovered well after 40 min (86 ± 4%). Markers of metabolism and necrosis were similar in 37° C/20 min and 32° C/40 min groups. Simple reduction in cardiac temperature by a few degrees after the onset of global ischemia dramatically prolongs the interval during which the heart remains resistant to functional deterioration. Preservation of hemodynamic function is associated with improved metabolic recovery and reduced necrosis. The application of mild hypothermia may be a simple first step towards development of clinical protocols for DCD heart recovery.

  15. Team-building through sailing: effects on health status, job satisfaction and work performance of health care professionals involved in organ and tissue donation.

    PubMed

    Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro

    2015-01-01

    The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be

  16. Outcome after admission to ITU following out-of-hospital cardiac arrest: are non-survivors suitable for non-heart-beating organ donation?

    PubMed

    Gratrix, Andrew P; Pittard, Alison J; Bodenham, Andrew R

    2007-05-01

    We have reviewed retrospective data from two large UK teaching hospitals regarding outcome following out-of-hospital cardiac arrest and the suitability of non-survivors for non-heart-beating organ donation. Patients were selected retrospectively from consecutive admissions from two intensive care units who had presented following out-of-hospital cardiac arrest, to a total of 50 patients in each centre. They had all been resuscitated to achieve a spontaneous cardiac output at the scene, in transit or after arrival in hospital, and required further intensive care support due to cardiovascular, respiratory, or neurological impairment. Eighty-six patients (86%) died in the Intensive Care Unit and only 14 (14%) survived to discharge from the Unit. A further nine (9%) patients died in hospital before discharge home. Four patients (4%) were alive after 6 months and three (3%) were alive after 1 year. Fifty-seven (57%) of patients had active withdrawal of treatment with only four (4%) being potentially suitable for organ procurement having not been excluded because of age, medical history or the length of time to die following withdrawal of treatment. Our results show that only a small increase in donor organs could be potentially achieved from this population. Further work is required to determine whether such patients should be considered as non-heart-beating donors.

  17. Understanding selective refusal of eye donation. Identity, beauty, and interpersonal relationships.

    PubMed

    Lawlor, Mitchell; Kerridge, Ian

    2014-03-01

    Corneal transplantation is the most common form of organ transplantation performed globally. However, of all organs, eyes have the highest rate of refusal of donation. This study explored the reasons why individuals decide whether or not to donate corneas. Twenty-one individuals were interviewed who had made a donation decision (13 refused corneal donation and eight consented). Analysis was performed using Grounded Theory. Refusal of corneal donation was related to concerns about disfigurement and the role of eyes in memory and communication. The request for donation therefore raised concerns about a potential adverse change in the ongoing relationship with the deceased, even in death. For those who refused donation, these concerns overshadowed awareness of need or benefit of transplantation. Adjusting the donation message to be more congruent with the real, lived experience of corneal donation may to some extent "prepare" individuals when the donation question is raised.

  18. [Organ and tissue donation after cessation of treatment in intensive care, the role of the nurse coordinator].

    PubMed

    Cailleton, Anthony; Lecomte, Emmanuel

    2016-09-01

    Since the end of 2014 in France, it has been possible to remove organs after a process of cessation of active treatment. This new procedure requires rigorous and well-managed organisation, as well as close collaboration between all those involved in the care, notably in the coordination of organ and tissue procurement.

  19. 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.

  20. The rate of anti-HIV seropositivity among donated cadavers: experience in a cadaver donation center.

    PubMed

    Wiwanitkit, Viroj; Agthong, Sithiporn

    2002-01-01

    Cadavers are crucial for the medical education provided by medical schools. However, currently, donation is the only way to obtain cadavers for education in Thailand. Moreover, some traditional beliefs result in insufficient numbers of cadavers. Apart from finding donors, the occupational health of the workers in the cadaver donation center and the users, the medical students, residents, and staffs should be addressed. Screening for anti-HIV in donated organs is the current trend in transplantation medicine. Therefore, screening for anti-HIV in donated cadavers is useful. Here, we report the rate of anti-HIV seropositivity in cadavers in a 1-year period in our setting, the largest Thai Red Cross Society hospital. Of the total 84 cadavers received, two cadavers (2.4%) were anti-HIV seropositive. With the increasing rate of anti-HIV, screening for anti-HIV serology in donated cadavers for medical teaching is of great benefit.

  1. Developing Organizations: Diagnosis and Action.

    ERIC Educational Resources Information Center

    Lawrence, Paul R.; Lorsch, Jay W.

    This book represent s a personal statement of the authors' evolving experience as collaborators in the work of developing organizations. Focus is on three critical interfaces: the organization-environment, the group-group, and the individual organization. Close attention is paid to the attainment both of organizational goals and of individual…

  2. The Dissection Room Experience: A Factor in the Choice of Organ and Whole Body Donation--A Nigerian Survey

    ERIC Educational Resources Information Center

    Anyanwu, Emeka G.; Obikili, Emmanuel N.; Agu, Augustine U.

    2014-01-01

    The psychosocial impact of human dissection on the lives of medical and health science students has been noted. To assess the impact of the dissection room experience on one's willingness to become a whole body and organ donor, the attitudes of 1,350 students and professionals from the medical, health, and non-health related disciplines to body…

  3. Medical equipment donations in Haiti: flaws in the donation process.

    PubMed

    Dzwonczyk, Roger; Riha, Chris

    2012-04-01

    The magnitude 7.0 earthquake that struck Haiti on 12 January 2010 devastated the capital city of Port-au-Prince and the surrounding area. The area's hospitals suffered major structural damage and material losses. Project HOPE sought to rebuild the medical equipment and clinical engineering capacity of the country. A team of clinical engineers from the United States of America and Haiti conducted an inventory and assessment of medical equipment at seven public hospitals affected by the earthquake. The team found that only 28% of the equipment was working properly and in use for patient care; another 28% was working, but lay idle for technical reasons; 30% was not working, but repairable; and 14% was beyond repair. The proportion of equipment in each condition category was similar regardless of whether the equipment was present prior to the earthquake or was donated afterwards. This assessment points out the flaws that existed in the medical equipment donation process and reemphasizes the importance of the factors, as delineated by the World Health Organization more than a decade ago, that constitute a complete medical equipment donation.

  4. An Assessment of HIV-Infected Patients Dying in Care for Deceased Organ Donation in a United States Urban Center.

    PubMed

    Richterman, A; Sawinski, D; Reese, P P; Lee, D H; Clauss, H; Hasz, R D; Thomasson, A; Goldberg, D S; Abt, P L; Forde, K A; Bloom, R D; Doll, S L; Brady, K A; Blumberg, E A

    2015-08-01

    Organ transplantation is an acceptable option for human immunodeficiency virus (HIV)-infected patients with end-stage kidney or liver disease. With worse outcomes on the waitlist, HIV-infected patients may actually be disproportionately affected by the organ shortage in the United States. One potential solution is the use of HIV-infected deceased donors (HIVDD), recently legalized by the HIV Organ Policy Equity (HOPE) Act. This is the first analysis of patient-specific data from potential HIVDD, retrospectively examining charts of HIV-infected patients dying in care at six HIV clinics in Philadelphia, Pennsylvania from January 1, 2009 to June 30, 2014. Our data suggest that there are four to five potential HIVDD dying in Philadelphia annually who might yield two to three kidneys and three to five livers for transplant. Extrapolated nationally, this would approximate 356 potential HIVDD yielding 192 kidneys and 247 livers annually. However, several donor risk indices raise concerns about the quality of kidneys that could be recovered from HIVDD as a result of older donor age and comorbidities. On the other hand, livers from these potential HIVDD are of similar quality to HIV-negative donors dying locally, although there is a high prevalence of positive hepatitis C antibody.

  5. Blood Transfusion and Donation

    MedlinePlus

    ... receiving the blood transfusion. To keep blood safe, blood banks carefully screen donated blood. The risk of catching ... one or more times before the surgery. A blood bank will store your blood for your use. NIH: ...

  6. Body Donation after Death: The Mental Setup of Educated People

    PubMed Central

    Sarkar, Aniruddha; Mandal, Shyamash

    2015-01-01

    Introduction Without dissection of cadavers teaching and learning of anatomy is nearly difficult; there remains a gap between the practical knowledge and the gathered theoretical knowledge. But there is a scarcity in the availability of the donated bodies for the sake of medical education. On the other hand a large number of people in our country are in waiting list for organ transplantation which could be overcome by deceased organ donation. Aim Aim of the study was to evaluate the awareness regarding body donation after death. Materials and Methods A cross-sectional study was conducted among medical students, engineering students and doctors in Indian population. Total 300 participants were answered the questionnaire providing information about the knowledge and attitude towards body and organ donation. Result 46.33% of entire study group had strongly positive attitude about cadaveric organ donation and 17% had no idea about this. 18% of total participants were unwilling for body donation after death. Conclusion The present study has been done elaborately to find out the different barriers for body or organ donation. It is clear from the study that though there is high level of awareness, nobody has filled up the pledge form till now. It indicates that there is a gap between the knowledge and motivation for organ and body donation after death which has to be overcome by proper guidance and education. Media and other voluntary organisations could take an important role for this purpose. PMID:26266106

  7. Pfizer donates drug to South Africa's poor.

    PubMed

    This article reports on Pfizer's AIDS drug donation to South Africa. The donated drug, Diflucan, treats cryptococcal meningitis, a lethal brain infection that occurs in one out of 10 HIV patients. Its daily dose in South Africa costs about US$15, far more than poor people can afford. The HIV and AIDS Treatment Action Campaign, an advocacy group, had lobbied New York-based Pfizer for a year to reduce the drug's price. The donation offered hope among activists that other pharmaceutical companies would follow suit and offer HIV- and AIDS-related drugs at a discount or for free. After the announcement of the donation, the group is now lobbying Glaxo Wellcome, maker of Zidovudine. The group is asking to make the drug available for free to reduce the risk of vertical transmission. Glaxo Wellcome, however, has no plans of offering Zidovudine for free, although the drug was offered 75% cheaper in developing nations.

  8. [Transplant coordinator: organ donation process].

    PubMed

    Gironés-Guillem, Purificación; Camaño-Puig, Ramón; Lillo-Crespo, Manuel

    2014-01-01

    Antecedentes: España se mantiene a la cabeza del mundo en donaciones, aunque parece que su número no aumenta en la misma proporción que las listas de espera, lo que hace necesario disminuir las situaciones de negativa cifradas en torno al 16%. Objetivo: analizar los informes de los coordinadores de trasplantes, conceptualizarlos y categorizarlos. Material y métodos: estudio retrospectivo y descriptivo de los informes elaborados por los coordinadores de trasplantes archivados en el Hospital La Fe, entre el 1 de mayo de 2004 y el 31 de diciembre de 2007. Resultados: se extrajeron 69 temas desde el punto de vista de la familia y 11 del de los entrevistadores, que se conceptualizaron, codificaron y clasificaron para textualizarlos de manera ordenada. Conclusiones: con el fin de lograr mayor efectividad podrían plantearse determinadas pautas para homogeneizar la acción de los coordinadores de trasplante en la entrevista.

  9. Hospital development and the performance of organ procurement organizations.

    PubMed

    McKinney, M M; Begun, J W; Ozcan, Y A

    1998-06-01

    With more than 56,000 patients on the national waiting list for organ transplants and relatively little growth in the number of donors, organ procurement organizations now recognize the need to aggressively market their services and the range of donor procurement opportunities to hospital personnel. This study examines the types and levels of hospital development activities being conducted by organ procurement organizations, the characteristics of organ procurement organizations that are more involved in hospital development, and the relationship between hospital development and organ procurement. Results from a national survey indicate that, as of the mid-1990s, organ procurement organizations had not made major investments in hospital development despite an increased recognition of the importance of these activities. Organ procurement organizations whose directors were more committed to hospital development exhibited higher levels of hospital development activity. Efforts to formalize hospital development activities through the establishment of a hospital development department and evaluation standards were associated with more organs procured per donor.

  10. Blood and Bone Marrow Donation

    MedlinePlus

    ... weeks before you feel fully recovered. Peripheral blood stem cell donation The risks of this type of stem ... ll be released from the hospital. Peripheral blood stem cell donation If blood stem cells are going to ...

  11. "The Tramp", a blood donation propagandist?

    PubMed

    Lefrère, J-J; Garraud, O

    2016-02-01

    The French pioneer for blood transfusion, who eventually organized the very early blood transfusion centers worldwide, went to imagine a scenario written in purpose for Charlie Chaplin, the unique character of "The Tramp" ("Charlot" in French). The movie Star was offered to feature a blood donation propagandist, and no longer the perpetual, well-known, "loser". This anecdote, besides being amusing, tells a lot on how Arnault Tzank encompassed all the difficulties in collecting blood enough to meet the demand, at all times; his proposal turns out to be extremely modern and questions nowadays marketing for blood donation.

  12. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  13. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  14. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  15. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  16. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  17. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  18. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  19. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  20. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  1. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine,...

  2. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine....515 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  3. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  4. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical... donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine, medical...

  5. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of...

  6. Controversies in kidney paired donation.

    PubMed

    Gentry, Sommer E; Montgomery, Robert A; Segev, Dorry L

    2012-07-01

    Kidney paired donation represented 10% of living kidney donation in the United States in 2011. National registries around the world and several separate registries in the United States arrange paired donations, although with significant variations in their practices. Concerns about ethical considerations, clinical advisability, and the quantitative effectiveness of these approaches in paired donation result in these variations. For instance, although donor travel can be burdensome and might discourage paired donation, it was nearly universal until convincing analysis showed that living donor kidneys can sustain many hours of cold ischemia time without adverse consequences. Opinions also differ about whether the last donor in a chain of paired donation transplants initiated by a nondirected donor should donate immediately to someone on the deceased donor wait-list (a domino or closed chain) or should be asked to wait some length of time and donate to start another sequence of paired donations later (an open chain); some argue that asking the donor to donate later may be coercive, and others focus on balancing the probability that the waiting donor withdraws versus the number of additional transplants if the chain can be continued. Other controversies in paired donation include simultaneous versus nonsimultaneous donor operations, whether to enroll compatible pairs, and interactions with desensitization protocols. Efforts to expand public awareness of and participation in paired donation are needed to generate more transplant opportunities.

  7. [Kidney donation by living donors. Surgical procedure].

    PubMed

    Baier, P K; Pisarski, P; Wimmenauer, S; Kirste, G

    1999-01-01

    The living donation of kidneys is gaining importance as a possible way to give a transplant to patients with terminal renal insufficiency. However we do not yet have experience with all the possibilities arising from this method. In particular, there is caution caused by the risks of the donor operation. In this context, the method is discussed according to the literature and our own experience of 89 living kidney donations. In our own practice with living donations, we have a success rate with 96% after 4 years and 82% after 16 years. We observed complications including wound infections (10.7%), haemorrhage, hernia and neurological complications (each 2.7%). When performed by specialists, the donor operation is safe and is a responsible alternative to the transplantation of cadaver kidneys, which opens up new possibilities in these times of organ shortage.

