Public knowledge about and attitudes toward organ donation, and public barriers to donate in Jordan: A cross-sectional study

BACKGROUND Organ donation is a critical issue that is receiving greater attention worldwide.In Jordan,the public’s knowledge about and attitudes toward organ donation play a significant role in the availability of organs for transplantation.AIM To assess the public knowledge about and attitudes toward organ donation in Jordan.METHODS A cross-sectional design was used to collect data from 396 Jordanian citizens via an online self-reported questionnaire.RESULTS Overall,396 participants were recruited.Of the entire sample,93.9%of the participants had heard about and had sufficient knowledge about organ donation but they had limited knowledge about brain death.The most common source of information about organ donation was social media networks.Females were found to score significantly higher than males for attitude.Those who had thought about organ donation or registered their names to donate scored signi-ficantly higher in terms of attitudes to donation than their counterparts who had not.The most common reasons for limited organ donation practices in Jordan were a lack of awareness programs and insufficient knowledge in society.CONCLUSION Greater public understanding of organ donation appears to be associated with more positive attitudes toward organ donation.Most participants responded positively regarding their attitude toward organ donation as they believed that this action could give another person a chance to live.Moreover,most agreed that they would donate their organs after their death.Otherwise,the participants had limited general knowledge about brain death,and most had not registered their names to donate their organs.These findings indicate the need for public awareness campaigns and educational programs to encourage more people to become organ donors.

Organ Donation and Obstacles: University Student Survey

Background: Organ transplantation has helped improve the quality of life of patients with lethal terminal organ failure. This success is owed to the progress made in many fields such as surgery, immunology…However, in our country Morocco, we are faced with reluctance to donate. The study’s objective is to evaluate the perception of organ donation among university students. Methods: We conducted this cross-sectional study with descriptive and analytical aims. Our target population consisted of 991 university students from eight higher education structures. An anonymous questionnaire was distributed to those students by a single interviewer. The questions of the survey answered four main themes. Thus, two types of studies were done. The first was a descriptive study of the socio-demographic characteristics of the selected population and their knowledge and attitudes about organ donation. The second was an analytical study of the correlation between the socio-demographic characteristics, type and level of education of the target population and their knowledge and attitudes towards organ donation. Results: 97.2% of the respondents have already heard about organ donation. If 836 of the students (84.4%) thought that transplantation could be an effective therapeutic alternative, 155 of the students (15.6%) were not aware of this possibility. Furthermore, 298 students, which means 30.1% of the students, did not know that organ transplantation was practiced in Morocco. The causes of refusal found in our study were numerous. 68.5% of students blamed the lack of information as the main cause of their reluctance. 64.7% were afraid of organ trafficking. 41.1% refused the idea of mutilating the body of the deceased, which could impact the funeral. 37.3% thought that donation would be a violation of the human body according to religious values. 33.9% were against donation because they hoped that the brain-dead patient could wake up. The main results of our survey showed the very favorable attitude towards organ donation and transplantation, despite the lack of knowledge on the subject. Conclusion: This study revealed the absence of information on the practice of organ transplantation in Morocco and the underestimation of the number of people waiting for transplantation. On the other hand, like the data found in the literature, our study highlights the religious obstacles and the lack of confidence in the legislation governing donation and transplantation in our country.

Attitudes,awareness,and knowledge levels of the Turkish adult population toward organ donation:Study of a nationwide survey

BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries.AIM To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation.METHODS This nationwide study surveyed 3000 adults(≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-Ⅱ(modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal interviews.RESULTS Out of 3000 individuals represented in the study population, 1465(48.8%) were male and 1535(51.2%) female. The results showed that most participants were under 45 years(59.0%) and married(72.1%), some had a bachelor’s degree or higher(21.9%), and very few(1.5%) had any direct experience with organ transplantation-whether in the family, or a family member on a transplantation waiting list. Most of the study population(88.3%) had not considered donating an organ, however, most(87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person’s body.CONCLUSION This study showed that Turkey’s adult population has inadequate knowledge about organ donation. The study advocates for public education programs to increase awareness among the general population about legislation related to organ donation.

