It's time to reward the gift of life

The present and future of transplant organ shortage: some potential remedies

Transplantation remains the modality of choice for patients with end stage renal disease (ESRD). However, while there has been a steady rise in the number of patients with ESRD the supply of donors (combine living and deceased) has fallen far behind the need, resulting in an increasing number of qualified patients remaining on the wait-list, and thousands being removed from the list every year because of death or becoming too sick for transplantation. This has also fed to transplant tourism around the world. Several countries have implemented a variety of policies to overcome their organ shortage that are presented in this article. There is an urgent need for developing policies geared to the cultural norms of different societies and universally accepted ethical principles to remedy this public health issue.

Romanian Laypeople's and Health Professionals' Views Regarding Living Organ Donation

BACKGROUND

Romanian laypeople's and health professionals' views on living organ donation were examined.

METHODS

From July 2015 to May 2016, 263 adults (among them 31 physicians and 20 nurses) judged the acceptability of living organ donation in 42 realistic scenarios composed of varying levels of 6 factors: 1. type of organ, 2. whether it could have been obtained from a cadaver, 3. donor-recipient relationship, 4. donor's level of autonomy, 5. financial compensation, and 6. patients' level of responsibility for their illness. In all scenarios, the patients were in need of either a kidney or liver transplantation.

RESULTS

The ratings were subjected to cluster analysis and analyses of variance. Seven qualitatively different positions were found that were termed never acceptable (12%), free market (44%), compensation (12%), altruism (6%), always acceptable (16%), responsibility (4%), and undetermined (6%). Physicians were more frequently in the free market or in the compensation clusters (81%) than laypeople (51%).

CONCLUSION

Only a few participants held the altruism model, even though this model has been promoted as the normative model by the World Health Organization and by most national legislations, including the legislation in Romania. Instead, the free market position and its variant-the compensation position-can be considered the majority positions (66%) in Romania.