  8. Voluntary Body Donation: The Gift that Lives on Forever

    NASA Astrophysics Data System (ADS)

    Saritha, S.; Rao, M. Vittoo; Sumangala; Supriya, G.; Kumar, Praveen

    2012-10-01

    Body donation is a gracious act, Shankarcharaya firmly believed in concept of Body Donation or Organ Donation and said Iddham sharirum paropakarum i.e. the body is for use of others and death is not the end, it is the beginning. Anatomy is important basic subject for medicalstudents, both U.G. & P.G. Best method of Anatomy learning is by dissection on human cadavers, which remains principle teaching tool. Human cadavers for purpose of study are a scarcity with mushrooming of medical institutions in this country. Unclaimed bodies are no more origin of cadavers. Whole Body donation is the need of the hour. A Voluntary Body Donation is defined as the act of giving oneís Body after death for Medical research and education. In this article a survey was done in S.V.S. Medical & Dental Colleges Faculty members and medical exhibition visitors which include lawyers, engineers, teachers and others during the year of 2010. The body donation including organ donation and various factors such as age, religion, culture and donorís attitude are discussed. Body donation provides the students and medical researchers with unparalleled opportunities to study the human body. Computers nor books cannot totally replace body dissection in learning the anatomy.

  9. "Why can't I give you my organs after my heart has stopped beating?" An overview of the main clinical, organisational, ethical and legal issues concerning organ donation after circulatory death in Italy.

    PubMed

    Giannini, Alberto; Abelli, Massimo; Azzoni, Giampaolo; Biancofiore, Gianni; Citterio, Franco; Geraci, Paolo; Latronico, Nicola; Picozzi, Mario; Procaccio, Francesco; Riccioni, Luigi; Rigotti, Paolo; Valenza, Franco; Vesconi, Sergio; Zamperetti, Nereo

    2016-03-01

    Donation after circulatory death (DCD) is a valuable option for the procurement of functioning organs for transplantation. Clinical results are promising and public acceptance is quite good in most western countries. Yet, although DCD is widespread in Europe, several problems still persist in Italy as well as in some other countries. This paper aims to describe the main clinical, organisational, ethical and legal issues at stake, bearing in mind the particular situation created by Italian legislation. Currently, as regards DCD, Italy is somewhat different from other countries. Therefore, every effort should be made for the safe and effective implementation of DCD programs: uncontrolled DCD programs should be promoted and encouraged, within the framework of shared and authoritative rules. At the same time, we need to tackle the question of controlled DCD, promoting debate among all involved subjects regarding the fundamental issues of end-of-life care within protocols that best integrate the highest standard of care for the dying and the legitimate interests of those awaiting a life-saving organ.

  10. Debate in embryo donation: embryo donation or both-gamete donation?

    PubMed

    Samani, Reza Omani; Moalem, Mohammad Reza Rezania; Merghati, Seyed Taha; Alizadeh, Leila

    2009-01-01

    So far, more than 2 million babies have been born worldwide through assisted reproduction technologies. For many couples, there is no treatment except by involving a third party. Recently, embryo donation law has been approved by Iran's parliament and now it is legal in Iran. But there is a misunderstanding regarding the source of embryos: they can be obtained from surplus frozen embryos of infertile couples or embryos can be made from donated spermatozoa and eggs from fertile married couples. Here in this paper we discuss ethical, religious and legal aspects of these two procedures and present the advantages and disadvantages of them. Meanwhile, the new term 'both-gamete donation' was defined for the procedure that is practised here instead of 'embryo donation'. In conclusion we can say: (i) Iranian law means only embryo donation and covers only surplus embryos from other infertile couples and not both-gamete donation; (ii) as gamete donation is practised in Iran upon decrees of clergy leaders, we have no law or legislation against both-gamete donation; (iii) there are many ethical, legal and religious questions about both-gamete donation to be answered; (iv) ethical and religious questions are fewer concerning embryo donation compared with both-gamete donation; and (v) embryo sharing is a good way for donation of fresh embryos.

  11. [Organic agriculture and sustainable development].

    PubMed

    Li, Yu; Wang, Gang

    2004-12-01

    Basing on the research and practice of organic agriculture at home and abroad, this paper discussed the objectives of developing green food and the principles that must be persisted in the practice in China. In the light of the arguments concerning with sustainable agriculture, we also discussed the significance of "alternative agriculture" in theory and practice. Compared with conventional high-intensity agriculture, the production approaches of organic alternatives can improve soil fertility and have fewer detrimental effects on the environment. It is unclear whether conventional agriculture can be sustained because of the shortcomings presented in this paper, and it has taken scientists approximately one century to research and practice organic farming as a representative of alternative agriculture. The development of green food in China has only gone through more than ten years, and there would be some practical and theoretical effects on the development of China's green food if we exploit an environment-friendly production pattern of organic agriculture which majors in keeping human health and maintaining sustainable agriculture.

  12. The rapid assessment of hospital procurement barriers in donation: assessing hospitals for change.

    PubMed

    Siminoff, Laura A; Marshall, Heather M

    2009-01-01

    Assessment of the hospital environment is integral to improving the organ donation process in healthcare organizations. This paper introduces a novel approach to the assessment and improvement of donation processes: the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD). The RAPiD is a qualitative needs assessment tool for identifying barriers to donor identification and referral, and family requests for donation. Improving the donation process has become a national priority and can potentially save or improve the lives of thousands of Americans each year. The RAPID yields a rich description of the hospital environment that is readily translated into action-oriented recommendations for change.

  13. "One man's trash is another man's treasure": exploring economic and moral subtexts of the "organ shortage" problem in public views on organ donation.

    PubMed

    Schicktanz, S; Schweda, M

    2009-08-01

    The debate over financial incentives and market models for organ procurement represents a key trend in recent bioethics. In this paper, we wish to reassess one of its central premises-the idea of organ shortage. While the problem is often presented as an objective statistical fact that can be taken for granted, we will take a closer look at the underlying framework expressed in the common rhetoric of "scarcity", "shortage" or "unfulfilled demand". On the basis of theoretical considerations as well as a socioempirical examination of public attitudes, we will argue that this rhetoric has an economic subtext that imbues the debate with normative premises that have far-reaching social and ethical consequences and need to be made explicit and discussed.

  14. Challenges in machine perfusion preservation for liver grafts from donation after circulatory death

    PubMed Central

    2013-01-01

    Donation after circulatory death (DCD) is a promising solution to the critical shortage of donor graft tissue. Maintaining organ viability after donation until transplantation is essential for optimal graft function and survival. To date, static cold storage is the most widely used form of preservation in clinical practice. However, ischemic damage present in DCD grafts jeopardizes organ viability during cold storage, and whether static cold storage is the most effective method to prevent deterioration of organ quality in the increasing numbers of organs from DCD is unknown. Here we describe the historical background of DCD liver grafts and a new preservation method for experimental and clinical transplantation. To prevent ischemia-reperfusion injury in DCD liver grafts, a hypothermic machine perfusion (HMP) technique has recently been developed and may be superior to static cold preservation. We present evidence supporting the need for improving liver perfusion performance and discuss how doing so will benefit liver transplantation recipients. PMID:24283383

  15. [Donation of bodies to science].

    PubMed

    Delmas, V

    2001-01-01

    Teaching and research in anatomy is mainly based on cadaveric dissection. Unclaimed bodies is no more the origin of cadavers, but body donation programs. The dissection is an important part in the anatomical curses of medical students and for anatomical research and special courses devoted to the surgeons. A body donation center was created in Paris in 1953 with the purpose of obtaining bodies for dissection. Donation is a clear will made by people free and informed. Donation is most often by altruism, conferrins life on another. Body donation is regulated by various act or reglementar text according to each country. One of the problem with the body gift is biological hazard, specially in research and clinical courses, but the rule is to consider unembalmed material as contaminated and to use all precautions with barrier for blood and bodily fluid. Body donation is one of the modern expression of solidarity.

  16. Developing organ offer and acceptance measures: when 'good' organs are turned down.

    PubMed

    Wolfe, R A; LaPorte, F B; Rodgers, A M; Roys, E C; Fant, G; Leichtman, A B

    2007-01-01

    Turndowns of offers of deceased donor kidneys for transplantation can contribute to inefficiencies in the organ distribution system and inequality in access to donated organs. Match run data were obtained for 4967 'good' kidneys placed and transplanted in 2005 after fewer than 50 offers. These kidneys were not recovered from donation after cardiac death or expanded criteria donors, or from donors with a history of substance abuse. On average, these good kidneys were not accepted until after seven offers to candidates and after offers to 2.4 programs. Models for the likelihood of acceptance found several donor and candidate characteristics to be significantly related to acceptance rates (p < 0.05). After accounting for these variables, there remained 2- to 3-fold differences among transplant programs in acceptance rates. These models could be used to identify kidney transplant centers with exceptional acceptance practices. Several strategies might be employed to increase acceptance rates for good organs.

  17. 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)

  18. 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...

  19. 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.

  20. Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

    PubMed

    Perry, Lora; Malkin, Robert

    2011-07-01

    It is often said that most of the medical equipment in the developing world is broken with estimates ranging up to 96% out of service. But there is little documented evidence to support these statements. We wanted to quantify the amount of medical equipment that was out of service in resource poor health settings and identify possible causes. Inventory reports were analyzed from 1986 to 2010, from hospitals in sixteen countries across four continents. The UN Human Development Index was used to determine which countries should be considered developing nations. Non-medical hospital equipment was excluded. This study examined 112,040 pieces of equipment. An average of 38.3% (42,925, range across countries: 0.83-47%) in developing countries was out of service. The three main causes were lack of training, health technology management, and infrastructure. We hope that the findings will help biomedical engineers with their efforts toward effective designs for the developing world and NGO's with efforts to design effective healthcare interventions.

  1. New classification of donation after circulatory death donors definitions and terminology.

    PubMed

    Thuong, Marie; Ruiz, Angel; Evrard, Patrick; Kuiper, Michael; Boffa, Catherine; Akhtar, Mohammed Z; Neuberger, James; Ploeg, Rutger

    2016-07-01

    In the face of a crisis in organ donation, the transplant community are increasingly utilizing donation after circulatory death (DCD) donors. Over the last 10 years, with the increasing usage of DCD donors, we have seen the introduction in a number of new terms and definitions. We report the results of the 6th International Conference in Organ Donation held in Paris in 2013 and report a consensus agreement of an established expert European Working Group on the definitions and terminology regarding DCD donation, including refinement of the Maastricht definitions. This document forms part of a special series where recommendations are presented for uncontrolled and controlled DCD donation and organ specific guidelines for kidney, pancreas, liver and lung transplantation. An expert panel formed a consensus on definitions and terms aiming to establish consistent usage of terms in DCD donation.

  2. Challenges of organ shortage for transplantation: solutions and opportunities.

    PubMed

    Saidi, R F; Hejazii Kenari, S K

    2014-01-01

    Organ shortage is the greatest challenge facing the field of organ transplantation today. A variety of approaches have been implemented to expand the organ donor pool including live donation, a national effort to expand deceased donor donation, split organ donation, paired donor exchange, national sharing models and greater utilization of expanded criteria donors. Increased public awareness, improved efficiency of the donation process, greater expectations for transplantation, expansion of the living donor pool and the development of standardized donor management protocols have led to unprecedented rates of organ procurement and transplantation. Although live donors and donation after brain death account for the majority of organ donors, in the recent years there has been a growing interest in donors who have severe and irreversible brain injuries but do not meet the criteria for brain death. If the physician and family agree that the patient has no chance of recovery to a meaningful life, life support can be discontinued and the patient can be allowed to progress to circulatory arrest and then still donate organs (donation after circulatory death). Increasing utilization of marginal organs has been advocated to address the organ shortage.

  3. An overview of the roles and responsibilities of Chinese medical colleges in body donation programs.

    PubMed

    Zhang, Luqing; Xiao, Ming; Gu, Mufeng; Zhang, Yongjie; Jin, Jianliang; Ding, Jiong

    2014-01-01

    The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low and fraught with a number of difficulties. In the past, traditional Chinese culture focused on preserving the human body intact, which often limited body donation. In recent years, the public has become more open toward body donation. At Nanjing Medical University, only 20 bodies were donated in 2001. After the university became involved in an organized body donation program, this number increased to 70 donated bodies per year (2007 to 2012). This article describes and reviews Chinese medical colleges as a special case study among body donation programs, particularly in terms of the multiple responsibilities and roles that such institutions must assume in the course of adopting these programs. Medical colleges in China must serve as advocates, coordinators, builders, managers, educators, and beneficiaries in undertaking body donation programs. It is important for medical colleges to recognize these pluripotent roles and educate the public in order to promote body donation programs. This case study may also effectively guide and encourage Chinese medical colleges in refining their own body donation programs in the future.

  4. Human fronto–mesolimbic networks guide decisions about charitable donation

    PubMed Central

    Moll, Jorge; Krueger, Frank; Zahn, Roland; Pardini, Matteo; de Oliveira-Souza, Ricardo; Grafman, Jordan

    2006-01-01

    Humans often sacrifice material benefits to endorse or to oppose societal causes based on moral beliefs. Charitable donation behavior, which has been the target of recent experimental economics studies, is an outstanding contemporary manifestation of this ability. Yet the neural bases of this unique aspect of human altruism, which extends beyond interpersonal interactions, remain obscure. In this article, we use functional magnetic resonance imaging while participants anonymously donated to or opposed real charitable organizations related to major societal causes. We show that the mesolimbic reward system is engaged by donations in the same way as when monetary rewards are obtained. Furthermore, medial orbitofrontal–subgenual and lateral orbitofrontal areas, which also play key roles in more primitive mechanisms of social attachment and aversion, specifically mediate decisions to donate or to oppose societal causes. Remarkably, more anterior sectors of the prefrontal cortex are distinctively recruited when altruistic choices prevail over selfish material interests. PMID:17030808

  5. Recommendations for donation after circulatory death kidney transplantation in Europe.

    PubMed

    van Heurn, L W Ernest; Talbot, David; Nicholson, Michael L; Akhtar, Mohammed Z; Sanchez-Fructuoso, Ana I; Weekers, Laurent; Barrou, Benoit

    2016-07-01

    Donation after circulatory death (DCD) donors provides an invaluable source for kidneys for transplantation. Over the last decade, we have observed a substantial increase in the number of DCD kidneys, particularly within Europe. We provide an overview of risk factors associated with DCD kidney function and survival and formulate recommendations from the sixth international conference on organ donation in Paris, for best-practice guidelines. A systematic review of the literature was performed using Ovid Medline, Embase and Cochrane databases. Topics are discussed, including donor selection, organ procurement, organ preservation, recipient selection and transplant management.

