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Griffin CP, Bowen JR, Walker MM, Lynam J, Paul CL. Understanding the value of brain donation for research to donors, next-of-kin and clinicians: A systematic review. PLoS One 2023; 18:e0295438. [PMID: 38117774 PMCID: PMC10732432 DOI: 10.1371/journal.pone.0295438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 12/22/2023] Open
Abstract
PURPOSE Post-mortem brain donation affords the opportunity to characterise disease by exploring global neuropathological changes. Such opportunities are essential to progress knowledge of CNS tumours such as Glioblastoma. A comprehensive understanding of the experience of consenting to brain donation is crucial to maximising consent rates while providing patient-centred care. This review aimed to synthesise the reported facilitators and barriers according to potential donors, next-of-kin (NOK) and clinician respondents. DESIGN Database searches included Embase, Medline, PsycINFO, Psychology and Behavioural Science and Scopus. Search terms focused on motivations, attitudes and psychosocial experiences of brain donation. Exclusions included organ transplantation and brain death. All studies were assessed for quality and validity using tools from the Joanna Briggs Institute. To determine perceptions of benefit and harm, a method guided by the thematic analysis of Braun and Clarke was employed to reflexively assess and identify common themes and experiences. RESULTS 40 studies (15 qualitative, 25 quantitative) were included involving participants with paediatric cancer, neurodegenerative and psychological diseases. Perceptions of benefit included benefit to future generations, aiding scientific research, avoidance of waste, improved treatments and the belief that donation will bring consolation or aid in the grieving process. Perceptions of harm included a perceived conflict with religious beliefs, disfigurement to the donor, emotional distress at the time of autopsy and discord or objections within the family. CONCLUSION Brain donation can afford a sense of purpose, meaning and empowerment for donors and their loved ones. Careful strategies are required to mitigate or reduce potential harms during the consent process.
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Affiliation(s)
- Cassandra P. Griffin
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jenna R. Bowen
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Marjorie M. Walker
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
| | - James Lynam
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Department of Medical Oncology, Calvary Mater, Newcastle, NSW, Australia
| | - Christine L. Paul
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Priority Research Centre Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, Australia
- Priority Research Centre Health Behaviour, University of Newcastle, Callaghan, Australia
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Cotrău P, Negrău M, Hodoșan V, Vladu A, Daina CM, Dulău D, Pantiș C, Daina LG. Organ Donation Awareness among Family Members of ICU Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1966. [PMID: 38004015 PMCID: PMC10673166 DOI: 10.3390/medicina59111966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: With one of the lowest donation rates in the European Union, Romania faces challenges in organ donation from brain death donors, within an opt-in system. This study aims to measure the attitudes and knowledge of ICU patient's relatives toward organ donation. Materials and Methods: A descriptive cross-sectional study was conducted in the intensive care unit of the Emergency Clinical County Hospital of Oradea, Romania. A 24-item self-administered questionnaire (N = 251) was used to collect data on knowledge about organ and tissue donation and transplantation, as well as the willingness to donate. Results: A high degree of awareness and willingness for organ donation and transplantation was recorded. The main positive predictor of willingness to donate was the perception of helping others by donating their organs after brain death (β = 0.537, OR = 1.711, p < 0.05), and the main negative predictor was the idea that the whole body should be buried intact (β = -0.979, OR = 0.376, p < 0.01). Conclusions: A basic understanding of organ donation and transplantation and favorable attitudes toward organ donation were registered. Families' interviews for organ donation consent may be affected due to extreme emotional distress.
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Affiliation(s)
- Petru Cotrău
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania; (V.H.); (A.V.); (D.D.)
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
| | - Marcel Negrău
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410087 Oradea, Romania
| | - Viviana Hodoșan
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania; (V.H.); (A.V.); (D.D.)
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
| | - Adriana Vladu
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania; (V.H.); (A.V.); (D.D.)
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
| | - Cristian Marius Daina
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410097 Oradea, Romania
| | - Dorel Dulău
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania; (V.H.); (A.V.); (D.D.)
| | - Carmen Pantiș
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410087 Oradea, Romania
| | - Lucia Georgeta Daina
- Emergency Clinical County Hospital of Oradea, 410169 Oradea, Romania; (M.N.); (C.M.D.); (C.P.); (L.G.D.)