China organ donation and transplantation update: the Hangzhou Resolution

The much-anticipated change in the practice of organ donation and transplantation in China is now underway and affirmed by an important Hangzhou Resolution promulgated at the 2013 China Transplant Congress.Support of the National Health and Family Planning Commission On October 29,2013,in a meeting of the National Health and Family Planning Commission (NHFPC)officials with Jie-Fu Huang,Head of National Organ Transplant Committee(OTC), Hai-Bo Wang,Director of China Organ Transplant Response System (COTRS)

Posthumous organ donation beliefs of college students:A qualitative study

Objective:To explore the perspectives and beliefs of college students toward posthumous organ donation,and the factors influencing their beliefs.Methods:This was a descriptive phenomenology study conducted with semi-structured indepth interviews.Nine college students attending three universities in Beijing who agreed to participate in this study were interviewed.Data were analyzed following the guideline suggested by Colaizzi(1978).Briefly,statements identified as noteworthy were coded and organized.A description was then written to formalize their meaning and returned to the participants for validation of the description.Results:In general,the participants exhibited positive attitudes toward posthumous organ donation.However,not all subjects indicated that they would become an organ donor.Based on the provided responses,four main themes emerged:(1)knowledge about organ donation,participants reported a general lack of education or understanding of organ transplantation and donation;(2)core beliefs on organ donation,despite believing it is valuable public service,participants were unwilling to go against the cultural beliefs held by parents and elders;(3)factors influencing beliefs on organ donation,including cultural and peer opinion,posthumous care of the body,legal registration,and publicity;(4)institutional and policy context,lack of guarantee for proper use of organs after donation was a concern.Conclusion:Despite positive attitudes towards posthumous organ donation,college students are hesitant to become donors because of lack of knowledge/publicity;cultural disdain;and lack of governmental assurance.

Nurses’ Recognition in Nursing for Patients and Families about Organ Donation after Brain Death, Care for Family Members and Supports for Nurses

Background: Globally, there a problem of disequilibrium between donation and organ transplantation, this equilibrium is remarkable in Japan. Especially there are few donations from brain death, and researches from the view point of nurses in clinical situation were needed. Purpose: The purpose of this study was to clarify the recognition of nurses in organ transplantation nursing, required care for families of patients, and required support for nurses to promote quality of nurses in organ donation. Methods: We conducted this research within 2 months in 2019 in Western Japan. A researcher conducted a semi-qualitative interview for nurses in organ transplantation nursing about their recognition of nursing, required care for family members, and required support for nurses once. Results: Nurses recognized that some family members who knew patients’ thoughts made decision easily and some who didn’t know had difficulties. Many nurses felt insufficiency for family cares and some confronted ethical problems. Though some nurses felt conflict about their own thoughts or religion, they took care of patients or family members with responsibility. As for care for families, nurses thought practice of care considering families’ feeling, support of decision making, and care for family to live positively after transplantation as required care. About support for nurses, nurses required education of transplantation, increase of staff members, chance to share dilemma, and mental care. Discussion: Nurses recognized the importance of decision making, and felt an insufficiency for family care or dilemmas. To propose high quality of nursing and organ donation or transplantation, education about transplantation including family care, management about resolution of dilemma or mental health may be required.

The Role of Strategic Communication for Organ Donations

One big achievement in the last decade is the rapid development in transplantation medicine, enabling seriously ill people to live longer. However, in the year 2014, 12 people in the European Union have died every day because of the lack of available organs. Nearly, 70,000 people were waiting for a matching graft. An analysis of donation and transplantation variation across the European member states shows that since many years, Spain occupies a pioneer role, whereas Germany and Austria are lagging behind. From the legal and administrative perspective, Spain and Austria are quite similar with their presumed consent system （opting out）, whereas Germany has an informed consent system （opting in）. Hence, there must be other influencing factors like the way of multilevel communication leading to the following research question： How does multilevel communication influence organ donations in Spain, Germany, and Austria？ On the basis of a cross-country study, it can be shown that strategic communication on the （inter）personal and organizational level supported by the creation of public awareness on the national level is crucial for succeeding in closing the gap between demands and realized organ transplantation.