  6. 32 CFR 553.6 - Donations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Donations. 553.6 Section 553.6 National Defense... NATIONAL CEMETERIES § 553.6 Donations. (a) Policy. Under Department of the Army policy, proffered donations... for the donation or gift. (2) Delivery is made to the cemetery or to another point designated by...

  7. A Comparison of Request Process and Outcomes in Donation After Cardiac Death and Donation After Brain Death: Results From a National Study.

    PubMed

    Siminoff, L A; Alolod, G P; Wilson-Genderson, M; Yuen, E Y N; Traino, H M

    2016-10-18

    Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of public reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semistructured telephone interviews yielded FDMs' sociodemographic data, donation attitudes, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with white FDMs more likely to authorize DCD or DBD than black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and refusal reasons. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar approach strategies and communication skills and the development of education campaigns about the public's acceptance of DCD.

  8. Potential donor segregation to promote blood donation.

    PubMed

    Martín-Santana, Josefa D; Beerli-Palacio, Asunción

    2008-04-01

    This work is set in the field of social marketing and more specifically in the context of blood donation. Its principal objective focuses on segregating potential donors by using the inhibitors or barriers to a blood donation behaviour as criteria. Moreover, an analysis of the predisposition to donate blood, the intrinsic and extrinsic motivations for donating blood, and the incentives that may stimulate their donation conduct was conducted for each of the four identified groups. The results reveal that the four segments differ significantly in their predisposition to donate, in their motivations and in the incentives that encourage them to donate blood.

  9. [Future technological evolutions in blood donation qualification].

    PubMed

    Assal, Azzedine; Py, Jean-Yves; Corbi, Cécile; Barlet, Valérie; Roubinet, Francis; De Micco, Philippe

    2007-05-01

    In the past decades, blood donation screening contributed significantly to blood safety improvement, thanks to the increasing performances of serological and nucleic acid testing (NAT) assays, as well as the evolution of automated systems technology. The rapid pace of NAT development can be clearly seen to extend into the future. NAT for additional viruses as well as the use of new automated systems for individual donation or smaller mini-pool testing, with multiplex assays, is currently debated. However, few added benefit is expected for blood safety from such developments, while cost-effectiveness appears to be poor. The next step in laboratory automation will probably be the implementation of robotic pre- and post-analytical procedures. In this article we review the potential future evolutions of screening technologies in blood qualification platforms, particularly those derived from nanobiotechnologies. DNA microarrays, Lab-On-Chips, biosensors and nanoparticles (quantum dots) will probably play a major role in the coming decade.

  10. 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

  11. [Marketing in the world of blood donation].

    PubMed

    Daigneault, Sylvie

    2007-05-01

    Public and non-profit organizations have long debated how marketing concepts and management styles apply to their sector of activity as they are largely derived from principles of consumerism and economic decision-making proper to the private sector. The arrival of marketing in the world of blood donation is no exception. The purpose of this article is to illustrate concretely how marketing techniques can contribute in achieving the objectives of a blood donation program: a marketing model that is adapted to the realities of blood donation in Quebec. Although types of marketing are as varied as the fields they are used in, the major marketing activities of this program fall under positioning, operational or relationship marketing. The process is presented in the form of a cycle that includes four major phases containing all marketing functions, that is, raising public awareness, acquiring a clientele, client retention and loyalty building, and establishing the relationship. Finally, the information and effective management of information are at the heart of the marketing process. In fact, research, understanding our customers and their expectations, and measuring our performance are essential for the success of any marketing initiative.

  12. Structure mechanism insights and the role of nitric oxide donation guide the development of oxadiazole-2-oxides as therapeutic agents against schistosomiasis.

    PubMed

    Rai, Ganesha; Sayed, Ahmed A; Lea, Wendy A; Luecke, Hans F; Chakrapani, Harinath; Prast-Nielsen, Stefanie; Jadhav, Ajit; Leister, William; Shen, Min; Inglese, James; Austin, Christopher P; Keefer, Larry; Arnér, Elias S J; Simeonov, Anton; Maloney, David J; Williams, David L; Thomas, Craig J

    2009-10-22

    Schistosomiasis is a chronic parasitic disease affecting hundreds of millions of individuals worldwide. Current treatment depends on a single agent, praziquantel, raising concerns of emergence of resistant parasites. Here, we continue our explorations of an oxadiazole-2-oxide class of compounds we recently identified as inhibitors of thioredoxin glutathione reductase (TGR), a selenocysteine-containing flavoenzyme required by the parasite to maintain proper cellular redox balance. Through systematic evaluation of the core molecular structure of this chemotype, we define the essential pharmacophore, establish a link between the nitric oxide donation and TGR inhibition, determine the selectivity for this chemotype versus related reductase enzymes, and present evidence that these agents can be modified to possess appropriate drug metabolism and pharmacokinetic properties. The mechanistic link between exogenous NO donation and parasite injury is expanded and better defined. The results of these studies verify the utility of oxadiazole-2-oxides as novel inhibitors of TGR and as efficacious antischistosomal agents.

  13. Complex Contagion of Campaign Donations.

    PubMed

    Traag, Vincent A

    2016-01-01

    Money is central in US politics, and most campaign contributions stem from a tiny, wealthy elite. Like other political acts, campaign donations are known to be socially contagious. We study how campaign donations diffuse through a network of more than 50,000 elites and examine how connectivity among previous donors reinforces contagion. We find that the diffusion of donations is driven by independent reinforcement contagion: people are more likely to donate when exposed to donors from different social groups than when they are exposed to equally many donors from the same group. Counter-intuitively, being exposed to one side may increase donations to the other side. Although the effect is weak, simultaneous cross-cutting exposure makes donation somewhat less likely. Finally, the independence of donors in the beginning of a campaign predicts the amount of money that is raised throughout a campaign. We theorize that people infer population-wide estimates from their local observations, with elites assessing the viability of candidates, possibly opposing candidates in response to local support. Our findings suggest that theories of complex contagions need refinement and that political campaigns should target multiple communities.

  14. Complex Contagion of Campaign Donations

    PubMed Central

    2016-01-01

    Money is central in US politics, and most campaign contributions stem from a tiny, wealthy elite. Like other political acts, campaign donations are known to be socially contagious. We study how campaign donations diffuse through a network of more than 50000 elites and examine how connectivity among previous donors reinforces contagion. We find that the diffusion of donations is driven by independent reinforcement contagion: people are more likely to donate when exposed to donors from different social groups than when they are exposed to equally many donors from the same group. Counter-intuitively, being exposed to one side may increase donations to the other side. Although the effect is weak, simultaneous cross-cutting exposure makes donation somewhat less likely. Finally, the independence of donors in the beginning of a campaign predicts the amount of money that is raised throughout a campaign. We theorize that people infer population-wide estimates from their local observations, with elites assessing the viability of candidates, possibly opposing candidates in response to local support. Our findings suggest that theories of complex contagions need refinement and that political campaigns should target multiple communities. PMID:27077742

  15. Donation to disaster relief campaigns: underlying social cognitive factors exposed.

    PubMed

    Oosterhof, Liesbeth; Heuvelman, Ard; Peters, Oscar

    2009-05-01

    A number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on attitudes, and the impact of media exposure. The aim was to expand and improve an already existing model by Cheung and Chan [Cheung, C. K., & Chan, C. M. (2000). Social-cognitive factors of donating money to charity, with special attention to an international relief organisation. Evaluation and Program Planning, 23, 241-253]. The expanded model showed a better fit. Furthermore, the expanded model explained two-thirds of the variance of the intention to donate to a disaster relief campaign. The greatest predictor of the intention to donate proved to be "Past donation to disaster relief campaigns." The factor "News exposure" was indicated to be a valuable additional factor, as it had a significant direct effect on "Awareness of a disaster relief campaign" and was the only factor that had a total effect on all other factors, including "Intention to donate to a disaster relief campaign."

  16. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.6 Organ procurement. The suitability of organs donated...

  17. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.6 Organ procurement. The suitability of organs donated...

  18. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.6 Organ procurement. The suitability of organs donated...

  19. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.6 Organ procurement. The suitability of organs donated...

  20. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.6 Organ procurement. The suitability of organs donated...

  1. Free blood donation mobile applications.

    PubMed

    Ouhbi, Sofia; Fernández-Alemán, José Luis; Toval, Ambrosio; Idri, Ali; Pozo, José Rivera

    2015-05-01

    Blood donation (BD) is a noble act and mobile applications (apps) can help increase awareness about it. This paper analyzes and assesses the characteristics of free apps for BD as regards features and functionality. A search in Google Play, Apple Apps store, Blackberry App World and Windows Mobile App store was carried out to select 169 free BD apps from the 188 apps identified. The results presented in this paper show that the majority of the apps selected have been developed for the Android operating system. Moreover, most of the apps selected are available to help users search for donors. Few of the apps could not be installed and/or accessed. Of those that could be installed: half of them do not require any kind of authentication; a few of them are available in more than one language; half of them have a geographical restriction; around 60 % of them do not notify the user of BD events and requests; one, which is available for Android and iOS, can connect with a laboratory; around 45 % of them allow users to share information via social networks, and the majority of them do not provide BD recommendations. These results are used as a basis to provide app developers with certain recommendations. There is a need for better BD apps with more features in order to increase the number of volunteer donors.

  2. 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.

  3. Living-Donor Kidney Transplantation: Reducing Financial Barriers to Live Kidney Donation--Recommendations from a Consensus Conference.

    PubMed

    Tushla, Lara; Rudow, Dianne LaPointe; Milton, Jennifer; Rodrigue, James R; Schold, Jesse D; Hays, Rebecca

    2015-09-04

    Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation's Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies.

  4. 3 CFR 8642 - Proclamation 8642 of March 31, 2011. National Donate Life Month, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... donors. As a result, people lose their lives each day while waiting. When each donation can touch dozens... registry. Individuals can register online or through the registration or renewal process for a driver’s license or identification card. When considering organ donation, Americans should consult their...

  5. Organic Rankine cycle receiver development

    NASA Technical Reports Server (NTRS)

    Haskins, H. J.

    1981-01-01

    The selected receiver concept is a direct-heated, once-through, monotube boiler operated at supercritical pressure. The cavity is formed by a cylindrical copper shell and backwall, with stainless steel tubing brazed to the outside surface. This core is surrounded by lightweight refractory insulation, load-bearing struts, and an outer case. The aperture plate is made of copper to provide long life by conduction and reradiation of heat away from the aperture lip. The receiver thermal efficiency is estimated to be 97 percent at rated conditions (energy transferred to toluene divided by energy incident on aperture opening). Development of the core manufacturing and corrosion protection methods is complete.

  6. Generation Y and Blood Donation: The Impact of Altruistic Help in a Darwiportunistic Scenario

    PubMed Central

    Scholz, Christian

    2010-01-01

    Summary This article focuses on the members of Generation Y and their willingness to offer voluntary (unpaid) blood donations. Using statistics from various sources, a three-stage model is developed to explain blood donation behaviour especially of this generation. It consists of i) developing altruism, ii) raising the willingness to donate blood, and iii) activating actual blood donation behaviour. Members of Generation Y live in a Darwinistic society. They also to some degree act opportunistically, but not in contradiction to altruism. For that reason, the article positions itself in the theoretical framework of Darwi-portunism and derives practical suggestions as well as implications for research. PMID:21048826

  7. How Somatic Adult Tissues Develop Organizer Activity.

    PubMed

    Vogg, Matthias C; Wenger, Yvan; Galliot, Brigitte

    2016-01-01

    The growth and patterning of anatomical structures from specific cellular fields in developing organisms relies on organizing centers that instruct surrounding cells to modify their behavior, namely migration, proliferation, and differentiation. We discuss here how organizers can form in adult organisms, a process of utmost interest for regenerative medicine. Animals like Hydra and planarians, which maintain their shape and fitness thanks to a highly dynamic homeostasis, offer a useful paradigm to study adult organizers in steady-state conditions. Beside the homeostatic context, these model systems also offer the possibility to study how organizers form de novo from somatic adult tissues. Both extracellular matrix remodeling and caspase activation play a key role in this transition, acting as promoters of organizer formation in the vicinity of the wound. Their respective roles and the crosstalk between them just start to be deciphered.

  8. Cultural acceptability and personal willingness of Iranian students toward cadaveric donation.

    PubMed

    Abbasi Asl, Jamal; Nikzad, Hossein; Taherian, Aliakbar; Atlasi, Mohammad Ali; Naderian, Homayoun; Mousavi, Gholamabbas; Kashani, Milad Motalebi; Omidi, Abdollah

    2017-03-01

    Cadaver dissection stands as a crucial component in medical curricula around the world, although computer-based multimedia programs have been introduced in order to replace the need for cadaver donations. Due to a decrease in the number of unclaimed bodies and rather few donations, there is an insufficient number of cadavers for anatomical studies in Iran. This study was carried out to evaluate medical students' awareness and willingness regarding body donation in Kashan University of Medical Sciences, Iran. In this study, a questionnaire was designed to focus on the cultural acceptability and personal willingness to donate one's body after death. Students from the university's anatomy classes (n = 331) participated in this study. Seventy-seven percent of the students expressed their agreement toward the idea of utilizing body donation services, though only 25.4% of participants were willing to donate their own bodies. None of the demographic factors were associated with cultural acceptability or personal willingness towards body donation. These findings indicated that besides "payment", other factors were associated with students' willingness to become donors. All factors of awareness except "previous awareness of organization" were associated with cultural acceptability. In this study, students suggested that encouraging people to register for body donation using mass media (25.6%) and teaching students to respect cadavers in the dissection environment (24.8%) were the best solutions for addressing the lack of cadavers. These findings indicated that a lack of awareness about body donation might be the main factor responsible for unwillingness towards body donation; therefore, improving the public's awareness and addressing the willingness of students regarding body donation may help overcome the current lack of donated cadavers. Anat Sci Educ 10: 120-126. © 2016 American Association of Anatomists.

  9. 31 CFR 596.301 - Donation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.301 Donation. The term donation means a transfer made in the form of a gift or...

  10. 31 CFR 596.301 - Donation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.301 Donation. The term donation means a transfer made in the form of a gift or...