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410097 Oradea, Romania
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Englbrecht JS, Schrader D, Kraus H, Schäfer M, Schedler D, Bach F, Soehle M. How Large is the Potential of Brain Dead Donors and what Prevents Utilization? A Multicenter Retrospective Analysis at Seven University Hospitals in North Rhine-Westphalia. Transpl Int 2023; 36:11186. [PMID: 37252613 PMCID: PMC10211426 DOI: 10.3389/ti.2023.11186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023]
Abstract
Organ donation after brain death is constantly lower in Germany compared to other countries. Instead, representative surveys show a positive attitude towards donation. Why this does not translate into more donations remains questionable. We retrospectively analyzed all potential brain dead donors treated in the university hospitals of Aachen, Bielefeld, Bonn, Essen, Düsseldorf, Cologne and Münster between June 2020 and July 2021. 300 potential brain dead donors were identified. Donation was utilized in 69 cases (23%). Refused consent (n = 190), and failed utilization despite consent (n = 41) were reasons for a donation not realized. Consent was significantly higher in potential donors with a known attitude towards donation (n = 94) compared to a decision by family members (n = 195) (49% vs. 33%, p = 0.012). The potential donor´s age, status of interviewer, and the timing of the interview with decision-makers had no influence on consent rates, and it was comparable between hospitals. Refused consent was the predominant reason for a donation not utilized. Consent rate was lower than in surveys, only a known attitude towards donation had a significant positive influence. This indicates that survey results do not translate well into everyday clinical practice and promoting a previously documented decision on organ donation is important.
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Affiliation(s)
| | | | | | | | | | - Friedhelm Bach
- Protestant Hospital Bethel (EvKB), Bielefeld, Germany
- Medical School OWL, Bielefeld University, Bielefeld, Germany
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Murakami M, Yamazaki H, Suzuki T, Soejima Y, Ishizuka O, Kamijo Y. Newspaper Campaign to Promote Deceased Organ Donation: Who Can Appeal to the General Japanese Population? Transplant Proc 2023; 55:268-273. [PMID: 36822886 DOI: 10.1016/j.transproceed.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Various interventions are reportedly effective in promoting organ donor registration. However, the identity of those who best serve as presenters to appeal to the general public is not known. METHODS A campaign for organ donor registration was conducted through a local newspaper advertisement in Japan. The advertisement appeared in 439,733 copies of the newspaper on January 9, 2021. In addition to the main message, 6 different presenters with photos of their faces and quick response codes were listed in the advertisement, namely a urologist, transplant physician, nephrologist, dialysis physician, ophthalmologist, and kidney transplant recipient who was a nephrologist himself (ie, a recipient and nephrologist). Newspaper readers watched each video about deceased organ donation via the quick response codes, and the number of video views acquired 30 days after the appearance was the main outcome, which was assessed using YouTube analytics. The proportions (95% CI) of people who watched each video among 439,733 newspaper readers were compared among the 6 presenters. RESULTS The analyzed videos were viewed 262 times. The video produced by the recipient and nephrologist had the highest number of views among the 6 presenters (proportion: 0.019% [95% CI, 0.015-0.023]), followed by the one produced by the dialysis physician (0.011% [95% CI, 0.008-0.014]), the nephrologist (0.010% [95% CI, 0.007-0.014]), the urologist (0.008% [95% CI, 0.006-0.012]), the transplant physician (0.006% [95% CI, 0.004-0.009]), and the ophthalmologist (0.005% [95% CI, 0.004-0.008]). CONCLUSIONS The appeal by the recipient and the nephrologist reached the highest proportion of people who watched the video about deceased organ donation in Japan.
