Organ donor problems and their management

Assessment of Awareness Level Regarding Organ Donation among Healthcare Professionals and Students in India

Introduction

Organ donation can be a life-saving opportunity for patients with severe organ failure. In India, the rate of organ donation of the deceased Indian population is exceptionally low. This necessitates enhancing awareness regarding organ donation among health care professionals and students, which can motivate the general population.

Aim

To assess and analyze the awareness level of healthcare professionals and students on organ donation in order to suggest potential strategies regarding improvement of awareness and willingness towards organ donation.

Materials and methods

A cross-sectional online and offline survey was conducted at the national level between July 2022 and September 2022. Indian healthcare professionals as well as students of various fraternities were included. The Snowball sampling technique was used for data collection. Statistical analysis was undertaken using the statistical package for the social sciences (SPSS) software, version 25.

Results

A total of 1,303 respondents were enrolled in this study. The majority of the participants were students (66.5%) residing in southern India (89.6%) pursuing medical profession (88.9%). The predominant age group was 18-24 years (73.9%). The awareness level regarding organ donation among healthcare professionals and students was 69%. Healthcare professionals and respondents aged 40 years and above had better awareness levels regarding organ donation which was reported as statistically significant (p < 0.001).

Conclusion

Healthcare professionals and students awareness about organ donation need to be improved. Strategies including but not limited to prioritizing employment and education to the first relatives of the deceased organ donor should be implemented by the government to legally improve organ donation willingness.

How to cite this article

Chandrasekaran S, Chandrasekaran VP, Nandi D, Setty RS, Srinivasan O, Kaur KN. Assessment of Awareness Level Regarding Organ Donation among Healthcare Professionals and Students in India. Indian J Crit Care Med 2023;27(1):57-63.

Criteria to Identify a Potential Deceased Organ Donor: A Systematic Review

OBJECTIVES

To systematically review the global published literature defining a potential deceased organ donor and identifying clinical triggers for deceased organ donation identification and referral.

DATA SOURCES

Medline and Embase databases from January 2006 to September 2017.

STUDY SELECTION

All published studies containing a definition of a potential deceased organ donor and/or clinical triggers for referring a potential deceased organ donor were eligible for inclusion. Dual, independent screening was conducted of 3,857 citations.

DATA EXTRACTION

Data extraction was completed by one team member and verified by a second team member. Thematic content analysis was used to identify clinical criteria for potential deceased organ donation identification from the published definitions and clinical triggers.

DATA SYNTHESIS

One hundred twenty-four articles were included in the review. Criteria fell into four categories: Neurological, Medical Decision, Cardiorespiratory, and Administrative. Distinct and globally consistent sets of clinical criteria by type of deceased organ donation (neurologic death determination, controlled donation after circulatory determination of death, and uncontrolled donation after circulatory determination of death) are reported.

CONCLUSIONS

Use of the clinical criteria sets reported will reduce ambiguity associated with the deceased organ donor identification and the subsequent referral process, potentially reducing the number of missed donors and saving lives globally through increased transplantation.

Brain Death and Management of Potential Organ Donor: An Indian Perspective

How to cite this article: Zirpe K, Gurav S. Brain Death and Management of Potential Organ Donor: An Indian Perspective. Indian J Crit Care Med 2019;23(Suppl 2):S151-S156.

Delayed graft function: risk factors and the effects of early function and graft survival

INTRODUCTION

Delayed graft function (DGF), a well-known immediate postoperative complication is defined as the need for dialysis during the first week after deceased donor kidney transplantation. It affects 25% to 50% of recipients. In this study we identified risk factors for DGF and its impact on patient and graft survivals.

METHODS

We retrospectively analyzed medical records from renal transplant recipients aged above 18 years who received a deceased donor kidney graft between November 2008 and December 2011, excluding kidney losses during the first week.

RESULTS

Among 137 transplantations, 64 (46.5%) displayed DGF. Multivariate analysis showed secondary renal disease (OR 3.7, CI 1.36-10.30; P = .011), HLA mismatches > 3 (OR 4.4, CI 1.53-12.51; P = .006) and donor urine output ≤ 3000 ml/24h (OR 25.8, CI 3.60-185.70; P = .001) to be significant risk factors for DGF. The hospitalization time was longer in the DGF group (38,2 ± 20,75 vs. 25,6 ± 8,18; P < .001). At 1 month, DGF group showed worse graft function based upon serum creatinine: 207.7 ± 148.52 vs 118.1 ± 36.63 μmol/L (P < .001). At 1 year follow-up, incidence of biopsy-proven acute renal rejection episodes was higher in the DGF (28; 51,9%) vs. the non-DGF group (18; 33,3%; P = .05). The 1-year recipient survival in DGF and no DGF groups were 90% vs 97% respectively (P = .124). With 1-year death censored graft survivals of 92% vs 100% respectively (P = .062).

CONCLUSION

Secondary renal disease, HLA mismatches and lower donor urinary output were associated with a greater incidence of DGF, leading to prolonged hospitalizations and an increased risk for an acute rejection episode.