Evaluation of Attitude toward Living Organ Donation among Adolescents in Southeast Spain

Attitude of the Older Population Toward Controlled Asystole Donation

INTRODUCTION

Studies about the knowledge of and attitude toward new lines of organ donation in a group of older people are important due to the increase in older organ donors.

OBJECTIVES

To analyze the attitude of citizens over 65 years of age in southeastern Spain toward controlled asystole donation (CAD) and to determine the psycho-social profile that influences this attitude.

METHODS

The study population consisted of citizens over 65 years of age. A representative sample was obtained in southeastern Spain (N = 420). A questionnaire about attitudes toward CAD was used, detailing in the questionnaire that this is a type of donation from people who have died of circulatory and respiratory criteria after the limitation of life support treatment. Several psychosocial variables were also taken into account. Statistical analysis included the χ2 test and multivariate analysis.

RESULTS

The completion rate was 84% (n = 351). Favorable attitude toward organ donation and transplantation (ODT) was 98% (n = 344) overall, and CAD was viewed favorably by 45% (n = 158). The psychosocial variables that influenced attitude toward CAD were mainly having received a talk about ODT (odds ratio [OR] 5.6), knowing the opinion of one's partner (OR 7.95), acceptance of cremation (OR 1.09), and acceptance of autopsy (OR 3.002).

CONCLUSIONS

The attitude of older people toward CAD is unfavorable despite a willingness to support ODT in general. This attitude is influenced by variables of social and family dialogue about ODT, attitude to body manipulation, and having received information about ODT.

Sex and Gender Disparities in Living Kidney Donation: A Scoping Review

Background

Women are more likely than men to be living kidney donors. We summarized the evidence concerning the reasons behind sex and gender disparities in living kidney donation (LKD).

Methods

A scoping review of quantitative and qualitative evidence on reasons for sex and gender disparities in LKD was conducted from inception to March 2023.

Results

Of 1123 studies screened, 45 were eligible for inclusion. Most studies were from North America, Europe, and Central Asia (n = 33, 73%). A predominance of women as living donors (55%-65%) was observed in 15 out of 18 (83%) studies. Reasons for sex and gender disparities in LKD included socioeconomic, biological, and cognitive or emotional factors. A gendered division of roles within the families was observed in most studies, with men being the primary income earner and women being the main caregiver. Fear of loss of income was a barrier to male donation. Human leukocyte antigen sensitization through pregnancy in female recipients precluded male partner donation, whereas female donation was supported by altruism and a positive attitude toward LKD.

Conclusions

Sex imbalance in LKD is prevalent, with a predominance of women as living donors. Such disparities are driven by societal and cultural perceptions of gender roles, pregnancy-induced sensitization, and attitudes toward donation and at least some of these factors are modifiable. Donor compensation to support predonation assessments and income loss, implementation of innovative desensitization treatments, promotion of paired kidney exchange program, and targeted educational initiatives to promote equitable living donation may help to close the gender gap in LKD.

Film Creation for Education on Concepts Related to Religion, Immigration, and Legislation in the Field of Organ Donation and Transplantation

BACKGROUND

In education, we can use cinema to create methodologies that develop the critical thinking to acquire knowledge in a collaborative way. Favorable attitudes toward organ donation and transplantation (ODT) is low in adolescents. Working on topics related to ODT, such as religion, immigration, and the law, can help to improve students' knowledge and endear them toward ODT with innovative educational methodologies.

OBJECTIVES

This study aims to analyze the change in knowledge about religion, immigration, and legislation on ODT after an educational proposal based on film creation.

METHODS

In this study, 16-year-old students participated in an educational proposal based on ODT education through filmmaking. A total of 543 students participated in the experimental group, and 320 participated in the control group. A validated ODT knowledge form was administered to both groups. Statistical analysis was carried out with SPSS version 21.0 package (SPSS, Inc, Chicago, IL, USA). A descriptive analysis and χ² test were performed to analyze the differences between the experimental group and control group. P < .05 was considered statistically significant.

RESULTS

The study had a 72% participation rate in the experimental group. After receiving the educational proposal, the students presented a greater knowledge with respect to the control group in all aspects: the position of the different religions in relation to organ donation, knowledge of the rights and obligations of immigrants in relation to the ODT, and knowledge of the law of presumed consent in ODT CONCLUSIONS: Working in the classroom on psychosocial aspects such as religion, immigration, and legislation through filmmaking can favorably influence the adolescent's awareness of organ donation.

The Audiovisual Creation in Educational Proposals on Organ Donation: Attitude Towards Organ Donation and Transplantation of Secondary School Teachers

BACKGROUND

Audiovisual creation allows teachers and students to become consumers and producers of information, creating collaborative environments. In the field of organ donation and transplantation (ODT), most of the educational proposals analyzed to date consist of presentations. The teacher does not usually have a decisive role in this type of methodologies, in addition to not having the appropriate training to be able to participate actively.

