Hospital Personnel in Surgical Services in a Transplant Hospital Faced With Living Liver Donation: An Attitudinal Survey

Attitudes Toward Living Organ Donation and Willingness to Be a Living Organ Donor Among Chinese Citizens in 3 Cities

OBJECTIVE

The level of awareness of living organ donation demonstrated by citizens may affect the rate of organ transplantation in their area of residence. The objective of this study was to assess the attitudes toward living organ donation and willingness to be a living organ donor among Chinese citizens.

METHODS

The study population consisted of 2250 citizens in Beijing, Shanghai, and Wuhan. Data were collected using a questionnaire developed by the researchers based on the existing literature and expert opinions. The questionnaire included questions designed to assess demographics, attitudes, and willingness. The data were analyzed using SPSS 22.0 software.

RESULTS

Overall, 2198 citizens completed the questionnaire, of whom 845 (38.4%) supported living organ donation; however, only 213 (9.6%) participants were supportive of their family members donating living organs. A total of 424 (19.3%) citizens were willing to be living organ donors. Of the respondents, 1173 (53.4%) were neutral toward living organ donation and 1463 (66.6%) were undecided about their willingness to donate. In addition, willingness was positively correlated with age, education level, income, marital status, and having descendants (P < .05). Those who had relatives or friends who had undergone organ transplantation were significantly more likely to be donors than those who did not (P < .05).

CONCLUSIONS

The results of our study suggest that Chinese citizens lack an understanding of living organ transplantation, indicating that more work needs to be done to inform the public about organ transplantation in China.

Factors influencing donor and recipient decision making in adult-to-adult living donor liver transplantation: a survey of a non-transplant population

BACKGROUND

This study aimed to (i) investigate the factors that influence donor and recipient decision making in adult-to-adult living donor liver transplantation (AALDLT); (ii) quantify the level of risk that would be acceptable to potential donors; and (iii) determine from whom an individual would be willing to receive a donation.

METHODS

A self-administered questionnaire using hypothetical scenarios centred on AALDLT was created and administered to participants recruited from the waiting room of an orthopaedic outpatient clinic at a teaching hospital in Sydney (n = 105). The questionnaire asked participants to consider scenarios in which they either (i) were a potential donor for a family member or close friend or (ii) themselves required a liver transplant.

RESULTS

Ninety-five (90%) participants expressed an in-principal willingness to consider living organ donation. The factors most important in deciding to be living liver donors were the probability of a good outcome for the recipient, the likelihood of the potential recipient's survival until a deceased donor liver became available and the risk of donor death. Donor death was also rated as the least acceptable donor outcome. Participants expressed a willingness to receive a donation from all proposed donor groups equally.

CONCLUSIONS

The acceptability of hypothetical living organ donation was very high in the population group studied. Participants were also willing to accept significantly higher risks of complications from organ donation than they would actually be exposed to. Clinicians should feel encouraged to discuss the risks and benefits of living donation frankly with patients and their families.

Live liver donation, ethics and practitioners: 'I am between the two and if I do not feel comfortable about this situation, I cannot proceed'

This paper discusses the views of 17 healthcare practitioners involved with transplantation on the ethics of live liver donations (LLDs). Donations between emotionally related donor and recipients (especially from parents to their children) increased the acceptability of an LLD compared with those between strangers. Most healthcare professionals (HCPs) disapproved of altruistic stranger donations, considering them to entail an unacceptable degree of risk taking. Participants tended to emphasise the need to balance the harms of proceeding against those of not proceeding, rather than calculating the harm-to-benefits ratio of donor versus recipient. Participants' views suggested that a complex process of negotiation is required, which respects the autonomy of donor, recipient and HCP. Although they considered that, of the three, donor autonomy is of primary importance, they also placed considerable weight on their own autonomy. Our participants suggest that their opinions about acceptable risk taking were more objective than those of the recipient or donor and were therefore given greater weight. However, it was clear that more subjective values were also influential. Processes used in live kidney donation (LKD) were thought to be a good model for LLD, but our participants stressed that there is a danger that patients may underestimate the risks involved in LLD if it is too closely associated with LKD.

Emotional-type psychopathologic symptoms among patients with terminal chronic alcohol-induced liver cirrhosis

INTRODUCTION

Patients with toxic substance abuse syndrome, such as alcohol abuse, have elevated psychopathologic morbidity and mortality such as mood disorders.

OBJECTIVE

To evaluate the emotional-type psychopathologic symptoms in patients with alcohol-induced hepatic cirrhosis on the liver transplant waiting list.

MATERIALS AND METHODS

Patients with alcoholic liver cirrhosis who were candidates for liver transplant (n = 41) completed the SA-45 questionnaire (González y Cuevas; 88), which assesses nine dimensions: somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A control group consisted of patients with chronic nonalcoholic terminal hepatopathies (n = 22).

RESULTS

Seventy-six percent of patients had some kind of psychopathologic symptom compared to 68% of the patients in the control group with other nonalcoholic etiologies (P > .05). The emotional-type clinical symptoms were: (1) somatizations: 37% of patients with alcoholic cirrhosis had this type of clinical symptoms compared to 32% of the control group (P > .05); (2) obsessive-compulsivity: 56% versus 46%, respectively (P > .05); (3) interpersonal sensitivity: 19% versus 9%, respectively (P > .05); (4) depression: 54% versus 27%, respectively (P = .045); (5) anxiety: 59% versus 46%, respectively (P > .05); (6) hostility: 29% versus 5%, respectively (P = .021); (7) phobic anxiety: 10% versus 14%, respectively (P > .05); (8) paranoid Ideation: 7% versus 5%, respectively (P > .05); (9) psychoticism: 5% versus 4%, respectively (P > .05).

CONCLUSIONS

The patients with alcoholic liver cirrhosis on the liver transplant waiting list had elevated psychopathologic symptoms. Depressive- and hostile-type emotional alterations were most frequent in this type of patients.