  11. Pro-Donation Behaviours of Nursing Students from the Four Countries of the UK

    PubMed Central

    McGlade, Donal; McClenahan, Carol; Pierscionek, Barbara

    2014-01-01

    Background The effectiveness of the organ donation system depends on the health professionals involved in procurement and in dealing with donors and their families. Concerns about lack of knowledge and experience of organ donation have been expressed among such professionals but there is a paucity of literature to indicate the basis of such concerns and where knowledge may be lacking. Given that regional variations in organ donation rates exist in the UK, this study investigates knowledge about and attitudes towards organ donation among student nurses in different countries of the UK and examines regional variations. Methods A questionnaire was distributed to 667 student nurses (female:male = 582∶85) aged 18 to 50 years (mean [SD] 25.4 [7.1] years) recruited from a total of five Universities (Scotland, Wales, Northern Ireland, England) during the period of January to September 2011. Results Registration behaviour among participants was shown to vary depending upon many different factors that include birthplace, residency, fear of death and concerns of medical distrust. Conclusions Regional variations in organ donation behaviour in the UK were found in the cohorts of student nurses who participated in this study. These variations include willingness to register and to donate specific body parts and not others. The relationship between attitude and behaviour and how this may influence the decision making process of organ donation, as well as the underlying factors that result in regional variations, require further investigation. PMID:24614807

  12. Organizational Termination as an Organization Development Issue.

    ERIC Educational Resources Information Center

    Nicoll, David

    1982-01-01

    Addresses the subject of organizational termination, suggesting it is an appropriate concern for the field of organization development, and that present methodologies are inadequate to deal with it. Describes a consulting experience with one dying organization and experimental intervention strategies. Describes behavioral reactions of staff to…

  13. Organization Development in Schools: Contemporary Conceptual Practices.

    ERIC Educational Resources Information Center

    Schmuck, Richard A.

    When school psychologists adopt an organization development perspective they are acting on a cluster of related concepts: (1) that because schools are social organizations, school effectiveness depends on the school's organizational culture; (2) that attempts to institute educational reforms only work when the reforms and the school culture mesh;…

  14. Anatomist on the dissecting table? Dutch anatomical professionals' views on body donation.

    PubMed

    Bolt, Sophie; Venbrux, Eric; Eisinga, Rob; Gerrits, Peter O

    2012-03-01

    Anatomical professionals know better than anyone else that donated bodies are a valuable asset to anatomical science and medical education. They highly value voluntary donations, since a dearth of bodies negatively affects their profession. With this in mind, we conducted a survey (n = 54) at the 171st scientific meeting of the Dutch Anatomical Society in 2009 to see to what extent anatomical professionals are willing to donate their own body. The results reveal that none of the survey participants are registered as a whole body donor and that only a quarter of them would consider the possibility of body donation. We argue that the two main constraints preventing Dutch anatomical professionals from donating their own body are their professional and their social environments. In contrast to the absence of registered body donors, half of the anatomical professionals are registered as an organ donor. This figure far exceeds the proportion of registered organ donors among the general Dutch population.

  15. Gendering the Gift of Life: Family Politics and Kidney Donation in Egypt and Mexico.

    PubMed

    Crowley-Matoka, Megan; Hamdy, Sherine F

    2016-01-01

    In this article, we demonstrate how living kidney donation is a particularly gendered experience. We draw on anthropologists' contributions to understanding the globalization of reproductive technologies to argue that kidney donation similarly endangers and preserves fertility, thereby unsettling and reifying gendered familial labor. Based on fieldwork in two ethnographic sites--Egypt and Mexico--we examine how kidney donation is figured as a form of social reproduction. In both settings, kidney recipients rely almost exclusively on organs from living donors. We focus on how particular gender ideologies--as evident, for example, in the trope of the "self-sacrificing mother"--can serve as a cultural technology to generate donations in an otherwise organ-scarce medical setting. Alternatively, transplantation can disrupt gender norms and reproductive viability. In demonstrating the pervasiveness of gendered tropes in the realm of transplantation, we unsettle assumptions about the "family" as the locus of pure, altruistic donation.

  16. Registered bone marrow donors' views on bodily donations.

    PubMed

    Sanner, M A

    1997-01-01

    The attitudes of 463 potential bone marrow donors toward blood donation, kidney donation in life, organ donation after death, autopsy, and donation of the whole body for anatomic dissection were surveyed, using a questionnaire that had previously been employed for assessing the attitudes of the public. The response rate was 96%. Three quarters of the respondents were blood donors and recruited via the blood center. The proportion that accepted the procedures varied between 24% for anatomic dissection and 97% for autopsy. Differences were small between individuals with positive attitudes and individuals who had also actively taken steps to activate these attitudes. Compared with the public, the bone marrow donors were more positive to all kinds of bodily donations. The conclusion is that if one is prepared to give from the body in life, one is also prepared to give after death. The results may indicate less death anxiety and fear of physical injury, and less fear of chaos either with or without altruism compared to the public.

  17. Vertebrate Endoderm Development and Organ Formation

    PubMed Central

    Zorn, Aaron M.; Wells, James M.

    2010-01-01

    The endoderm germ layer contributes to the respiratory and gastrointestinal tracts, and all of their associated organs. Over the past decade, studies in vertebrate model organisms; including frog, fish, chick, and mouse; have greatly enhanced our understanding of the molecular basis of endoderm organ development. We review this progress with a focus on early stages of endoderm organogenesis including endoderm formation, gut tube morphogenesis and patterning, and organ specification. Lastly, we discuss how developmental mechanisms that regulate endoderm organogenesis are used to direct differentiation of embryonic stem cells into specific adult cell types, which function to alleviate disease symptoms in animal models. PMID:19575677

  18. Evaluation of Factors Limiting Corneal Donation.

    PubMed

    Röck, Daniel; Wude, Johanna; Yoeruek, Efdal; Bartz-Schmidt, Karl Ulrich; Röck, Tobias

    2016-11-15

    BACKGROUND This study aimed to investigate factors limiting corneal donation at the University Hospital Tübingen. MATERIAL AND METHODS We retrospectively studied all hospital deaths from January 2012 to December 2015, considering each deceased patient as a potential corneal donor. During this period an ophthalmic resident managed corneal donor procurement on a full-time basis. Various factors limiting corneal donation were examined. RESULTS Among the 3412 deaths, 2937 (86.1%) displayed nonfulfillment of corneal donation. Consent for corneal donation was obtained in 475 cases (13.9%). The mean annual corneal donation rate was 13.9 donors per 100 deaths (range: 11.2-17.8). The leading causes of nonfulfillment of corneal donations were refusal to donate (49.8%, 1698 cases) and medical contraindications (23.6%, 805 cases). After next-of-kin interview of 2173 potential donors (109 potential donors were excluded because of logistical problems), willingness to participate in corneal donation was present in 475 cases (21.9%), whereas in 1698 cases (78.1%) corneal donation was refused. CONCLUSIONS Our study showed refusal to donate is the most important factor limiting corneal donation. It seems that increasing the knowledge of people about corneal donation through public education and media are necessary to address the corneal shortage.

  19. 17 CFR 256.426.1 - Donations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Donations. 256.426.1 Section... COMPANY ACT OF 1935 Income and Expense Accounts § 256.426.1 Donations. This account shall include all payments or donations for charitable, social or community welfare purposes....

  20. 48 CFR 245.609 - Donations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Donations. 245.609 Section 245.609 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF... Inventory 245.609 Donations. Agencies may donate, with GSA approval and without expense to the United...

  1. Developing leadership talent in healthcare organizations.

    PubMed

    Wells, Wendy; Hejna, William

    2009-01-01

    Effective initiatives for developing and retaining leadership talent are built around five supporting elements: Identification of key leader competencies. Effective job design. A strong focus on leadership recruitment, development, and retention. Leadership training and development throughout all levels of the organization. Ongoing leadership assessment and performance management.

  2. Arthropod community organization and development in pear

    NASA Astrophysics Data System (ADS)

    Gut, Larry J.; Liss, W. J.; Westigard, P. H.

    1991-01-01

    Arthropod communities in pear are conceptualized as hierarchically organized systems in which several levels of organization or subsystems can be recognized between the population level and the community as a whole. An individual pear tree is taken to be the community habitat with arthropod subcommunities developing on leaf, fruit, and wood subcommunity habitats. Each subcommunity is composed of trophically organized systems of populations. Each system of populations is comprised of a functional group or guild of phytophagous arthropods that use the habitat primarily for feeding but also for overwintering or egg deposition, and associated groups of specialized predators, parasitoids, and hyperparasitoids. Several species move from one subcommunity to another during the course of community development and thus integrate community subsystems. Community development or change in organization through time is conceptualized as being jointly determined by the development of the habitat and the organization of the species pool. The influence of habitat development on community development within a species pool is emphasized in this research. Seasonal habitat development is expressed as change in the kinds and biomasses of developmental states of wood, leaf, and fruit subcommunity habitats. These changes are accompanied by changes in the kinds, biomasses, and distributions of associated community subsystems.

  3. Meanings of blood, bleeding and blood donations in Pakistan: implications for national vs global safe blood supply policies.

    PubMed

    Mumtaz, Zubia; Bowen, Sarah; Mumtaz, Rubina

    2012-03-01

    Contemporary public policy, supported by international arbitrators of blood policy such as the World Health Organization and the International Federation of the Red Cross, asserts that the safest blood is that donated by voluntary, non-remunerated donors from low-risk groups of the population. These policies promote anonymous donation and discourage kin-based or replacement donation. However, there is reason to question whether these policies, based largely on Western research and beliefs, are the most appropriate for ensuring an adequate safe blood supply in many other parts of the world. This research explored the various and complex meanings embedded in blood using empirical ethnographic data from Pakistan, with the intent of informing development of a national blood policy in that country. Using a focused ethnographic approach, data were collected in 26 in-depth interviews, 6 focus group discussions, 12 key informant interviews and 25 hours of observations in blood banks and maternity and surgical wards. The key finding was that notions of caste-based purity of blood, together with the belief that donors and recipients are symbolically knitted in a kin relationship, place a preference on kin-blood. The anonymity inherent in current systems of blood extraction, storage and use as embedded in contemporary policy discourse and practice was problematic as it blurred distinctions that were important within this society. The article highlights the importance-to ensuring a safe blood supply-of basing blood procurement policies on local, context-specific belief systems rather than relying on uniform, one-size-fits-all global policies. Drawing on our empirical findings and the literature, it is argued that the practice of kin-donated blood remains a feasible alternative to the global ideal of voluntary, anonymous donations. There is a need to focus on developing context-sensitive strategies for promoting blood safety, and critically revisit the assumptions underlying

  4. Meanings of blood, bleeding and blood donations in Pakistan: implications for national vs global safe blood supply policies

    PubMed Central

    Mumtaz, Zubia; Bowen, Sarah; Mumtaz, Rubina

    2012-01-01

    Contemporary public policy, supported by international arbitrators of blood policy such as the World Health Organization and the International Federation of the Red Cross, asserts that the safest blood is that donated by voluntary, non-remunerated donors from low-risk groups of the population. These policies promote anonymous donation and discourage kin-based or replacement donation. However, there is reason to question whether these policies, based largely on Western research and beliefs, are the most appropriate for ensuring an adequate safe blood supply in many other parts of the world. This research explored the various and complex meanings embedded in blood using empirical ethnographic data from Pakistan, with the intent of informing development of a national blood policy in that country. Using a focused ethnographic approach, data were collected in 26 in-depth interviews, 6 focus group discussions, 12 key informant interviews and 25 hours of observations in blood banks and maternity and surgical wards. The key finding was that notions of caste-based purity of blood, together with the belief that donors and recipients are symbolically knitted in a kin relationship, place a preference on kin-blood. The anonymity inherent in current systems of blood extraction, storage and use as embedded in contemporary policy discourse and practice was problematic as it blurred distinctions that were important within this society. The article highlights the importance—to ensuring a safe blood supply—of basing blood procurement policies on local, context-specific belief systems rather than relying on uniform, one-size-fits-all global policies. Drawing on our empirical findings and the literature, it is argued that the practice of kin-donated blood remains a feasible alternative to the global ideal of voluntary, anonymous donations. There is a need to focus on developing context-sensitive strategies for promoting blood safety, and critically revisit the assumptions

  5. Directed altruistic living donation: what is wrong with the beauty contest?

    PubMed Central

    Moorlock, Greg

    2015-01-01

    This paper explores the specific criticism of directed altruistic living organ donation that it creates a ‘beauty contest’ between potential recipients of organs. The notion of the beauty contest in transplantation was recently used by Neidich et al who stated that ‘[a]ltruism should be the guiding motivation for all donations, and when it [is], there is no place for a beauty contest’. I examine this beauty contest objection from two perspectives. First, I argue that, when considered against the behaviour of donors, this objection cannot be consistently raised without also objecting to other common aspects of organ donation. I then explore the beauty contest objection from the perspective of recipients, and argue that if the beauty contest is objectionable, it is because of a tension between recipient behaviour and the altruism that supposedly underpins the donation system. I conclude by briefly questioning the importance of this tension in light of the organ shortage. PMID:26126975

  6. Directed altruistic living donation: what is wrong with the beauty contest?

    PubMed

    Moorlock, Greg

    2015-11-01

    This paper explores the specific criticism of directed altruistic living organ donation that it creates a 'beauty contest' between potential recipients of organs. The notion of the beauty contest in transplantation was recently used by Neidich et al who stated that '[a]ltruism should be the guiding motivation for all donations, and when it [is], there is no place for a beauty contest'. I examine this beauty contest objection from two perspectives. First, I argue that, when considered against the behaviour of donors, this objection cannot be consistently raised without also objecting to other common aspects of organ donation. I then explore the beauty contest objection from the perspective of recipients, and argue that if the beauty contest is objectionable, it is because of a tension between recipient behaviour and the altruism that supposedly underpins the donation system. I conclude by briefly questioning the importance of this tension in light of the organ shortage.

  7. [Suitability of autologous blood donation before bone marrow donation].

    PubMed

    Gouëzec, H; Ferré, N; Hervé, F; Lapart, C; Leberre, C; Bernard, M; Dauriac, C; Nimubona, S

    2015-06-01

    We assessed the benefit of predeposite autologous blood donation (PAD) before bone marrow (BM) donation on transfusion requirements, haemoglobin concentrations (Hb) and the occurrence of adverse events (AE). We collected data retrospectively from 50 donors of BM with PAD from 2010 to 2014. An autologous transfusion (AT) was given to 50% of the donors (group 1). In the group 2, the products from PAD were not used. The total volume median of marrow harvested was 17.7 mL/k (range 12.3-21.4) in the group 1 and 13.3 mL/k (8.6-22.6) in the group 2. The female ratio was higher in the group 1 (60%) than in the group 2 (16%). Bone marrow harvest led to a decline in Hb (from PAD to first day after BM donation) by 2.9 g/dL (1.5-5.5) in the group 1 and by 3.5 g/dL (1.2-5) in the group 2. The post-harvest Hb (D+1) median was identical in the two groups: 10.9 g/dL (7.6-13.5) in the group 1 versus 11.5 g/dL (9.3-13.4) in the group 2. Six AE were reported in each group. In the group with AE, the median weight was lower: 58 k (50-71) versus 75 k (52-110); and the median total volume of marrow harvested was higher: 20.1 mL/k (9.9-21.4) versus 14.3 mL/k (8.6-22.6). All post-harvest Hb were ≥ 7.6g/dL. This study shows the high loss of Hb after BM donation but not enough to prove a blood transfusion in BM donors with median age of 36 years (16-62) and without comorbidity. The occurrence of AE (25% of BM donors) justifies a careful surveillance after the BM donation. The PAD should not be routinely offered to bone marrow donors.