OBJECTIVES

To analyze the change in teachers' attitudes towards ODT after participating in an educational proposal based on the creation of short films.

METHODS

Teachers of secondary education in ten schools in southeastern Spain. The proposal consisted in the creation of short films based on topics related to ODT by the students. A validated ODT attitude form was administered to teachers at the beginning of the proposal and at the end of the proposal. A descriptive analysis was carried out together with McNemar test was used to compare the pre and post test results of the teacher. P < .05 was considered statiscally significant.

RESULTS

The favorable attitude towards organ donation at death increased after the proposal (64% vs 88%; P = .008). Favorable attitude towards organ donation from a relative also improved (52% vs 76%; P = .008), as did favorable attitude towards living kidney donation (52% vs 88%; P < .001), living liver donation (36% vs 85%; P = .008) and xenotransplantation (45% vs 82%; P < .001).

CONCLUSIONS

The teachers improves after an educational proposal based on the creation of short films related to ODT.

Factors Influencing Decision Making About Living Donation Among Medical Students

AIM

This study aimed to assess the factors influencing decision making about living donation among medical students.

METHOD

Three standardized survey questionnaires (the Altruism Questionnaire A-N, the Individual Questionnaire for studying approaches to transplantology, the Interpersonal Reactivity Index) were used among 316 students of nursing and paramedics.

RESULTS

Nearly all the respondents (98%) approve cell transplantation, tissue transplantation, and organ transplantation if obtained from living donors. Of the respondents, 66% would consent to donate bone marrow, and 26% would give their consent only in specific situations. Most respondents reported to be encouraged to donate organs by the ability to help other people (56%), while their refusal would be because of the fear of undergoing medical procedures (13%). Older age and a higher score in the personal distress subscale are correlated with a lack of consent to donate bone marrow for transplantation. In the case of living organ donation, the increase in the scores in the fantasy scale caused a higher chance for consent to living donation, whereas older age was the predictor of lack of consent. Higher scores in the perspective taking subscale were found to be significantly correlated with fear of surgical treatment as the reason for refusing to give one's consent to living donation. The belief that willingness to become a donor shows a person who has a sense of prosocial behavior was influenced by the fantasy and the empathic concern subscales.

CONCLUSIONS

The study group approves cell transplantation, tissue transplantation, and organ transplantation from living donors. These attitudes are determined by empathic behavior.

Attitude of Older People Toward Living Donation

BACKGROUND

Living donation is a potential source of organs that could help to reduce the organ transplant deficit. Given that we have a worldwide aging population, it is important to assess the opinion of older people toward this type of donation.

OBJECTIVES

To analyze the attitude of people aged > 65 years toward living kidney donation (LKD) and living liver donation (LLD) and to investigate the variables affecting their attitudes.

METHODS

A multicentric study was carried out using a representative sample of people > 65 years stratified by sex and geographic location in southeastern Spain (n = 420). The measurement instrument was a validated questionnaire about LKD and LLD. Statistics were analyzed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software. Descriptive analysis was carried out using Student t test, χ² test, and a multivariate analysis.

RESULTS

The questionnaire completion rate was 84% (n = 351) with 88% (n = 310) in favor of LKD, and 89% (n = 311) in favor of LLD. Favorable attitude decreased to 3% when the donation under consideration was unrelated. Attitudes toward LKD and LLD were associated with having received information from the television (P = .016 and P = .045) and from friends (P = .017 and P = .03); accepting an autopsy after death (P = .001 and P = .002); and not being worried about scars (P = .015 and P = .044). In the multivariate analysis, the following variables continued to be significant: having received information from the television (odds ratio [OR], 2) and from friends (OR, 10.3); and the acceptance of an autopsy (OR, 2).

CONCLUSIONS

Older people are in favor of both LKD and LLD, assuming it is a related donation. In addition, the information the elderly population receives regarding organ donation and transplantation affects their attitudes.

Psychological profile of teenagers toward organ donation: a multicentric study in Spain

Background

It is important for teenagers to have a favorable attitude toward organ donation and transplantation (ODT) in order to increase the number of future donors. To determine the attitude of teenagers in the South East of Spain toward ODT and to analyze the psychosocial variables related to this attitude.

Methods

The study population consisted of young teenagers in the South East of Spain. A stratified sample was selected by geographical location, sex and age (n = 4, 117). Attitude was assessed using a validated questionnaire about ODT (PCID-ODT Ríos). Statistical analysis: Student’s t-test, Chi-squared test and a multivariate analysis.