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Affiliation(s)
- Minoru Murakami
- Department of Nephrology, Saku Central Hospital, Nagano, Japan; Patient Driven Academic League (PeDAL), Tokyo, Japan.
| | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Yuji Soejima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Nagano, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Nagano, Japan
| | - Yuji Kamijo
- Department of Nephrology, Shinshu University School of Medicine, Nagano, Japan
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The New Age of Organ Donation-What Factors Have an Influence on the Attitude of Older People? An Attitudinal Survey in Southeastern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148524. [PMID: 35886383 PMCID: PMC9316408 DOI: 10.3390/ijerph19148524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/08/2022] [Indexed: 02/05/2023]
Abstract
Currently, more than half of all donors are aged over 65 years, and previous studies have shown that this group is less willing to support organ donation. Objective: to analyse the attitude of people aged over 65 years toward organ donation and transplantation (ODT) and to determine how their psychosocial profile affects their attitude. Study population: citizens residing in southeastern Spain older than 65 years of age. A representative sample was obtained, which was stratified by gender and geographical location (n = 420). A validated questionnaire about ODT was used. Statistical analysis: a bivariate analysis was performed using the X2 test and a multivariate analysis. The favourable attitude toward the donation of one’s own organs was 53%. The psychosocial variables affecting attitude were mainly: having discussed ODT with one’s family (p < 0.001) or friends (OR 2.223), acceptance of cremation (OR 2.508), and acceptance of an autopsy (OR 2.578). Citizens aged over 65 tend to have an unfavourable attitude toward the donation of their own organs. The lack of dialogue about ODT in social and family settings, and the attitude to the manipulation of one’s own body after death, are aspects of a respondent’s psychosocial profile, which influence this attitude.
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Molina-Pérez A, Delgado J, Frunza M, Morgan M, Randhawa G, de Wijdeven JRV, Schicktanz S, Schiks E, Wöhlke S, Rodríguez-Arias D. Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe. Transplant Rev (Orlando) 2021; 36:100673. [PMID: 34864448 DOI: 10.1016/j.trre.2021.100673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
GOAL To assess public knowledge and attitudes towards the family's role in deceased organ donation in Europe. METHODS A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection were performed by two or more independent reviewers for each record. RESULTS Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. CONCLUSIONS Public views on the authority of the family in organ donation decision-making requiere further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation.
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Affiliation(s)
- Alberto Molina-Pérez
- Institute for Advanced Social Studies, Spanish National Research Council, Cordoba, Spain; Public Issues working group, ELPAT-ESOT, Padova, Italy.
| | - Janet Delgado
- Public Issues working group, ELPAT-ESOT, Padova, Italy; Department of Philosophy 1, University of Granada, Granada, Spain
| | - Mihaela Frunza
- Department of Philosophy, Faculty of History and Philosophy, Babes-Bolyai University of Cluj, Cluj, Romania
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King's College London, United Kingdom
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, England, United Kingdom
| | | | - Silke Schicktanz
- Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Eline Schiks
- Department of Policy, Dutch Transplant Foundation, Leiden, the Netherlands
| | - Sabine Wöhlke
- Department of Health Sciences, HAW-Hamburg, Hamburg, Germany
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Schmidt S, Ghouzi A, Petrov G, Hofmann N, Boergel M, Sixt SU. Cornea donation in Germany: Obtaining consent. Clin Transplant 2020; 34:e13895. [DOI: 10.1111/ctr.13895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/08/2020] [Accepted: 04/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - George Petrov
- Department of Anesthesiology University Hospital of Duesseldorf Duesseldorf Germany
| | - Nicola Hofmann
- German Society for Tissue Transplantation Hannover Germany
| | - Martin Boergel
- German Society for Tissue Transplantation Hannover Germany
| | - Stephan Urs Sixt
- German Society for Tissue Transplantation Hannover Germany
- Department of Anesthesiology University Hospital of Duesseldorf Duesseldorf Germany
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Murakami M, Fukuma S, Ikezoe M, Izawa S, Watanabe H, Yamaguchi H, Kitazawa A, Takahashi K, Natsukawa S, Fukuhara S. Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan. Ann Transplant 2020; 25:e918936. [PMID: 31896742 PMCID: PMC6977621 DOI: 10.12659/aot.918936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Although knowledge is an important factor that influences decisions regarding deceased organ donation, the associations of knowledge with attitude and behavior regarding organ donation remain uncertain in countries with low organ donation rates like Japan. Material/Methods We conducted a cross-sectional survey of hospital medical and non-medical staff in 15 Japanese medical facilities. The questionnaire included items on knowledge, attitude, and behavior toward deceased organ donation and transplantation. Participants were divided into 3 groups according to the tertile of knowledge score. Modified Poisson regression models were used for associations of knowledge score with organ donor registration and willingness to become an organ donor after death. Results Of the 1967 staff, 1275 returned the questionnaires (response rate, 64.8%). There were 1190 study subjects with complete data for analysis. For the lowest (n=512), middle (n=428), and highest (n=250) tertile knowledge groups, the proportions of participants who registered and expressed willingness to donate organs were 20.1%, 23.4%, and 28.4% and 31.1%, 38.3%, and 44.0%, respectively. The adjusted proportion ratios for organ donor registration were 0.90 (95% CI, 0.73–1.10) for the middle and 1.00 (0.80–1.26) for the highest tertile of knowledge, compared with the lowest tertile. However, participants with the highest tertile of knowledge score expressed higher willingness for organ donation than the lowest tertile (adjusted proportion ratio, 1.37; 95% CI, 1.13–1.66). Conclusions For hospital staff in Japanese medical facilities, high knowledge about organ donation and transplantation was not associated with donor registration, but was associated with willingness to become an organ donor.