  8. Obtaining consent for eye donation.

    PubMed

    Diamond, G A; Campion, M; Mussoline, J F; D'Amico, R A

    1987-02-15

    We prospectively studied 100 consecutive deaths at St. Vincent's Hospital and Medical Center in New York City for possible eye donation. Fifty-two patients were unsuitable mainly because of medical contraindications and age at death. Of the 48 suitable candidates, 21 pairs (44%) of eyes were obtained. Sixteen of the 42 eyes (38%) were used for transplantation. Projection of the number of corneas obtainable for transplant in New York City were calculated. The figures indicated that the three-month waiting list of the New York Eye-Bank for Sight Restoration, Inc., could be eradicated if hospitals were able to get seven donors from every 100 deaths suitable for donation, a rate only 16% of that realized in this study.

  9. Organ transplantation: the Latin American legislative response.

    PubMed

    Fuenzalida-Puelma, H L

    1990-01-01

    As medical barriers to human organ transplants have fallen, serious legal and ethical obstacles have emerged. This article provides an overview of those obstacles, taking into account the relevant legislation in force in 16 Latin American countries in 1989. The author proceeds by considering postmortem and inter-vivos organ donations separately and examining the principal ethical and legal issues relating to each kind. In the case of postmortem donation these deal mainly with donor consent, recipient selection, funding of transplant costs, and possible conflict of interest. In the case of inter-vivos donation they relate again to donor consent and funding as well as to certain other matters-notably donor compensation, commerce in organs, and international sharing of organs. On the whole it is concluded that the countries of Latin America, together with the nations of the world in general, urgently need to develop more comprehensive legislation on organ procurement and transplantation.

  10. Lipaemic donations: truth and consequences.

    PubMed

    Lippi, Giuseppe; Franchini, Massimo

    2013-10-01

    The problem of using material of unsuitable quality, including "nontransparent turbid milky plasma" or more simply "turbid plasma", for producing blood components is not trivial for several epidemiological, technical, analytical, clinical and economical reasons. With some exception, most national and international guidelines mandate that blood components should preferably not be produced from lipaemic donations. The origin of lipaemic blood is variegated, and includes physiological or paraphysiological causes and metabolic disorders, whereas a broad range of common diseases and drugs can also be associated with hypertriglyceridaemia. Overall, the frequency of lipaemic donations ranges between 0.31% and 0.35%, although sporadic reports have highlighted that the frequency might be much higher, up to 13%. Lipaemic donations pose two leading problems in transfusion medicine, that are interference during laboratory testing, and safety of producing blood components from hypertriglyceridaemic materials. While the former issue can be overcome by using chemical or mechanical methods, the clinical use of lipaemic blood for producing components remains an unresolved question. Transfusion medicine should thereby embark on a landmark effort to find a universal agreement of behaviours and harmonization of policies worldwide.

  11. Social and ethical issues in mitochondrial donation

    PubMed Central

    Dimond, Rebecca

    2015-01-01

    Introduction or background The UK is at the forefront of mitochondrial science and is currently the only country in the world to legalize germ-line technologies involving mitochondrial donation. However, concerns have been raised about genetic modification and the ‘slippery slope’ to designer babies. Sources of data This review uses academic articles, newspaper reports and public documents. Areas of agreement Mitochondrial donation offers women with mitochondrial disease an opportunity to have healthy, genetically related children. Areas of controversy Key areas of disagreement include safety, the creation of three-parent babies, impact on identity, implications for society, definitions of genetic modification and reproductive choice. Growing points The UK government legalized the techniques in March 2015. Scientific and medical communities across the world followed the developments with interest. Areas timely for developing research It is expected that the first cohort of ‘three parent’ babies will be born in the UK in 2016. Their health and progress will be closely monitored. PMID:26351372

  12. Challenging the moral status of blood donation.

    PubMed

    Snelling, Paul C

    2014-12-01

    The World Health Organisation encourages that blood donation becomes voluntary and unremunerated, a system already operated in the UK. Drawing on public documents and videos, this paper argues that blood donation is regarded and presented as altruistic and supererogatory. In advertisements, donation is presented as something undertaken for the benefit of others, a matter attracting considerable gratitude from recipients and the collecting organisation. It is argued that regarding blood donation as an act of supererogation is wrongheaded, and an alternative account of blood donation as moral obligation is presented. Two arguments are offered in support of this position. First, the principle of beneficence, understood in a broad consequentialist framework obliges donation where the benefit to the recipient is large and the cost to the donor relatively small. This argument can be applied, with differing levels of normativity, to various acts of donation. Second, the wrongness of free riding requires individuals to contribute to collective systems from which they benefit. Alone and in combination these arguments present moral reasons for donation, recognised in communication strategies elsewhere. Research is required to evaluate the potential effects on donation of a campaign which presents blood donation as moral obligation, but of wider importance is the recognition that other-regarding considerations in relation to our own as well as others' health result in a range not only of choices but also of obligations.

  13. Organization Development. Symposium 16. [AHRD Conference, 2001].

    ERIC Educational Resources Information Center

    2001

    This symposium on organization development (OD) consists of three presentations. "A Study of Gender Management Preferences as Related to Predicted Organizational Management Paradigms for the Twenty-First Century" (Cathy Bolton McCullough) reports a study that found that access to diverse management preferences and the manner in which the…

  14. Investigating kidney donation as a risk factor for hypertension and microalbuminuria: findings from the Swiss prospective follow-up of living kidney donors

    PubMed Central

    Thiel, Gilbert T; Nolte, Christa; Tsinalis, Dimitrios; Steiger, Jürg; Bachmann, Lucas M

    2016-01-01

    Objectives To assess the role of nephrectomy as a risk factor for the development of hypertension and microalbuminuria. Design Prospective, long-term follow-up study. Setting Swiss Organ Living-Donor Health Registry. Participants All living kidney donors in Switzerland between 1993 and 2009. Interventions Data on health status and renal function before 1 year and biennially after donation were collected. Primary and secondary outcome measures Comparison of 1-year and 5-year occurrences of hypertension among normotensive donors with 1-year and 5-year estimates from the Framingham hypertension risk score. Multivariate random intercept models were used to investigate changes of albumin excretion after donation, correcting for repeated measurements and cofactors such as age, male gender and body mass index. Results A total of 1214 donors contributed 3918 data entries with a completed biennial follow-up rate of 74% during a 10-year period. Mean (SD) follow-up of donors was 31.6 months (34.4). Median age at donation was 50.5 years (IQR 42.2–58.8); 806 donors (66.4%) were women. Donation increased the risk of hypertension after 1 year by 3.64 (95% CI 3.52 to 3.76; p<0.001). Those participants remaining normotensive 1 year after donation return to a risk similar to that of the healthy Framingham population. Microalbuminuria before donation was dependent on donor age but not on the presence of hypertension. After nephrectomy, hypertension became the main driver for changes in albumin excretion (OR 1.19; 95% CI 0.13 to 2.25; p=0.03) and donor age had no effect. Conclusions Nephrectomy propagates hypertension and increases susceptibility for the development of hypertension-induced microalbuminuria. PMID:27006347

  15. National Organ and Tissue Donation Initiative

    MedlinePlus

    ... New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South ... New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South ...

  16. How France launched its donation after cardiac death program.

    PubMed

    Antoine, C; Mourey, F; Prada-Bordenave, E

    2014-02-01

    On the basis of the literature and results presented at the 6th International Conference, donation after cardio-circulatory death provides a significant, practical, additional high quality source of transplantable organs. The vast majority of DCD are 'controlled' Maastricht category III donors. In 2010, the parliamentary information mission on the revision of the bioethics laws invited the Intensive Care Societies to debate and to make recommendations to implement controlled donation after circulatory death. They came to the conclusion that such retrieval is possible in France and insisted on the medical criteria that frame it: the writing of the medical procedures, the ethical aspects and the delay. The major recommendations of the ethics committees were firstly, The WLST decision is independent of the possibility of organ donation; secondly, the strict respect of "The dead donor and organ transplantation rule" and the updated national guidance for the WLST; thirdly, the drafting of a nationally agreed protocol defining the mandatory conditions to determine death and to perform procurement and transplantation. Organ donation after WLST will be authorised only in pilot centres with a locally agreed WLST policy including external second opinion and written transcript of the WLST decision, experienced intensive care staff, a local organ procurement coordination team familiar with DBD and DCD protocols and only in hospitals authorised for organ procurement. It is important to have an optimal and standardized national guidance to limit the known risk factors of graft failure (donor and recipient choice, warm and cold ischemia time), to increase acceptance by medical community and civil society and to improve results and allow more powerful analysis.

  17. Family Over Rules? An Ethical Analysis of Allowing Families to Overrule Donation Intentions.

    PubMed

    Shaw, David; Georgieva, Denie; Haase, Bernadette; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; McDonald, Maryon; Ploeg, Rutger

    2017-03-01

    Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the "right" way and have recorded their wishes or live in a jurisdiction with a "presumed consent" system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed. In some jurisdictions, the rate of "family overrule" is over 10%. In this article, we provide a systematic ethical analysis of the family overrule of donation of solid organs by deceased patients, and examine arguments both in favor of and against allowing relatives to "veto" the potential donor's intentions. First, we provide a brief review of the different consent systems in various European countries, and the ramifications for family overrule. Next, we describe and discuss the arguments in favor of permitting donation intentions to be overruled, and then the arguments against doing so. The "pro" arguments are: overrule minimises family distress and staff stress; families need to cooperate for donation to take place; families might have evidence regarding refusal; and failure to permit overrules could weaken trust in the donation system. The "con" arguments are: overrule violates the patient's wishes; the family is too distressed and will regret the decision; overruling harms other patients; and regulations prohibit overrule. We conclude with a general discussion and recommendations for dealing with families who wish to overrule donation. Overall, overrule should only rarely be permitted.

  18. Giving ourselves: the ethics of anatomical donation.

    PubMed

    Gunderman, Richard B

    2008-01-01

    In some European countries, such as Italy, medical education is threatened by a dearth of anatomical specimens. Such a shortage could spread to other nations, including the United States. This article addresses two ethical questions in body donation. Why might people choose to donate their bodies to education and science? What sorts of ethical appeals might anatomists, physicians, and other health professionals make to patients and family members for anatomical donation? Two models of giving, egoistic and liberal, merit close examination.

  19. Embryo donation in Iran: an ethical review.

    PubMed

    Afshar, Leila; Bagheri, Alireza

    2013-12-01

    Iran is the only Muslim country that has legislation on embryo donation, adopted in 2003. With an estimated 10-15% of couples in the country that are infertile, there are not any legal or religious barriers that prohibit an infertile couple from taking advantage of Assisted Reproductive Technologies (ARTs). Although all forms of ARTs available in Iran have been legitimized by religious authorities, there is a lack of legislation in all ARTs except embryo donation. By highlighting ethical issues in embryo donation, the paper presents a critical review of the Act of Embryo Donation in Iran. The paper argues that the Act does not provide enough safeguards for the future child and assurance for the safety of the donated embryos. It also does not restrict embryo donation to surplus embryos from infertile couples and is silent about the number of embryos that could be donated by each couple as well as the number of recipients for donated embryos by a couple. The Act is also silent about the issues of genetic linkage (nasab) and heritage which are challenging issues, especially in a conservative Islamic society. As a result, the future child may not inherit from their birth parents, as it is not required by the Act, or from the genetically related parents under the anonymity policy. Finally there is no standard national protocol or guidelines to evaluate the safety of the donated embryos. The paper concludes that despite its benefits, the Act lacks clarity, and it is subject to misunderstanding and confusion.

  20. Exposure to traumatic experiences is associated with abnormal neural mechanism during charitable donation.

    PubMed

    Wei, Dongtao; Wang, Kangcheng; Shen, Yimo; Du, Xue; Li, Wenfu; Dupuis-Roy, Nicolas; Qiu, Jiang; Zhang, Qinglin

    2013-10-30

    Previous studies suggested that posttraumatic stress disorder (PTSD) might be associated with dysfunctional reward processing. At present, little is known about the neural mechanisms of reward-related processing during a charitable donation task in trauma survivors who do not go on to develop PTSD. We used functional magnetic resonance imaging (fMRI) to investigate the neural basis of charitable donation in non-PTSD survivors of the Sichuan earthquake. Results showed that activations in the striatum of trauma survivors were reduced in both the low donation (donated a small amount to the Red Cross) and the high donation conditions (donated a large amount to the Red Cross) compared with the healthy controls. Furthermore, the trauma survivors also exhibited less activity in the insula than the healthy controls in the high donation condition. These findings suggest that abnormal reward-related activations might be associated with dysfunctions in the reward pathway of trauma survivors. Also, we discuss the possibility that traumatic experiences attenuate the reactivity of reward-related brain areas to positive emotions (as induced by advantageous donations).

  1. Influencing factors on the cord-blood donation of post-partum women.

    PubMed

    Kim, Miok; Han, Seungchul; Shin, Minho

    2015-06-01

    This study aims to identify the factors on the cord-blood donation of Korean post-partum women, who may store, donate, or discard their infant's cord blood. This descriptive research assesses the level of knowledge and attitude of post-partum women in Korea, regarding cord blood and its usage. The participants in this study were 320 post-partum women of which 109 stored, 34 donated, and 177 discarded their cord blood. The knowledge level of women who donated or stored their cord blood was higher than that of those who discarded. The attitude level of the women who donated was higher than that of those who stored or discarded. Knowledge, attitude, income, and source of information were the factors on the cord-blood donation; high knowledge, high attitude, low income, and information source from mass media contributes to cord-blood donation. In order to promote the cord-blood donation, it is necessary to develop guidelines for cord-blood education to improve the knowledge and attitudes of child-bearing women and healthcare professionals.

  2. Blood Donation, Payment, and Non-Cash Incentives: Classical Questions Drawing Renewed Interest

    PubMed Central

    Buyx, Alena M.

    2009-01-01

    Summary Blood is scarce, and ensuring a sufficient blood supply remains difficult for many countries. Payment for blood as a strategy to increase donations has remained highly controversial for decades, and the debate about ethical issues in paying donors has become somewhat stuck. At least from a policy perspective, it is important to find a compromise which allows for devising and implementing acceptable and successful policies to increase the blood supply. In this paper, such a compromise is developed both from a theoretical and empirical perspective, namely implementing well-designed non-cash incentives which cut across the rigid dichotomy of altruistic donations versus payment for donations. In order for this compromise to work, more attention to donation motives, the choice architecture, and the setting in blood donation needs to be paid. PMID:21076552

  3. [Liver transplant with donated graft after controlled cardiac death. Current situation].