A New Lease of Life Organ donation gains wider acceptance in China as an efficient donation system raises awareness

Wu Yue, a lung transplant recipi ent. now regards August 31, the day she underwent surgery, as her re-birth day. In the eyes＇ of many people, the 30-year- old woman is an embodiment of love, dili gence and intelligence.

Organ Donation in China

CHINA’S first voluntary organ donation system is in the midst of its trial run. The program is being tested in 11 pilot regions around the country, having harvested organs from more than 100 donors in this inaugural year. Overseen by the Red Cross Society of China and the country’s Ministry of Health, the system follows cardiac death standards in organ donation

Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per patient.Endocrine management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management approaches.Previous studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant recipients.AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients.METHODS A retrospective review of adult BPODs from a single level 1 trauma center over ten years was performed.Exclusion criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital course.Levothyroxine and steroid administration,the number of organs donated,the types of organs donated,and demographic information were recorded.Univariate analyses were performed with P<0.05 considered to be statistically significant.RESULTS A total of 88 patients met inclusion criteria,69(78%)of whom received levothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(P>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient population.Limitations to this study include the retrospective design and the relatively small number of organ donors who met inclusion criteria.This study is unique in that it mitigates steroid administration as a confounding variable and focuses specifically on the adjunctive use of levothyroxine.

Critical care specialists,the missing link in organ procurement for transplantation

The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units(CCU),followed by their clinical evaluation,diagnostic procedures,and therapeutic interventions,mostly conducted in CCUs.It concludes with the request for organ donation and,if accepted,the retrieval of organs.Despite most interventions occurring in detection units,there has been a neglect of the strategic role played by critical care specialists(CCS)in managing and caring for brain-dead or near-brain-death patients.Questions arise:Are they willing to undertake this responsibility?Do they fully comprehend the nature of organ procurement?Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition?Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it,ultimately aiming to increase and enhance organ donation rates.

Attitudes toward organ donation in China

Background Organ transplantation represents an important advance in modern medical science,and it has benefited many patients with organ failure; however,the severe deficiency of organ sources has been a bottleneck that has limited the benefits -this technology can bring.The aim of this study was to show the results of a survey on Chinese people＇s awareness and attitudes toward organ donation.Methods We designed a questionnaire regarding organ donation consisting of 20 short questions,which were distributed to 10 groups.Most of the questions were multiple-choice; the core question related to people＇s attitudes to organ donation and the development of organ donation.The survey was held in the outpatient hall of Beijing Chao-Yang Hospital,a commercial district,and four professional colleges.Participants were randomly selected,and answered questions about gender,age,educational background,profession,and study major.Results In all,2930 valid responses were received.Male：female ratio was nearly 1：1.2 （mean age 38 years）.Over 90.0% of participants knew about organ transplantation and which organs could be transplanted; more than 95.0% knew about organ donation,but the time they had been aware of it varied.Nearly 90.0% of the participants approved of deceased organ donation; 73.0% indicated they would like to donate their organs post mortem.Participants who knew more about organ failure and organ transplantation were more likely to support organ donation.College students were very positive about organ donation,though as they gain professional knowledge their attitudes may change.Altogether,65.3% of participants approved of living organ donation,which was obviously lower than the figure for deceased organ donation （P 〈0.05）.In all,85.7% of participants approved of compensation to the deceased donor＇s family.To promote organ donation in China,62.9% of participants indicated that the public＇s knowledge about organ donation should be increased via the media and various kinds of education.Only 20.0% of the participants believed that legislation was required.Conclusions We conclude that at present the Chinese public has a basic understanding about organ transplantation and donation.The majority respondents were in favor of deceased organ donation and were willing to donate their own organs after death.