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Affiliation(s)
- Minoru Murakami
- Department of Healthcare Epidemiology, School of Public Health in The Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | - Shingo Fukuma
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaya Ikezoe
- Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | | | | | | | | | - Katsusada Takahashi
- Saku Central Hospital Health Services Facility for The Elderly, Nagano, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in The Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
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Reluctance and Willingness for Organ Donation After Death Among the Slovene General Population. Zdr Varst 2019; 58:155-163. [PMID: 31636723 PMCID: PMC6778422 DOI: 10.2478/sjph-2019-0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 07/29/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction The paper presents the findings of the first large-scale survey on post-mortem organ donation among the general Slovenian population. It focuses on the reported donation willingness, the barriers to joining the register of organ donors and the position towards consent to donate organs of deceased relatives. Methods A face-to-face survey was conducted on a probability sample of 1,076 Slovenian residents between October and December 2017. The performed analyses included estimations of means and proportions for target variables, an evaluation of between-group differences and a partial proportional odds model to study the relations between organ donation willingness and socio-demographic characteristics. Results The mean reported willingness to donate one’s own organs after death was 3.77 on a 5-point scale, with less than a third of respondents claiming to be certainly willing. Only 6% of those at least tentatively willing to donate organs were certain to join the register of organ donors in the future. The most frequently reported barriers to registration were unfamiliarity with the procedure and a lack of considering it beforehand. The reported willingness to donate organs of a deceased relative strongly depended on the knowledge of the relative’s wishes, yet 80% of the respondents did not discuss their wishes with any family members. Conclusions The findings confirm the gap between the reported donation willingness and joining the register of donors. Future post-mortem organ donation strategies need to consider socio-demographic and attitudinal factors of donation willingness and help stimulate the communication about organ donation wishes between family members.
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Keel I, Schürch R, Weiss J, Zwahlen M, Immer FF. Is there an association between consent rates in Swiss hospitals and critical care staffs' attitudes towards organ donation, their knowledge and confidence in the donation process? PLoS One 2019; 14:e0211614. [PMID: 30735508 PMCID: PMC6368376 DOI: 10.1371/journal.pone.0211614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/17/2019] [Indexed: 11/19/2022] Open
Abstract
This study investigated the critical care staff’s attitude, knowledge and involvement with donation, skills and confidence with donation-related tasks and their association with consent rates at the hospital level. In 2015, we conducted a cross-sectional survey among critical care staff of hospitals involved in organ donation using an anonymous online questionnaire with a response rate of 56.4% (n = 2799). The hospital level consent rate was obtained from the Swiss Monitoring of Potential Donors database (2013–2015). For each hospital, we calculated a mean score for each predictor of interest of the Hospital Attitude Survey and investigated the association with hospital consent rates with generalized linear mixed-effect models. In univariable analysis, one score point increase in doctors' confidence resulted in a 66% (95% CI: 45%–80%) reduction in the odds to consent, and one score point increase in nurses' attitudes resulted in a 223% (95% CI: 84%–472%) increase in the odds to consent. After simultaneously adjusting for all major predictors found in the crude models, only levels of education of medical and nursing staff remained as significant predictors for hospital consent rates. In Switzerland, efforts are needed to increase consent rates for organ donation and should concentrate on continuous support as well as specific training of the hospital staff involved in the donation process.