    PubMed

    Abradelo De Usera, Manuel; Jiménez Romero, Carlos; Loinaz Segurola, Carmelo; Moreno González, Enrique

    2013-11-01

    An increasing pressure on the liver transplant waiting list, forces us to explore new sources, in order to expand the donor pool. One of the most interesting and with a promising potential, is donation after cardiac death (DCD). Initially, this activity has developed in Spain by means of the Maastricht type II donation in the uncontrolled setting. For different reasons, donation after controlled cardiac death has been reconsidered in our country. The most outstanding circumstance involved in DCD donation is a potential ischemic stress, that could cause severe liver graft cell damage, resulting in an adverse effect on liver transplant results, in terms of complications and outcomes. The complex and particular issues related to DCD Donation will be discussed in this review.

  4. Food allergies developing after solid organ transplant.

    PubMed

    Needham, J M; Nicholas, S K; Davis, C M

    2015-12-01

    The development of food allergy is an increasingly recognized form of morbidity after solid organ transplant. It occurs more commonly in liver transplant recipients, although it has also been reported in heart, lung, kidney, and intestinal transplants. Pediatric transplant recipients are more likely to develop symptoms compared to adults, and reports of frequency vary widely from 5% to 38% in pediatric liver transplant recipients. Multiple mechanisms have been proposed in the literature, although no single mechanism can yet account for all reported observations. As food allergy can have at worst potentially fatal consequences, and at best require lifestyle adjustment through food avoidance, it is important for recipients to be aware of the donor's food allergies and particularly in pediatrics, the possibility of completely de novo allergies. This review explores the recent reports surrounding food allergy after solid organ transplant, including epidemiology, proposed mechanisms, and implications for practice.

  5. The Integrated Development of Sensory Organization

    PubMed Central

    Lickliter, Robert

    2011-01-01

    Synopsis The natural environment provides a flux of concurrent stimulation to all our senses, and the integration of information from different sensory systems is a fundamental feature of perception and cognition. How information from the different senses is integrated has long been of concern to several scientific disciplines, including psychology, cognitive science, and the neurosciences, each with different questions and methodologies. In recent years, a growing body of evidence drawn from these various disciplines suggests that the development of early sensory organization is much more plastic and experience-dependent than was previously realized. In this article, I briefly explore some of these recent advances in our understanding of the development of sensory integration and organization and discuss implications of these advances for the care and management of the preterm infant. PMID:22107892

  6. Recent developments in high temperature organic polymers

    NASA Technical Reports Server (NTRS)

    Hergenrother, P. M.

    1991-01-01

    Developments in high temperature organic polymers during the last 5 years with major emphasis on polyimides and poly(arylene ether)s are discussed. Specific polymers or series of polymers have been selected to demonstrate unique properties or the effect chemical structure has upon certain properties. This article is not intended to be a comprehensive review of high temperature polymer advancements during the last 5 years.

  7. Methods development for total organic carbon accountability

    NASA Technical Reports Server (NTRS)

    Benson, Brian L.; Kilgore, Melvin V., Jr.

    1991-01-01

    This report describes the efforts completed during the contract period beginning November 1, 1990 and ending April 30, 1991. Samples of product hygiene and potable water from WRT 3A were supplied by NASA/MSFC prior to contract award on July 24, 1990. Humidity condensate samples were supplied on August 3, 1990. During the course of this contract chemical analyses were performed on these samples to qualitatively determine specific components comprising, the measured organic carbon concentration. In addition, these samples and known standard solutions were used to identify and develop methodology useful to future comprehensive characterization of similar samples. Standard analyses including pH, conductivity, and total organic carbon (TOC) were conducted. Colorimetric and enzyme linked assays for total protein, bile acid, B-hydroxybutyric acid, methylene blue active substances (MBAS), urea nitrogen, ammonia, and glucose were also performed. Gas chromatographic procedures for non-volatile fatty acids and EPA priority pollutants were also performed. Liquid chromatography was used to screen for non-volatile, water soluble compounds not amenable to GC techniques. Methods development efforts were initiated to separate and quantitate certain chemical classes not classically analyzed in water and wastewater samples. These included carbohydrates, organic acids, and amino acids. Finally, efforts were initiated to identify useful concentration techniques to enhance detection limits and recovery of non-volatile, water soluble compounds.

  8. Who donates their body to science? An international, multicenter, prospective study.

    PubMed

    Cornwall, Jon; Perry, Gary F; Louw, Graham; Stringer, Mark D

    2012-01-01

    The altruistic act of body donation provides a precious resource for both teaching and researching human anatomy. However, relatively little is known about individuals who donate their bodies to science (donors), and in particular whether donors in different geographical locations share similar characteristics. A multicenter prospective survey of donors registering during 2010 in three different geographical locations, New Zealand, Ireland, and the Republic of South Africa, was conducted to identify donor characteristics. The 28-question survey included sections on body donation program awareness, reasons for donating, giving tendency, education, ethnicity, relationship status, occupation, religion, and political preference. Two hundred surveys (81%) were returned [New Zealand 123 (85% response rate), Republic of South Africa 41 (67%), and Ireland 36 (92%)]. Results indicate that donors share certain characteristics including reason for donating (80% cited a desire to aid medical science as the main reason for wishing to donate their body); family structure (most donors are or have been in long-term partnerships and ≥ 85% have siblings); and a higher proportion with no religious affiliation compared to their reference population. Some variations between locations were noted including donor age, the mode of program awareness, occupation, relationship status, political preference, organ donor status and with whom donors had discussed their decision to donate. This information could be important for assisting the identification of potential body donors in new and established bequest programs.

  9. 49 CFR 24.108 - Donations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Donations. 24.108 Section 24.108 Transportation Office of the Secretary of Transportation UNIFORM RELOCATION ASSISTANCE AND REAL PROPERTY ACQUISITION FOR FEDERAL AND FEDERALLY-ASSISTED PROGRAMS Real Property Acquisition § 24.108 Donations. An owner whose...

  10. Giving Ourselves: The Ethics of Anatomical Donation

    ERIC Educational Resources Information Center

    Gunderman, Richard B.

    2008-01-01

    In some European countries, such as Italy, medical education is threatened by a dearth of anatomical specimens. Such a shortage could spread to other nations, including the United States. This article addresses two ethical questions in body donation. Why might people choose to donate their bodies to education and science? What sorts of ethical…

  11. Minimizing risk in anonymous egg donation.

    PubMed

    Ahuja, K K; Simons, E G; Nair, S; Rimington, M R; Armar, N A

    2003-11-01

    Assisted conception carries with it known and putative medical and surgical risks. Exposing healthy women to these risks in order to harvest eggs for donation when a safer alternative exists is morally and ethically unacceptable. Egg sharing minimizes risk and provides a source of eggs for donation. Anonymity protects all parties involved and should not be removed.

  12. The Books in Bill Clinton's Donation.

    ERIC Educational Resources Information Center

    Zhang, Hongyang; Webb, T. D.

    2002-01-01

    Explains President Clinton's donation of books about the United States to the Peking University Library and compares it to a donation of Chinese books from the Peking University library to the library of Kapiolani Community College (Hawaii). Suggests appropriate directions for U.S.-China academic library cooperation and for international academic…

  13. Ovum donation: examining the new Israeli law.

    PubMed

    Gruenbaum, Benjamin F; Pinchover, Zachary S; Lunenfeld, Eitan; Jotkowitz, Alan

    2011-11-01

    Ovum donation affords countless couples that under natural circumstances would not be able to produce offspring the ability to carry out natural pregnancies. With advancements in biotechnology including egg collection and in vitro fertilization (IVF), physicians can now successfully implant fertilized embryos. Due to Israel's tremendous involvement in IVF for its own citizens, the national laws that govern egg donation are of great importance. On September 5th 2010, the Israeli Parliament (Knesset) passed a law that allows young women between the ages of 21 and 35 to donate their eggs for paid financial compensation. The new law allows infertile women between the ages of 18 and 54 to request egg donation and IVF, which will partially be covered under state insurance plans. This article provides a description of the new Israeli law regulating ovum donation and the practical, moral and ethical debate surrounding the new system.

  14. Complications related to blood donation: A multicenter study of the prevalence and influencing factors in voluntary blood donation camps in Karnataka, India

    PubMed Central

    Agarwal, Rajat Kumar; Periyavan, Sundar; Dhanya, Rakesh; Parmar, Lalith G.; Sedai, Amit; Ankita, Kumari; Vaish, Arpit; Sharma, Ritesh; Gowda, Prabha

    2016-01-01

    Introduction: Complications associated with blood donation significantly lower odds of subsequent donations. The aim of the study is to assess the prevalence of complications related to blood donation, identify the influencing factors, and come up with suggestions for minimizing discomfort to donors and making outdoor voluntary blood donation camps safer. Materials and Methods: This study covered 181 blood donation camps organized by Sankalp India Foundation where 16 blood banks participated from 01-04-2011 to 01-08-2014 in Karnataka. Uniform protocols for donor selection, predonation preparation, counseling, postdonation care, and refreshments were used. The postdonation complications were recorded on a form immediately, after they were observed. Results: We observed 995 (3.2%) complications in 30,928 whole blood donations. Of these 884 (2.86%) mild, 77 (0.25%) moderate, and 5 (0.02%) severe complications were observed. Local symptoms (blood outside vessels, pain, and allergy) contributed 1.0%, and generalized symptoms (vasovagal reaction) contributed 2.2% to all the complications. Conclusion: We observed 322 complications for every 10,000 donations. Since 27 out of every 10000 experience moderate and severe complication, the readiness to manage complications is crucial. Women donors, young donors, and donors with a lower weight are at a significantly greater risk of experiencing complications, highlighting the need for specific guidelines for the management of higher risk donor groups. Complications varied significantly between various blood banks. Predonation hydration was effective in limiting complications with generalized symptoms. We recommend a robust donor hemovigilance program for voluntary blood donation for monitoring complications and enable assessment of effectiveness and implementation of appropriate interventions. PMID:27011671

  15. Genome Duplication: The Heartbeat of Developing Organisms

    PubMed Central

    DePamphilis, Melvin L.

    2016-01-01

    The mechanism that duplicates the nuclear genome during the trillions of cell divisions required to develop from zygote to adult is the same throughout the eukarya, but the mechanisms that determine where, when and how much nuclear genome duplication occur regulate development and differ among the eukarya. They allow organisms to change the rate of cell proliferation during development, to activate zygotic gene expression independently of DNA replication, and to restrict nuclear DNA replication to once per cell division. They allow specialized cells to exit their mitotic cell cycle and differentiate into polyploid cells, and in some cases, to amplify the number of copies of specific genes. It is genome duplication that drives evolution, by virtue of the errors that inevitably occur when the same process is repeated trillions of times. It is, unfortunately, the same errors that produce age-related genetic disorders such as cancer. PMID:26970621

  16. Poor organ quality and donor-recipient age mismatch rather than poor donation rates account for the decrease in deceased kidney transplantation rates in a Germany Transplant Center.

    PubMed

    Tittelbach-Helmrich, Dietlind; Thurow, Christian; Arwinski, Stephan; Schleicher, Christina; Hopt, Ulrich T; Bausch, Dirk; Drognitz, Oliver; Pisarski, Przemyslaw

    2015-02-01

    Kidney transplantation is limited not by technical or immunological challenges but by lack of donor organs. Whereas the number of patients on waiting list increased, the transplantation rate decreased. We analyzed the development of decline rates and reasons as well as the fate of declined organs. In total, 1403 organs offered to 1950 patients between 2001 and 2010 were included. Of 440 organs offered between 2009 and 2011 that were declined, we investigated whether these organs were transplanted elsewhere and requested delayed graft function, creatinine, graft and patient survival. Data were compared to results of transplantations at the same time at our center. Decline rate increased from 47% to 87%. Main reasons were poor organ quality and donor-recipient age or size mismatch. Of the rejected organs, 55% were transplanted at other centers with function, graft and patient survival equivalent to patients transplanted at our center during that period. The number of decline has increased over time mainly due to a growing number of marginal donors accounting for poor organ quality or a mismatch of donor and recipient. If proper donor-recipient selection is performed, many organs that would otherwise be discarded can be transplanted successfully.

  17. Anything but the eyes: culture, identity, and the selective refusal of corneal donation.

    PubMed

    Lawlor, Mitchell; Kerridge, Ian

    2011-12-15

    At the time that a patient is diagnosed as brain dead, a substantial proportion of families who give consent to heart and kidney donation specifically refuse eye donation. This in part may relate to the failure of those involved in transplantation medicine and public education to fully appreciate the different meanings attached to the body of a recently deceased person. Medicine and science have long understood the body as a "machine." This view has fitted with medical notions of transplantation, with donors being a source of biologic "goods." However, even a cursory glance at the rituals surrounding death makes it apparent that there is more to a dead body than simply its biologic parts; in death, bodies continue as the physical substrate of relationships. Of all the organs, it is the eyes that are identified as the site of sentience, and there is a long tradition of visual primacy and visual symbolism in virtually all aspects of culture. It therefore seems likely that of all the body parts, it is the eyes that are most central to social relationships. A request to donate the eyes therefore is unlikely to be heard simply in medical terms as a request to donate a "superfluous" body part for the benefit of another. That the eyes are not simply biologic provides one explanation for both the lower rates of corneal donation, compared with that of other organs, and the lack of adequate corneal donation to meet demand.

  18. Entrepreneurial ventures and whole-body donations: a regional perspective from the United States.

    PubMed

    Anteby, Michel; Hyman, Mikell

    2008-02-01

    Human cadavers are crucial to medical science. While the debate on how to secure sufficient cadavers has focused primarily on donors' behaviors, procuring organizations' roles in increasing donations remain less explored. The United States offers a unique setting in which to examine this question since entrepreneurial ventures supplying cadavers for medical science have recently emerged alongside traditional academic-housed programs, raising both hopes and fears about their impact on whole-body donations. To assess their potential impact, an archival survey of voluntary, in-state whole-body donors to two programs procuring in the same U.S. state was conducted. The programs' specimen recipients were also analyzed. One program is academic-housed and the other is an entrepreneurial venture. Both offered equal levels of financial support to donating parties. Eighty donations and 120 specimen shipping invoices from 2005 were analyzed in each program. Donations to the two programs did not significantly differ in terms of donors' sex, marital status, maximum educational level, and estimated hourly wage. The entrepreneurial venture's donors were, however, significantly younger, more likely to be from a minority group, and more likely to have died from cancer. For-profit organizations, continuing medical training organizations, and medical device companies were more likely recipients of the entrepreneurial venture's specimens. Non-profit and academic organizations were more likely recipients of the academic-housed program's specimens. These findings suggest that although the programs procured from a somewhat similar pool of donors, they also complemented one another. The entrepreneurial program procured donations that the academic-housed program often did not attract. Specimen recipients' distinct demands partly explain these procurement behaviors. Thus, organizational efforts to meet demands seem to shape the supply. Examining organizations alongside donors might provide

  19. Whole blood and apheresis donors in Quebec, Canada: Demographic differences and motivations to donate.

    PubMed

    Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne

    2015-12-01

    This study sought to compare demographics and donation motivations among plasma/platelet donors (PPDs) and whole blood donors (WBDs), in a voluntary and non-remunerated context. Motives to donate blood and demographic characteristics were collected through questionnaires completed by 795 WBDs and 473 PPDs. Comparison of WBDs and PPDs under chi-square tests showed that 17 out of 23 motivators were statistically different according to various demographic variables. These results demonstrate the existence of specific donor profiles both for WBDs and PPDs. Agencies should develop new recruitment strategies tailored to these donors, especially if they wish to convince WBDs to convert to apheresis donation.