The organ donation in China

Obrgan transplantation is one of the greatest achievements in the history of medicine during the 20th century. It has changed the practice of traditional medicine wherein the treatment of diseases relies mainly on drugs. Organ transplantation has saved the lives and restored the health in many patients with fatal illness or end-stage organ failure. It has brought a revolutionary change in medical practice and reflects true human wisdom and knowledge. Due to the advances in the organ transplant technology and the basic research in transplant immunology as well as the development of a variety of immunosuppressive agents, organ transplantation has been an effective treatment for patients with organ failure.

Pragmatic solution for organ donation in response to challenges faced by the Chinese society： summary for the National Donation after Circulatory Death Pilot Program

Oygan transplant is an advanced medical technology brought to China from the West in the latter half of the 20th century. Thanks to the strenuous efforts of generations, it has become a mature clinical practice, having saved the lives of a great number of patients suffering from end-stage organ failure. Different from other medical technologies, an organ transplant requires a donated transplantable organ, and the donation and allocation are embedded in social issues such as culture, tradition, ethics, and law.

Extended criteria brain-dead organ donors:Prevalence and impact on the utilisation of livers for transplantation in Brazil

BACKGROUND Despite its association with higher postoperative morbidity and mortality,the use of extended criteria donor(ECD)livers for transplantation has increased globally due to the high demand for the procedure.AIM To investigate the prevalence of ECD in donation after brain death(DBD)and its impact on organ acceptance for transplantation.METHODS Retrospective analysis of DBD organ offers for liver transplantation between 2017 and 2020 in a high-volume transplant centre.The incidence of the Eurotransplant risk factors to define an ECD(ET-ECD)among DBD donors and the likelihood of organ acceptance over the years were analysed.The relationship between organ refusal for transplantation,the occurrence,and the number of ET-ECD was assessed by simple and multiple logistic regression adjustment.RESULTS A total of 1619 organ donors were evaluated.Of these,78.31%(n=1268)had at least one ET-ECD criterion.There was an increase in the acceptance of ECD DBD organs for transplantation(1 criterion:from 23.40%to 31.60%;2 criteria:from 13.10%to 27.70%;3 criteria:From 6.30%to 13.60%).For each addition of one ETECD variable,the estimated chance of organ refusal was 64.4%higher(OR 1.644,95%CI 1.469-1.839,P<0.001).Except for the donor serum sodium>165 mmol/L(P=0.310),all ET-ECD criteria increased the estimated chance of organ refusal for transplantation.CONCLUSION A high prevalence of ECD DBD was observed.Despite the increase in their utilisation,the presence and the number of extended donor criteria were associated with an increased likelihood of their refusal for transplantation.

Bodies, Persons, and Respect for Humanity： A Kantian Look at the Permissibility of Organ Commerce and Donation

Can choosing to sale one＇s kidney be morally permissible？ ＂No＂, Kant would answer. Humanity, whether in one＇s own person or that of any other, must never be treated merely as a means, but always at the same time as an end, is Kant＇s instruction （Groundwork 4：429）. He thought that organ sale violates this imperative. Lectures on Ethics （27：346） shows that ＂... a man is not entitled to sell his limbs for money If a man does that, he turns himself into a thing, and then anyone may treat him as they please, because he has thrown his person away....＂ This paper explains Kant＇s reasons against commerce in organs, drawing on his views on prostitution, and the moral impermissibility of sexual use within this context, a case which he himself compares to the selling of one＇s body part（s）. Can choosing to donate one＇s kidney be morally permissible？ If we take Kant＇s views at face value, it would follow that organ donation is on a par with morality only if it takes place in a context where people have gained rights over each other＇s persons （for example, in a marital context）. In this context, however, a person has a right to her partner＇s kidney should she happen to need it, which can open the path to bodily violation. Moreover, this view severely restricts the permissibility of organ donation. In this paper, I argue that a closer examination of Kant＇s views on what is involved in the idea of respecting humanity could reveal that organ donation does not violate the categorical imperative. In fact, it could be said to follow from such an imperative that we actually have a duty to organ donation.