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Affiliation(s)
- Isabelle Keel
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Roger Schürch
- CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Julius Weiss
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Franz F. Immer
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
- * E-mail:
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Ashkenazi T, Steinberg A, Cohen J. A National Survey of Attitudes of the Zionist Ultra-Orthodox Community in Israel to Organ Donation. Prog Transplant 2019; 29:43-47. [PMID: 30599807 DOI: 10.1177/1526924818817062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Council of the Chief Rabbinate formally accepted neurologically declared death as an indication of death for all legal and religious purposes following changes made to practice parameters in order to comply with Jewish Law (halacha). This removed Jewish-legal barriers for organ donation. We surveyed the Zionist ultra-Orthodox community to identify the reasons for their continued reluctance to donate. METHODS A questionnaire was designed to assess personal, cultural, religious, and system-related considerations relating to organ donation. A telephone survey of persons identifying themselves with the Zionist ultra-Orthodox community was conducted to include 300 respondents (150 males and 150 females). RESULTS The response rate was 5.5% (300 of 6799 approached). While most participants (79%) agreed that organ donation improved or saved lives, a minority (25%) expressed willingness to donate. The most important inhibiting factors were related to religion, namely, importance of being buried intact (84%) and donation being against halacha (46%). Most respondents (67%) would approach a religious figure for advice, and willingness to donate increased when informed that donation was permitted (68%) and supported (63%) by orthodox religious authorities. Finally, a minority (37%) perceived the allocation process to be fair and adequately supervised (36%). CONCLUSIONS This study identified religious and system-related constraints as important inhibiting factors to donation, factors which were potentially modifiable. Since this community relies on their religious leaders for guidance, public support by authoritative and accepted religious leaders is required to reassure the community of the legitimacy and positive aspects of organ donation.
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Affiliation(s)
- Tamar Ashkenazi
- National Transplant Center, Ministry of Health, Tel Aviv, Israel
| | - Avraham Steinberg
- Department of Medical Ethics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Jonathan Cohen
- National Transplant Center, Ministry of Health, Tel Aviv, Israel.,Department of General Intensive Care, Rabin Medical Center, Campus Beilinson, Petah Tikva, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Jones CP, Papadopoulos C, Randhawa G. Who's opting-in? A demographic analysis of the U.K. NHS Organ Donor Register. PLoS One 2019; 14:e0209161. [PMID: 30601839 PMCID: PMC6314572 DOI: 10.1371/journal.pone.0209161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/02/2018] [Indexed: 12/03/2022] Open
Abstract
The NHS Organ Donor Register (NHS ODR) is a centralised database for U.K. residents wishing to be organ donors. Opt-in membership to the NHS ODR demonstrates an expression of a wish to donate, which can be key in decisions made by family members at time of death. By examining the demographic breakdown of the 24.9 million registrants, campaigns can be better targeted to increase membership among those groups underrepresented on the NHS ODR. Data from the NHS ODR (as of March 2017) was analysed using Chi2 Goodness of Fit analyses and Chi2 Test of Independence for the categorical variables of gender, nation of residency at time of registration, ethnicity, organ preference, registration age and age at registration. Goodness of fit analyses showed significant differences between demographic representation on the NHS ODR compared to the U.K. population. Cramer’s V showed significant associations were only of note (above 0.1) for age, ethnicity in the U.K. as a whole and ethnicity in England. Older (70+) and younger people (0–14) were underrepresented and those of White Ethnicity overrepresented on the NHS ODR. Although association strength was weak, more women and less residents of England were present compared to the U.K. population. Tests of independence showed significant differences between age at registration and current age on the register and cornea donation preferences. These results indicate areas for targeting by campaigns to increase NHS ODR membership. By understanding the strength of these associations, resources can be utilised in areas where underrepresentation is larger and will have the most impact to demographics of the NHS ODR. Additionally, by identifying which groups are over and underrepresented, future research can explore the reasons for this in these demographic groups.