  20. A prospective analysis of blood donation history and risk of non-Hodgkin lymphoma.

    PubMed

    Ishii, Kazusa; Birmann, Brenda M; Zhang, Xuehong; Giovannucci, Edward; Bertrand, Kimberly A

    2016-01-01

    Blood donation may influence subsequent NHL development via temporary immune system alterations. To test the hypothesis that frequent blood donation is associated with an increased risk of NHL and its most common histologic subtypes, this study followed 36 576 men in the Health Professionals Follow-up Study (HPFS), who provided information on frequency of blood donation in the past 30 years in 1992. This study confirmed 544 incident cases of NHL through 2010. Cox proportional hazards regression was used to calculate hazards ratios (HR) and 95% CI for the risk of all NHL and major NHL histologic subtypes associated with number of blood donations. In this prospective study, there was no significant evidence of an association between blood donation frequency and incidence of NHL (age-adjusted HR = 1.26, 95% CI = 0.94-1.68, comparing > 20 donations vs 0 donations over 30 years, p for trend = 0.18) or of any major NHL subtypes.

  1. Patient-Reported Outcomes Following Living Kidney Donation: A Single Center Experience.

    PubMed

    Rodrigue, James R; Vishnevsky, Tanya; Fleishman, Aaron; Brann, Tracy; Evenson, Amy R; Pavlakis, Martha; Mandelbrot, Didier A

    2015-09-01

    This article describes the development and implementation of an initiative at one transplant center to annually assess psychosocial outcomes of living kidney donors. The current analysis focuses on a cohort of adults (n = 208) who donated a kidney at BIDMC between September 2005 and August 2012, in which two post-donation annual assessments could be examined. One and two year post-donation surveys were returned by 59 % (n = 123) and 47 % (n = 98) of LKDs, respectively. Those who did not complete any survey were more likely to be younger (p = 0.001), minority race/ethnicity (p < 0.001), and uninsured at the time of donation (p = 0.01) compared to those who returned at least one of the two annual surveys. The majority of donors reported no adverse physical or psychosocial consequences of donation, high satisfaction with the donation experience, and no donation decision regret. However, a sizable minority of donors felt more pain intensity than expected and recovery time was much slower than expected, and experienced a clinically significant decline in vitality. We describe how these outcomes are used to inform clinical practice at our transplant center as well as highlight challenges in donor surveillance over time.

  2. To donate or not donate, that is the question: an analysis of the critical factors of blood donation.

    PubMed

    Pereira, Jefferson Rodrigues; Sousa, Caissa Veloso E; Matos, Eliane Bragança de; Rezende, Leonardo Benedito Oliveira; Bueno, Natália Xavier; Dias, Álvaro Machado

    2016-08-01

    Currently, in Brazil, 1.78% of the population area blood donors, a level lower than the ideal one that, according to WHO, should be between 3% and 5% of the population. Following this scenario, the current study has a general goal of identifying and analyzing the main critical factors of the process of blood donation in the city of Belo Horizonte, MG, under the perception of donors, potential donors and non donors. A qualitative research approach was conducted, through twenty-four semi-structured interviews. The results highlight the lack of information in the various stages of the blood donation system. During the stages of donor recruitment and awareness, communication actions convey to society incomplete information about the donation process, discouraging future actions of donation. On the other hand, a lack of appreciation of the donation experience and the construction of social values associated with the donor prevent the multiplication of social behaviors for donation. The results of this study, found from theoretical framework outlined in this study, highlight the causes or critical factors that impede changes in behavior, incremental or radical, proposed by social marketing.

  3. Intermittent noninvasive ventilation at San José Hospital in Chile: report of a German donation.

    PubMed

    Arellano Maric, M P; Roldán Toledo, R; Huttmann, S E; Storre, J H; Windisch, W

    2015-03-01

    Home mechanical ventilation is currently expanding in Chile, but its application along the country is hindered by financial and geographical reasons. In 2006 the San José Hospital in Santiago de Chile developed a non-invasive ventilation (NIV) center as a strategy to overcome the limitations of ventilator availability from public resources. Since then, this center provides intermittent diurnal sessions of NIV to patients with chronic hypercapnic respiratory failure. In 2013, a collaboratory work between the Chilean doctors, the German Interdisciplinary Society of Home Mechanical Ventilation (DIGAB = Deutsche Interdisziplinäre Gesellschaft für Außerklinische Beatmung) and the German non-invasive (NIV) home care provider "Heinen und Löwenstein" organized a donation of 100 second-hand ventilators (BiPAP Synchrony; Respironics, USA) including masks and tubing systems, which were provided by Heinen und Löwenstein. The ventilator devices arrived in Santiago in January 2014. Since then, the following initiatives have been launched: 1) the establishment of a domiciliary mechanical ventilation program independent of governmental founding, 2) NIV setting-titration, 3) renewal of ventilators at the hospital's intermittent NIV unit. Future goals are the establishment of a rehabilitation unit with concomitant NIV therapy and a clinical research program. Therefore, the German donation of ventilators and equipment has a reported impact on the development of NIV in Chile.

  4. 41 CFR 109-44.702 - Donations to public bodies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Donations to public... AND DISPOSAL 44-DONATION OF PERSONAL PROPERTY 44.7-Donations of Property to Public Bodies § 109-44.702 Donations to public bodies....

  5. 45 CFR 2544.115 - Who may offer a donation?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Who may offer a donation? 2544.115 Section 2544... COMMUNITY SERVICE SOLICITATION AND ACCEPTANCE OF DONATIONS § 2544.115 Who may offer a donation? Anyone... donation to the Corporation....

  6. 39 CFR 777.51 - Acceptance of donations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Acceptance of donations. 777.51 Section 777.51... ACQUISITION POLICIES Donations § 777.51 Acceptance of donations. Nothing in these regulations shall prevent a person from making a gift or donation of real property or any part thereof, or any interest therein,...

  7. 23 CFR 710.505 - Real property donations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Real property donations. 710.505 Section 710.505...-WAY AND REAL ESTATE Property Acquisition Alternatives § 710.505 Real property donations. (a) Donations..., whichever is greater. All donations of property received prior to the approval of the NEPA document...

  8. [Cultural diversity in gamete and embryos donation].

    PubMed

    Epelboin, S

    2014-09-01

    Through gamete and embryo donation have successively emerged new ways of designing individuals who, in turn, have generated mutations in the concept of parenthood. A debate is open to the society, which often raises ideological cleavages. Indeed, donation practices mobilize the conflicting interests of donor of gametes, the recipient couple, child, whose origins are complex, although his filiation is legally clear. Its place in the family genealogy can be examined in relation to other societies, which admit plural concepts called "classificatory" kinship. They set up role partition between parents and educators. Setting anthropological perspective provides a broadening of the reflection to answer questions from the donation practices, including genealogical questions of revelation to the child of his conception, his incorporation in family and social group and the importance of compensation of donation.

  9. Intra-Family Gamete Donation: A Solution to Concerns Regarding Gamete Donation in China?

    PubMed

    Liao, Juhong; Devolder, Katrien

    2016-09-01

    Gamete donation from third parties is controversial in China as it severs blood ties, which are considered of utmost importance in Confucian tradition. In recent years, infertile couples are increasingly demonstrating a preference for the use of gametes donated by family members to conceive children-known as "intra-family gamete donation." The main advantage of intra-family gamete donation is that it maintains blood ties between children and both parents. To date there is no practice of intra-family gamete donation in China. In this paper, we investigate intra-family adoption in China in order to illustrate that intra-family gamete donation is consistent with Confucian tradition regarding the importance of maintaining blood ties within the family. There are several specific ethical issues raised by intra-family gamete donation. It may, for example, result in consanguinity and the semblance of incest, lead to confused family relationships, and raise concerns about possible coercion of familial donors. Confucian tradition provides a new approach to understand and deal with these ethical issues in a way that Western tradition does not. As a result, we suggest intra-family gamete donation could be an acceptable solution to the problem of infertility in China. However, further discussion and open debates on the ethical issues raised by intra-family gamete donation are needed in China.

  10. Living kidney donation: the importance of public education.

    PubMed

    Tumin, Makmor; Rasiah, Rajah; Noh, Abdillah; Satar, NurulHuda Mohd; Chong, Chin-Sieng; Lim, Soo-Kun; Ng, Kok-Peng

    2014-04-01

    A sample of Malaysians in the Klang Valley indicating their decision on becoming unrelated living kidney donors was surveyed regarding huge amounts of financial incentives to be rewarded to them. From the 1310 respondents, 72.1% said "no" on becoming a living donor. The reason "I don't think humans can live with only one kidney" scored the highest (35.6%), and from the 27.9% of the respondents who are willing to donate their organ with the right financial incentive, most of the respondents picked the reasons "I want to do something noble in life" (50%), and monetary reason scored the lowest (6.2%), indicating that financial incentive is not a major reason guiding individuals' decision on becoming living donors. We suggest that the government should put priority at targeting public education to raise the understanding on the risk, safety and the quality of life of donation and transplantation, and improving the public trust on the donation and the surgical methods to carry out transplantation.

  11. Ethical perspectives on living donor organ transplantation in Asia.

    PubMed

    Concejero, Allan M; Chen, Chao-Long

    2009-12-01

    Live donors are a continuing source of organ grafts for solid organ transplantation in Asia. Ethical issues surrounding the development of living donor organ transplantation in Eastern countries are different from those in Western countries. Donor safety is still the paramount concern in any donor operation. Issues on organ trafficking remain societal concerns in low-income nations. Religion, cultural background, economic prerogatives, and timely legislation contribute to the social acceptance and maturation of organ donation.

  12. Conflicts of Interest and Effective Oversight of Assisted Reproduction Using Donated Oocytes.

    PubMed

    Blake, Valarie K; McGowan, Michelle L; Levine, Aaron D

    2015-01-01

    Oocyte donation raises conflicts of interest and commitment for physicians but little attention has been paid to how to reduce these conflicts in practice. Yet the growing popularity of assisted reproduction has increased the stakes of maintaining an adequate oocyte supply and (where appropriate) minimizing conflicts. A growing body of professional guidelines, legal challenges to professional self-regulation, and empirical research on the practice of oocyte donation all call for renewed attention to the issue. As empirical findings better inform existing conflicts and their potential harms, we can better attempt to reduce these conflicts. To that end, the article first describes the nature of conflicts in oocyte donation and relevant regulations and professional guidelines. We then describe studies on conflicts at four phases of oocyte donation: recruitment, screening, stimulation, and post-stimulation monitoring. Next we consider three models for conflict reduction in medicine generally: improved professional self-regulation, outright restriction like Stark anti-referral laws, or the use of conflict mediators, like in living organ donation. We ultimately conclude that improved professional self-regulation is a reasonable starting place for oocyte donation.

  13. Dialling for donations: practices and actions in the telephone solicitation of human tissues.

    PubMed

    Elizabeth Weathersbee, T; Maynard, Douglas W

    2009-09-01

    Altruistic actions such as the donation of public goods have long been the subject of social scientific debate. While scholars have recognised the importance of analysing the solicitation of donated goods such as human organs and tissues, to date none has examined actual interaction for this fateful event as it unfolds in real time. In this paper, we use data from 186 audio-recorded telephone interactions between donation centre personnel and family members of the recently deceased along with in-depth interviews and observations conducted in the call centre, to examine this particular donation solicitation interaction. Using conversation analysis, we demonstrate the step-by-step sequencing of the interaction that begins with the ringing phone generated by the call centre personnel which eventually leads to the formulation of the reason for the call, the tacit donation solicitation. Our close analysis of the sequential organisation of this interaction shows how solicitation is done cautiously, incrementally, and tacitly rather than overtly, reflecting its status as a dispreferred action. This analysis suggests that configurations in the wording of solicitations may operate interactionally but inadvertently to discourage the act of donation that call centre personnel are attempting to elicit.

  14. Challenges and advances in optimizing liver allografts from donation after circulatory death donors

    PubMed Central

    Sutherland, Andrew Ian; Oniscu, Gabriel C.

    2016-01-01

    In recent years, there has been a shift in the donor demographics with an increase in donation after circulatory death (DCD). Livers obtained from DCD donors are known to have poorer outcomes when compared to donors after brainstem death and currently only a small proportion of DCD livers are used. This review outlines the recent technological developments in liver DCD donation, including clinical studies using normothermic regional perfusion and extracorporal machine perfusion of livers from DCD donors. PMID:27003962

  15. Predicting donor asystole following withdrawal of treatment in donation after cardiac death.

    PubMed

    Pine, J K; Goldsmith, P J; Ridgway, D M; Pollard, S G; Menon, K V; Attia, M; Ahmad, N

    2010-12-01

    Donation after cardiac death donation allows donor pool expansion. The period between withdrawal of treatment and donor a systole is extremely variable; its prolongation often results in unsuccessful organ procurement. We sought to assess a variety of donor variables to determine whether they predicted successful organ retrieval. We included all Donation after Cardiac Death (DCD) retrievals between 2002 and 2009, which were grouped as successful (n = 104) versus unsuccessful (n = 42). Factors that predicted unsuccessful organ procurement included older donor age, donor history of hypertension, higher at withdrawal, and absence of inotropic support. On multivariate analysis, mean arterial pressure retained its significance. Prediction of withdrawal-to-asystole time is complex, but our analysis suggested that donor blood pressure at withdrawal is an important predictor of whether retrieval would be successful.

  16. Sources of Donated Books for Schools and Libraries, 2014. Publication No. RE003

    ERIC Educational Resources Information Center

    Peace Corps, 2014

    2014-01-01

    This publication helps volunteers identify organizations that can provide books and other educational resources to their communities. It provides contact information and guidance on how volunteers and their community partners can submit requests and receive donations from the organizations listed, and it emphasizes the importance of sustainability…

  17. 76 FR 40336 - Fisheries of the Exclusive Economic Zone Off Alaska; Prohibited Species Donation Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Convention between the United States and Canada for the Preservation of the Halibut Fishery of the North...,233 pounds, and 52,262 pounds, respectively, of steaked salmon to food bank organizations. During..., respectively, of steaked halibut to food bank organizations. The donations came from the BSAI trawl...