Cold ischemia time in liver transplantation:An overview

The standard approach to organ preservation in liver transplantation is by static cold storage and the time between the cross-clamping of a graft in a donor and its reperfusion in the recipient is defined as cold ischemia time(CIT).This simple definition reveals a multifactorial time frame that depends on donor hepatectomy time,transit time,and recipient surgery time,and is one of the most important donor-related risk factors which may influence the graft and recipient’s survival.Recently,the growing demand for the use of marginal liver grafts has prompted scientific exploration to analyze ischemia time factors and develop different organ preservation strategies.This review details the CIT definition and analyzes its different factors.It also explores the most recent strategies developed to implement each timestamp of CIT and to protect the graft from ischemic injury.

Ethical frontiers in liver transplantation

Liver transplantation represents a pivotal intervention in the management of end-stage liver disease,offering a lifeline to countless patients.Despite significant strides in surgical techniques and organ procurement,ethical dilemmas and de-bates continue to underscore this life-saving procedure.Navigating the ethical terrain surrounding this complex procedure is hence paramount.Dissecting the nuances of ethical principles of justice,autonomy and beneficence that underpin transplant protocols worldwide,we explore the modern challenges that plaques the world of liver transplantation.We investigate the ethical dimensions of organ transplantation,focusing on allocation,emerging technologies,and decision-making processes.PubMed,Scopus,Web of Science,Embase and Central were searched from database inception to February 29,2024 using the following key-words:“liver transplant”,“transplantation”,“liver donation”,“liver recipient”,“organ donation”and“ethics”.Information from relevant articles surrounding ethical discussions in the realm of liver transplantation,especially with regards to organ recipients and allocation,organ donation,transplant tourism,new age technologies and developments,were extracted.From the definition of death to the long term follow up of organ recipients,liver transplantation has many ethical quandaries.With new transplant techniques,societal acceptance and perceptions also play a pivotal role.Cultural,religious and regional factors including but not limited to beliefs,wealth and accessibility are extremely influential in public at-titudes towards donation,xenotransplantation,stem cell research,and adopting artificial intelligence.Understanding and addressing these perspectives whilst upholding bioethical principles is essential to ensure just distribution and fair allocation of resources.Robust regulatory oversight for ethical sourcing of organs,ensuring good patient selection and transplant techniques,and high-quality long-term surveillance to mitigate risks is essential.Efforts to promote equitable access to transplantation as well as prioritizing patients with true needs are essential to address disparities.In conclusion,liver transplantation is often the beacon of hope for individuals suffering from end-stage liver disease and improves quality of life.The ethics related to transplantation are complex and multifaceted,considering not just the donor and the recipient,but also the society as a whole.

Pathological Characteristics of Liver Allografts from Donation after Brain Death Followed by Cardiac Death in Pigs

Donation after brain death followed by circulatory death （DBCD） is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs （25-30 kg） were allocated randomly into donation after brain death （DBD）, donation after circulatory death （DCD） and DBCD groups. Brain death was induced by aug- menting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were col- lected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [（0.56±0.30）%] and DBCD [（0.50 ±0.11）%] groups was much lower than that in DCD group [（3.78±0.33）%] （P〈0.05）. And there was no significant difference between DBD group and DBCD group （P〉0.05））. The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude.METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student´s t test, χ2 test and logistic regression analysis.RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one’s family (P < 0.001) and friends (P < 0.001); (10) a partner’s opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001).CONCLUSION: Spanish medical students have a favorable attitude toward LLD.