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Affiliation(s)
- Catrin Pedder Jones
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, United Kingdom
- * E-mail:
| | - Chris Papadopoulos
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, United Kingdom
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, United Kingdom
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Molina-Pérez A, Rodríguez-Arias D, Delgado-Rodríguez J, Morgan M, Frunza M, Randhawa G, Reiger-Van de Wijdeven J, Schiks E, Wöhlke S, Schicktanz S. Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic review. Transplant Rev (Orlando) 2019; 33:1-8. [DOI: 10.1016/j.trre.2018.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/21/2018] [Accepted: 09/14/2018] [Indexed: 11/26/2022]
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Schmidt S, Schulte A, Schwarz S, Hofmann N, Tietz S, Boergel M, Sixt SU. Fresh osteochondral allografts-procurement and tissue donation in Europe. Injury 2017; 48:1296-1301. [PMID: 28551055 DOI: 10.1016/j.injury.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue. Apart from the logistic challenges this entails, an experienced recovery team is needed. Furthermore, the public as well as medical staff is much less aware of the possibility and requirements of tissue donation than organ donation and families of deceased are rarely approached for bone and cartilage donation. This review aims to highlight the current situation of organ and tissue donation in Europe with special focus on the processing of bones and possible safety and quality concerns. We analyze what may prevent consent and what might be done to improve the situation of tissue donation.
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Affiliation(s)
- S Schmidt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany.
| | - A Schulte
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Schwarz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - N Hofmann
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Tietz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - M Boergel
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S U Sixt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany; Clinic for Anesthesiology, University Hospital of Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
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Bedenko RC, Nisihara R, Yokoi DS, Candido VDM, Galina I, Moriguchi RM, Ceulemans N, Salvalaggio P. Analysis of knowledge of the general population and health professionals on organ donation after cardiac death. Rev Bras Ter Intensiva 2016; 28:285-293. [PMID: 27626950 PMCID: PMC5051187 DOI: 10.5935/0103-507x.20160043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/05/2016] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
| | - Renato Nisihara
- Departamento de Medicina, Universidade Positivo, Curitiba, PR, Brazil
| | - Douglas Shun Yokoi
- Curso Acadêmico de Medicina, Universidade Positivo, Curitiba, PR, Brazil
| | | | - Ismael Galina
- Curso Acadêmico de Medicina, Universidade Positivo, Curitiba, PR, Brazil
| | | | - Nico Ceulemans
- Curso Acadêmico de Medicina, Universidade Positivo, Curitiba, PR, Brazil
| | - Paolo Salvalaggio
- Departamento de Medicina, Universidade Positivo, Curitiba, PR, Brazil
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Impact of telephone consent and potential for eye donation in the UK: the Newcastle Eye Centre study. Eye (Lond) 2015; 30:342-8. [PMID: 26514245 DOI: 10.1038/eye.2015.216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/13/2015] [Indexed: 11/08/2022] Open
Abstract
AIMS To examine the impact of telephone consent introduced in 2007 on the eye donation rate and to report the changing trend and potential for improvement in eye donation in Newcastle upon Tyne, UK. METHODS Relevant data were retrospectively collected from the local eye retrieval database for two separate years, namely, 2006 (before the introduction of telephone consent) and 2010. All the hospitals within Newcastle were included in the study. RESULTS From 2006 to 2010, there was a 3.5-fold increase in eye donation from 32 (of 2479 deaths) to 111 donors per year (of 2213 deaths) in Newcastle (P<0.001). Consent was obtained via face-to-face interview in all 32 (100%) and 59 (53.2%) donors in 2006 and 2010, respectively. Introduction of telephone consent increased the donation rate by an additional 88.1% (from 59 to 111 donors) in 2010 (P<0.001). In addition, there was a significant increase in medical notes of the deceased being reviewed from 27.1% (671/2479 cases) in 2006 to 62.4% (1382/2213 cases) in 2010 (P<0.001). Acceptance rate of eye donation was 45.7% (32/70) in 2006 and 49.6% (111/224) in 2010 (P=0.575). Acceptance rate was positively associated with registration on organ donor register (P<0.001) and telephone consent (P<0.001), but not with age (P=0.883), gender (P=0.234), or location of death (P=0.984) of the potential donors. CONCLUSION There has been a substantial improvement in eye donation rate in Newcastle over the recent years. Introduction of telephone consent and high-quality eye donation service serve as effective measures for increasing eye donation.
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