  18. 22 CFR 203.12 - Cooperative Development Organizations (CDOs).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cooperative Development Organizations (CDOs). 203.12 Section 203.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.12 Cooperative Development Organizations (CDOs). CDOs are not PVOs...

  19. 22 CFR 203.12 - Cooperative Development Organizations (CDOs).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Cooperative Development Organizations (CDOs). 203.12 Section 203.12 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.12 Cooperative Development Organizations (CDOs). CDOs are not PVOs...

  20. The development of organic super electron donors.

    PubMed

    Zhou, Shengze; Farwaha, Hardeep; Murphy, John A

    2012-01-01

    In the past decade, a host of exceptionally strong organic electron donors has been designed and prepared; their redox potentials are more negative than any previous neutral organic donors and extend beyond E(1/2) = -1 V vs. the saturated calomel electrode (SCE). Their ability to reduce a wide range of organic functional groups has been demonstrated and this article provides an overview of the main advances in the area and the guiding principles for the design of these reagents.

  1. 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.

  2. [Social marketing of blood donation: an analysis of new donors' predisposition].

    PubMed

    Barboza, Stephanie Ingrid Souza; Costa, Francisco José da

    2014-07-01

    This article aims to understand the motivational factors that influence individuals to donate blood, in order to support the social marketing measures for recruiting new donors. Based on theoretical research, a structural model was developed to analyze influences and interactions of constructs in individuals' intentions to donate blood. A field survey used a structured questionnaire with a sample of 346 individuals. The analysis included descriptive analysis, evaluation of psychometric consistency, and structural equation modeling with partial least squares estimation. Fear showed a negative influence and the reference group a positive influence on individual predisposition to donate blood. This indicated that social marketing for blood donation can be more effective in encouraging new donors if it remains focused on these two factors.

  3. Kidney donation after circulatory death (DCD): state of the art.

    PubMed

    Summers, Dominic M; Watson, Christopher J E; Pettigrew, Gavin J; Johnson, Rachel J; Collett, David; Neuberger, James M; Bradley, J Andrew

    2015-08-01

    The use of kidneys from controlled donation after circulatory death (DCD) donors has the potential to markedly increase kidney transplants performed. However, this potential is not being realized because of concerns that DCD kidneys are inferior to those from donation after brain-death (DBD) donors. The United Kingdom has developed a large and successful controlled DCD kidney transplant program that has allowed for a substantial increase in kidney transplant numbers. Here we describe recent trends in DCD kidney donor activity in the United Kingdom, outline aspects of the donation process, and describe donor selection and allocation of DCD kidneys. Previous UK Transplant Registry analyses have shown that while DCD kidneys are more susceptible to cold ischemic injury and have a higher incidence of delayed graft function, short- and medium-term transplant outcomes are similar in recipients of kidneys from DCD and DBD donors. We present an updated, extended UK registry analysis showing that longer-term transplant outcomes in DCD donor kidneys are also similar to those for DBD donor kidneys, and that transplant outcomes for kidneys from expanded-criteria DCD donors are no less favorable than for expanded-criteria DBD donors. Accordingly, the selection criteria for use of kidneys from DCD donors should be the same as those used for DBD donors. The UK experience suggests that wider international development of DCD kidney transplantation programs will help address the global shortage of deceased donor kidneys for transplantation.

  4. 25 CFR 900.105 - Who takes title to excess or surplus Federal property donated to an Indian tribe or tribal...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures... or tribal organization upon acceptance by the Indian tribe or tribal organization of a proper deed...

  5. 25 CFR 900.105 - Who takes title to excess or surplus Federal property donated to an Indian tribe or tribal...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures... or tribal organization upon acceptance by the Indian tribe or tribal organization of a proper deed...

  6. 25 CFR 900.105 - Who takes title to excess or surplus Federal property donated to an Indian tribe or tribal...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Property Donation Procedures... or tribal organization upon acceptance by the Indian tribe or tribal organization of a proper deed...

  7. Learning Organizations. Developing Cultures for Tomorrow's Workplace.

    ERIC Educational Resources Information Center

    Chawla, Sarita, Ed.; Renesch, John, Ed.

    This anthology contains 32 essays: "Beginner's Mind" (Sarita Chawla);"Communities of Commitment: The Heart of Learning Organizations" (Fred Kofman, Peter Senge); "Managing the Dream" (Charles Handy); "Ahead of the Wave: Valuing Gender Perspective in Learning Cultures" (Marilynne Anderson); "Mastering…

  8. ON DEVELOPING CLEANER ORGANIC UNIT PROCESSES

    EPA Science Inventory

    Organic waste products, potentially harmful to the human health and the environment, are primarily produced in the synthesis stage of manufacturing processes. Many such synthetic unit processes, such as halogenation, oxidation, alkylation, nitration, and sulfonation are common to...

  9. An Ethnographic Study of a Developing Virtual Organization in Education

    ERIC Educational Resources Information Center

    Couch, Stephanie R.

    2012-01-01

    This ethnographic study answers calls for research into the ways that virtual organizations (or innovation-driven collaborative teams) form and develop, what supports and constraints their development, and the leadership models that support the organizations' work. The study examines how a virtual organization emerged from an intersegmental…

  10. [Blood donation in foreign populations in Marseille].

    PubMed

    Duboz, Priscilla; Boëtsch, Gilles; Cunéo, Bernard

    2010-01-01

    Blood donations by populations from the Maghreb and Sub-Saharan Africa are a public health necessity for reasons of genetic polymorphism. This article aims to determine whether blood donors' social characteristics ? i.e. greater socio-economic integration and a strong sense of citizenship ? constitute deterrents to blood donation among foreign populations. Results show that donors from the Maghreb and Sub-Saharan Africa are not better integrated than non-donors from the same areas. However, blood donors express a significantly greater sense of citizenship than non-donors. Donors from the Maghreb and Sub-Saharan Africa feel a greater sense of citizenship than non-donors from the same areas. The study of blood donation in these categories of population has two major implications. In biological terms, blood donation by foreign populations constitutes a response to transfusion needs. In cultural terms, blood donation is used by populations from the Maghreb and Sub-Saharan Africa as an active means of expressing their sense of citizenship.

  11. Donation after circulatory death: burying the dead donor rule.

    PubMed

    Rodríguez-Arias, David; Smith, Maxwell J; Lazar, Neil M

    2011-08-01

    Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death.

  12. 25 CFR 900.99 - Who takes title to any land that is part of excess BIA or IHS real property donated to an Indian...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Who takes title to any land that is part of excess BIA or... Donation Procedures Bia and Ihs Excess Property § 900.99 Who takes title to any land that is part of excess... tribal organization requests donation of fee title to excess real property that includes land not held...

  13. Reevaluating Canada's policy for blood donations from men who have sex with men (MSM).

    PubMed

    Jubran, Bellal; Billick, Maxime; Devlin, Gabriel; Cygler, Jeremy; Lebouché, Bertrand

    2016-12-01

    During the HIV/AIDS epidemic of the 1980s, most of the developed world instituted a permanent ban on blood donations from men who have sex with men (MSM). In recent years, public health agencies across Europe and North America are reconsidering and rescinding these restrictions. We examine the Canadian climate, where MSM may donate blood only after a 5-year deferral period. We review circumstances of the initial ban on MSM blood donations and recent social, legal, and economic changes that have encouraged Canadian public health officials to consider policy reform. We also review international evidence about the impact of reforming MSM blood donations. Given improvements in HIV screening technology, results from mathematical modeling studies, and empirical data from Italy, the UK, and Australia, we conclude that changing Canada's MSM blood donation policy from a 5- to a 1-year deferral would not increase the number of transfusion-transmitted HIV infections. We provide empirical support to the recently elected Liberal Canadian government's political promise to decrease restrictions on MSM blood donations.

  14. Reevaluating Canada's policy for blood donations from men who have sex with men (MSM).

    PubMed

    Jubran, Bellal; Billick, Maxime; Devlin, Gabriel; Cygler, Jeremy; Lebouché, Bertrand

    2016-08-17

    During the HIV/AIDS epidemic of the 1980s, most of the developed world instituted a permanent ban on blood donations from men who have sex with men (MSM). In recent years, public health agencies across Europe and North America are reconsidering and rescinding these restrictions. We examine the Canadian climate, where MSM may donate blood only after a 5-year deferral period. We review circumstances of the initial ban on MSM blood donations and recent social, legal, and economic changes that have encouraged Canadian public health officials to consider policy reform. We also review international evidence about the impact of reforming MSM blood donations. Given improvements in HIV screening technology, results from mathematical modeling studies, and empirical data from Italy, the UK, and Australia, we conclude that changing Canada's MSM blood donation policy from a 5- to a 1-year deferral would not increase the number of transfusion-transmitted HIV infections. We provide empirical support to the recently elected Liberal Canadian government's political promise to decrease restrictions on MSM blood donations.

  15. First experience of liver transplantation with type 2 donation after cardiac death in France.

    PubMed

    Savier, Eric; Dondero, Federica; Vibert, Eric; Eyraud, Daniel; Brisson, Hélène; Riou, Bruno; Fieux, Fabienne; Naili-Kortaia, Salima; Castaing, Denis; Rouby, Jean-Jacques; Langeron, Olivier; Dokmak, Safi; Hannoun, Laurent; Vaillant, Jean-Christophe

    2015-05-01

    Organ donation after unexpected cardiac death [type 2 donation after cardiac death (DCD)] is currently authorized in France and has been since 2006. Following the Spanish experience, a national protocol was established to perform liver transplantation (LT) with type 2 DCD donors. After the declaration of death, abdominal normothermic oxygenated recirculation was used to perfuse and oxygenate the abdominal organs until harvesting and cold storage. Such grafts were proposed to consenting patients < 65 years old with liver cancer and without any hepatic insufficiency. Between 2010 and 2013, 13 LTs were performed in 3 French centers. Six patients had a rapid and uneventful postoperative recovery. However, primary nonfunction occurred in 3 patients, with each requiring urgent retransplantation, and 4 early allograft dysfunctions were observed. One patient developed a nonanastomotic biliary stricture after 3 months, whereas 8 patients showed no sign of ischemic cholangiopathy at their 1-year follow-up. In comparison with a control group of patients receiving grafts from brain-dead donors (n = 41), donor age and cold ischemia time were significantly lower in the type 2 DCD group. Time spent on the national organ wait list tended to be shorter in the type 2 DCD group: 7.5 months [interquartile range (IQR), 4.0-11.0 months] versus 12.0 months (IQR, 6.8-16.7 months; P = 0.08. The 1-year patient survival rates were similar (85% in the type 2 DCD group versus 93% in the control group), but the 1-year graft survival rate was significantly lower in the type 2 DCD group (69% versus 93%; P = 0.03). In conclusion, to treat borderline hepatocellular carcinoma, LT with type 2 DCD donors is possible as long as strict donor selection is observed.

  16. Metallo-Organic Decomposition (MOD) film development

    NASA Technical Reports Server (NTRS)

    Parker, J.

    1986-01-01

    The processing techniques and problems encountered in formulating metallo-organic decomposition (MOD) films used in contracting structures for thin solar cells are described. The use of thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) techniques performed at Jet Propulsion Laboratory (JPL) in understanding the decomposition reactions lead to improvements in process procedures. The characteristics of the available MOD films were described in detail.

  17. Essay Development and Organization for the GED Examination.

    ERIC Educational Resources Information Center

    Tubman, Alan

    Developed as a teaching aid for a General Educational Development (GED) preparation class, this essay writing guide gives students the tools they need to develop and organize ideas for writing an essay with confidence. By following a sequential procedure in this very structured approach, students learn to turn out a well-organized essay. The…

  18. The Organization for Economic Cooperation and Development

    DTIC Science & Technology

    2010-02-08

    in April 2009, the G-20 leaders indicated that they were adopting measures to curtail tax havens and to target “non-cooperative jurisdictions.” In...7 See The OECD’s Crocodile Tears at http://www.flyingfish.org.uk/articles/oecd/tears.htm The...financing of terrorism, terrorist acts and terrorist organizations; • Freeze and confiscate funds or other assets of terrorists, adopt measures which allow

  19. Organic Binder Developments for Solid Freeform Fabrication

    NASA Technical Reports Server (NTRS)

    Cooper, Ken; Mobasher, Amir A.

    2003-01-01

    A number of rapid prototyping techniques are under development at Marshall Space Flight Center's (MSFC) National Center for Advanced Manufacturing Rapid Prototyping Laboratory. Commercial binder developments in creating solid models for rapid prototyping include: 1) Fused Deposition Modeling; 2) Three Dimensional Printing; 3) Selective Laser Sintering (SLS). This document describes these techniques developed by the private sector, as well as SLS undertaken by MSFC.

  20. Public views on the donation and use of human biological samples in biomedical research: a mixed methods study

    PubMed Central

    Lewis, Celine; Clotworthy, Margaret; Hilton, Shona; Magee, Caroline; Robertson, Mark J; Stubbins, Lesley J; Corfield, Julie

    2013-01-01

    Objective A mixed methods study exploring the UK general public's willingness to donate human biosamples (HBSs) for biomedical research. Setting Cross-sectional focus groups followed by an online survey. Participants Twelve focus groups (81 participants) selectively sampled to reflect a range of demographic groups; 1110 survey responders recruited through a stratified sampling method with quotas set on sex, age, geographical location, socioeconomic group and ethnicity. Main outcome measures (1) Identify participants’ willingness to donate HBSs for biomedical research, (2) explore acceptability towards donating different types of HBSs in various settings and (3) explore preferences regarding use and access to HBSs. Results 87% of survey participants thought donation of HBSs was important and 75% wanted to be asked to donate in general. Responders who self-reported having some or good knowledge of the medical research process were significantly more likely to want to donate (p<0.001). Reasons why focus group participants saw donation as important included: it was a good way of reciprocating for the medical treatment received; it was an important way of developing drugs and treatments; residual tissue would otherwise go to waste and they or their family members might benefit. The most controversial types of HBSs to donate included: brain post mortem (29% would donate), eyes post mortem (35%), embryos (44%), spare eggs (48%) and sperm (58%). Regarding the use of samples, there were concerns over animal research (34%), research conducted outside the UK (35%), and research conducted by pharmaceutical companies (56%), although education and discussion were found to alleviate such concerns. Conclusions There is a high level of public support and willingness to donate HBSs for biomedical research. Underlying concerns exist regarding the use of certain types of HBSs and conditions under which they are used. Improved education and more controlled forms of consent for