Attitude Toward Living Kidney Donation: Differences Between Students From Two Spanish Universities

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.

Veterinary Students' Attitude Toward Living Kidney Donation: A Multicenter Stratified Study From Spain

Living kidney related donations (LKRD) should be promoted because of the current deficit of organs for transplantation. The objective of the study was to analyze the attitude of Spanish veterinary students toward LKRD, because they may influence public opinion in the future, and to determine the factors that condition it.

METHODS

A sociological, interdisciplinary, multicenter, and observational study was carried out in the veterinary students enrolled in Spain (n = 9000) in the university academic year 2010-2011. A sample of 2815 students was stratified by geographical area and academic year. The students' attitude toward LKRD was assessed using a psychosocial validated questionnaire (PCID-DVR Rios), was self-administered, and was completed anonymously. Veterinary schools were randomly selected. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis was preformed using t test, χ² test, and logistic regression analysis.

RESULTS

The completion rate was 95% (n = 2683); 93% (n = 2504) were in favor of LKRD and 36% (n = 945) supported unrelated living kidney donation. The following variables were associated with having a more favorable attitude: (1) sex (P < .001), (2) being a student of southern universities (P = .03), (3) attitude toward deceased donation (P < .001), (4) having a father (P < .001) or a mother (P < .001) in favor of organ donation, and (5) having discussed the subject with friends (P = .03) or family (P = .02). However, only 60% would accept a kidney from a relative.

CONCLUSION

Spanish veterinary students have a favorable attitude toward LKRD. However, only 60% would accept a kidney from a relative.

What Do Future Nursing Professionals Believe About Living Donor Kidney Transplantation? An Analysis of Attitudes of Nursing Students of the Medical University of Poznan in Western Poland

BACKGROUND

Living donor kidney transplantation (LDKT) is the best treatment option in the late stage of chronic kidney disease. The objective of the study was to analyze the attitudes of nursing students at the Medical University of Poznan toward living donation of kidney.

METHODS

Sampling points were compulsory attendance in the 5 nursing courses of the degree of fulfilment of 80%. The validated questionnaire (PCID-DVR Rios) was self-administered and anonymous.

RESULTS

The completion rate was 92% (324 of 354). Among the students, 91% (n = 296) were in favor of LDKT, 5% (n = 15) were undecided, and 4% (n = 11) remained is against. When the living kidney donor is not related, 57% (n = 185) of respondents were in favor. The factors that are associated with a more favourable attitude are 1) the needs of organs for transplantation are covered (P = .012); 2) attitude in favor of organ donation and transplantation (P ≤ .001); 3) attitude toward living liver donation (P = .001); 4) attitude in favor of acceptance of LDKT for a relative (P ≤ .001); 5) discussing organ donation and transplantation with friends (P = .002); and 6) attitude in favor of organ donation from a family member (P = .011). In the multivariate analysis, highlights are acceptance of the donation of a living kidney donor from a family member [OR = 9.900 (35.714-2.770); P ≤ .001] and donating a piece of liver in life [OR = 50 (166.666-14.492); P ≤.001].

CONCLUSIONS

Among the nursing students, 91% are in favor of living kidney donation.