Organ Donation Awareness among Family Members of ICU Patients

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.

Associations between the Willingness to Donate Samples to Biobanks and Selected Psychological Variables

Over the past few decades, there has been a dynamic development of biobanks collecting human biological material and data. Advances in biomedical research based on biobanks, however, are highly dependent on the successful enrolment and participation of human subjects. Therefore, it is crucial to recognise those factors affecting the willingness of individuals to participate in biomedical research. There are very few studies pointing to the role of trust, preferred values and specific psychological factors. The aim of our study was the analysis of the most significant relationships between selected moral and psychological variables (i.e., preferred values, types of trust and personality) and willingness to donate biological material to biobanks. The research was carried out on a Polish representative national sample of 1100 people over 18 years of age. Statistical methods with regression models were used during the analyses. The willingness to donate samples to a biobank was associated with different types of trust and specific values. Based on regression analysis, the most important factors related to the willingness to donate material to biobanks seemed to be (1) trust towards scientists and doctors and (2) selected preferred values such as knowledge, self-development and tradition. Other values or personality traits did not seem to be as important in this context. The obtained results can be useful in building the social responsibility of biobankers and scientists, issuing more appropriate opinions by research ethics committees and planning better communication strategies between participants and biobanks.

Placenta Donation - The Expectant Mother's View

The placenta has been used in different facets of medicine however some low-income countries are yet to apply these uses for different reasons. A cross-sectional study of 150 expectant mothers attending antenatal clinic was conducted to determine the willingness to donate the placenta. Analysis was conducted using Statistical Package for the Social Sciences version 20 with a level of significance set at P ≤ .05. The mean age of the participants was 32.3 (SD±5.0) years. Almost all (98.7%) were married while 89.3% had tertiary-level education. The majority (82.7%) knew there was no connection between the placenta and baby after delivery; however, only 12.0% knew about placenta donation and 10.0% were willing to donate the placenta at delivery. About three quarters (74.0%) were unwilling to promote the donation of the placenta, most (55.0%) believed that the placenta was used for rituals, while some (19.0%) thought placenta donation would affect the child's future. Participants' occupation, 'knowledge about placenta donation and its uses' and willingness to promote donation were all significantly associated with their willingness to donate (P < .05). Willingness to donate the placenta at delivery was low in this study. Participants' occupation and their knowledge were some factors influencing willingness to donate the placenta for medical use.

It's in Me to Give: Canadian Gay, Bisexual, and Queer Men's Willingness to Donate Blood If Eligible Despite Feelings of Policy Discrimination

Blood donation policies governing men who have sex with men have shifted significantly over time in Canada-from an initial lifetime ban in the wake of the AIDS crisis to successive phases of time-based deferment requiring periods of sexual abstinence (5 years to 1 year to 3 months). We interviewed 39 HIV-negative gay, bisexual, queer, and other sexual minority men (GBM) in Vancouver, Toronto, and Montreal to understand their willingness to donate blood if eligible. Transcripts were coded following inductive thematic analysis. We found interrelated and competing expressions of biological and sexual citizenship. Most participants said they were "safe"/"low risk" and "willing" donors and would gain satisfaction and civic pride from donation. Conversely, a smaller group neither prioritized the collectivizing biological citizenship goals associated with expanding blood donation access nor saw this as part of sexual citizenship priorities. Considerable repair work is required by Canada's blood operators to build trust with diverse GBM communities.

Prioritizing Factors Affecting Deceased Organ Donation in Malaysia: Is a New Organ Donation System Required?

Purpose

The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia.

Patients and Methods

The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors.

Results

Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent.

Conclusion

This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.

Can financial rewards complement altruism to raise deceased organ donation rates?

BACKGROUND

Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.

METHODS

Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.

ETHICAL CONSIDERATIONS

The study was approved by the University of Malaya ethics committee.

RESULTS

The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.

CONCLUSION

Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

Cultural influences on willingness to donate organs among urban native Americans

BACKGROUND

The need for organ donation is substantial among Native Americans, driven by the disproportionate burden of ESRD. Due to the dearth of knowledge about willingness to donate (WTD) among urban Native Americans, a group that represents over half of the US Native population, we aimed to examine factors affecting donation.

METHODS

We conducted a cross-sectional survey of a convenience sample, using a questionnaire developed specifically for this study using community-based participatory research. The questionnaire was designed to be culturally relevant to the Native community, based on questions from three previously validated instruments and developed through one-on-one interviews. We performed logistic regression to associate survey answers with WTD.

RESULTS

Seventy percent of our 183 respondents stated that they would be willing to have their organs donated after death; however, only 41% were already registered as an organ donor on their driver's license. Logistic regression analysis found specific items in domains of trust of the medical community and spirituality most closely associated with WTD. Sixty-two percent of Native Americans surveyed reported they would not donate organs because they distrust the medical community.

DISCUSSION

Our findings suggest multiple areas of focus for increasing organ donation within this subset of the diverse Native community. Efforts to promote donation should be aimed at building trust in the medical community.

The Perception of Medical Students at King Abdulaziz University Hospital Regarding the Liver Transplant Allocation System

Background: The benefit of liver transplantation is not only to increase the patient’s lifetime but also for persistent relief of pain and anxiety. Shortage of the organ is the main hindrance of transplantation around the world, leading authorities to pass a general law for the reasonable distribution of organs and come up with the Model for End-Stage Liver Disease (MELD) system which scores the severity of liver disease and risk of mortality in order to detect the mechanism of allocation. 

Objective: This study aims to assess medical students’ perception of the liver transplant and allocation system.

Methods: A cross-sectional survey was carried out among 402 medical students at King Abdulaziz University in Jeddah, Saudi Arabia.

Results: The majority of the medical students (84.4%) believed that a successful liver transplant improves both lifetime and quality of life. Most of the students also saw that the minimum survival rate should be five years after transplantation and that the patient should recover to be at least ambulatory, even if restricted by strenuous physical activity. When asked whether urgency or prospect of success defined a successful transplant, most of the students who chose urgency were preclinical (50.7%), while the prospect of success was the dominant answer chosen by students in their clinical years of study (66.1%).

Conclusion: The criteria determining the success of a liver transplant include a gain in both lifetime and quality of life. The majority of respondents wanted the capacity to benefit to be considered in the liver allocation system.

Knowledge and ethical perception regarding organ donation among medical students

BACKGROUND

To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan.

METHODS

Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20.

RESULTS

A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students' opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P = 0.000).

CONCLUSION

Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic.

The association of state and national legislation with living kidney donation rates in the United States: a national study

The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95% confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.