Results

The questionnaire completion rate was 87% (n = 3572). Attitude toward ODT was favorable in 46% of cases (n = 1633) and undecided in 43% (n = 1543). Several psychosocial variables had a favorable effect on donation: believing that one has good information about ODT (Odds Ratio [OR] 1.706); discussing the subject with the family (OR 1.543) and friends (OR 1.818); carrying out pro-social activities (OR 1.642); having a favorable attitude toward cremation (OR 1.466) and autopsy (OR 1.470); and, finally, not being afraid of scars (OR 4.184).

Conclusions

Teenagers in the South East of Spain are not currently inclined to support organ donation. This attitude is related to many psychosocial factors, mainly connected to not having good information about the subject, not discussing it in social circles and the fear of body mutilation. It would be appropriate to create educational interventional strategies in this group to prevent a negative impact on future donation rates.

Body image in transplant recipients and living organ donors

PURPOSE OF REVIEW

The purpose of this article is to describe the current evidence regarding the prevalence and significance of concerns about body image in transplant recipients and organ donors.

RECENT FINDINGS

Body image and organ integration concerns have been reported as main themes in the psychological adaptation to transplantation. Their prevalence, severity, description and impact vary wildly. There is a lack of validated instruments to measure body image or organ integration in transplant patients. For organ recipients, satisfaction with body image depends on the organ, genre, pretransplant medical illness, time since transplantation and post-transplant medication regimen. Complete or partial denial of the graft is frequently reported. For organ donors, body image is influenced by the type of surgical incision. There is little evidence that body image or organ integration impact medical or psychological outcomes after transplantation or organ donation.

SUMMARY

Body image is becoming a significant component of measuring the quality of life in transplant patients. Body image may become a factor in decisions about if and when to pursue transplant for nonlife-threatening conditions (e.g. face transplantation), about the type of incision or about the immunosuppressant regimen. For mental health professionals, understanding the complexities of body image and organ integration will help enhance the assistance provided before and after transplant or donation.

Characteristics of potential living kidney donors and recipients: donor disqualification reasons--experience of a Polish center

INTRODUCTION

Kidney transplantation is efficacious as a renal replacement, particularly pre-emptive living donation. In Poland, the rate of transplantation of living donor kidneys is only 3%. The aim of the study was to identify the most common reasons to disqualify a potential living kidney donor.

METHODS

We evaluated 124 kidney donor candidates for 111 potential recipients at 1 medical center for genders and ages of donor and recipient; thus relation, donor disqualification reasons, number of potential donors for a particular recipient, prior transplantations, and kidney vasculature.

RESULTS

The 111 recipients of ages 2-62 years had, 1, 2, or 3 potential donors were tested in 101, 1, and 7, cases respectively. We had 18.9% recipients referred for pre-emptive transplantation; 59.5% were on haemodialysis and 21.6% on peritoneal dialysis. In all, 89% recipients sought first kidney transplantations. Kidneys were procured from 49/124 (39.5%) of the initially evaluated donors. The full examination was completed by 92 potential donors with 68/124 donors disqualified early. Single and multiple renal arteries were detected in 56 and 36 potential donors, respectively. Donor disqualification was due to medical contraindications (39.7%), earlier transplantation from a deceased donor (25%), immunologic constraints (23.5%), donor consent withdrawn (6%) or psychological and social reasons (4.4%).

CONCLUSIONS

A considerable number of donor candidates are disqualified for medical reasons.

Public awareness and attitudes to living organ donation: systematic review and integrative synthesis

BACKGROUND

The deceased-donor organ shortage has driven widespread adoption of living-donor transplantation. Yet, public views on living donation are not well understood. This study aims to synthesize studies on public awareness and attitudes toward living organ donation.

METHODS

Electronic databases and reference lists were searched to September 2012. Summary estimates from survey data were obtained by random effects meta-analysis. Qualitative descriptive synthesis of each study was performed.

RESULTS

Forty-seven studies involving 34,610 respondents were included. The proportion of respondents aware of living organ donation was 76.7% (4 studies, n=3248; 95% confidence interval, 46.2%-97.0%; I=99.7%). The majority were in favor of living directed donation (85.5% (11 studies, n=15,836; 95% confidence interval, 81.6%-89.6%; I=98%), with recipient and community benefit as the rationale provided. However, barriers included fear of surgical and health risks, lack of knowledge, respect for cultural norms, financial loss, distrust in hospitals, and avoiding recipient indebtedness. The public voiced concern about possible risks or an obligatory pressure exerted on the donor. Many supported reimbursement for out-of-pocket expenses, paid leave, wait-listing priority, health insurance, and donor acknowledgment. There was strong opposition to financial incentives, which they believed risked exploitation and inequity and diminished voluntary altruistic donation.

CONCLUSIONS

The public is generally supportive of living donation and articulated important equity and ethical considerations for protecting the health and safety of living donors. This supports increased public engagement and strengthening of a shared view among professionals and the public in living donation practice and policy.