Towards achieving national self-sufficiency in organ donation in India - A call to action.
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ABSTRACT:
SUBMITTER: Jha V
PROVIDER: S-EPMC4165049 | biostudies-literature | 2014 Sep
REPOSITORIES: biostudies-literature
Publications
Towards achieving national self-sufficiency in organ donation in India - A call to action.
Indian journal of nephrology 20140901 5
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Project description:Although overall donation and transplantation activity is higher in Europe than on other continents, differences between European countries in almost every aspect of transplantation activity (for example, in the number of transplantations, the number of people with a functioning graft, in rates of living versus deceased donation, and in the use of expanded criteria donors) suggest that there is ample room for improvement. Herein we review the policy and clinical measures that should be considered to increase access to transplantation and improve post-transplantation outcomes. This Roadmap, generated by a group of major European stakeholders collaborating within a Thematic Network, presents an outline of the challenges to increasing transplantation rates and proposes 12 key areas along with specific measures that should be considered to promote transplantation. This framework can be adopted by countries and institutions that are interested in advancing transplantation, both within and outside the European Union. Within this framework, a priority ranking of initiatives is suggested that could serve as the basis for a new European Union Action Plan on Organ Donation and Transplantation.
| S-EPMC8097678 | biostudies-literature
Project description:Background: Organ shortage is a global issue and it is imperative to take steps to bridge this gap. In the Indian context, despite its demographic dividend, the rate of organ donation has been abysmally low. This emphasizes a need to demystify the antecedents of organ donation intention among the Indian population. Methods: Using a cross-sectional research design and adopting a post-positivism research philosophy, this study identified 259 respondents by adopting a purposive sampling approach and data on knowledge of organ donation was collected using a structured, pretested questionnaire. Results: Awareness of organ donation law in India is low on specific issues and respondents from the health science & medicine discipline scored better on knowledge about organ donation. The findings show that most participants had heard about organ donation and had a favourable attitude toward it. The primary sources of information on organ donation were television and newspapers, and healthcare service providers. A complementary partial median is established (β = .217, t = 5.889, p < .001) which implies that willingness to discuss with family significantly mediates the association between attitude towards organ & tissue donation and willingness to sign the donor card. Conclusion: This study revealed that there is a general awareness of organ and tissue donation among the Indian population, but they lack clarity on certain specific issues. Mass media has to be effectively used to build awareness campaigns revolving around enhancing knowledge on a specific issue and building acceptance of the concept of organ and tissue donation.
| S-EPMC10317467 | biostudies-literature
Project description:ImportanceOrgan transplant is a life-saving procedure for patients with end-stage organ failure. In the US, organ procurement organizations (OPOs) are responsible for the evaluation and procurement of organs from donors who have died; however, there is controversy regarding what measures should be used to evaluate their performance.ObjectiveTo evaluate OPO performance metrics using combined mortality and donation data and quantify the associations of population demographics with donation metrics.Design, setting, and participantsThis national cohort study includes data from the US organ transplantation system from January 2008 through December 2017. All individuals who died within the US, as reported by the National Death index, were included.ExposuresDeath, organ donation, and donation eligibility.Main outcomes and measuresEvaluation of the variation in donation metrics and the use of ineligible donors by OPO and demographic subgroup.ResultsThis study included 17 501 742 deaths and 75 769 deceased organ donors (45 040 men [59.4%]; 51 908 White individuals [68.5%]). Of these donors, 15 857 (20.9%) were not eligible, as defined by the OPOs. The median donation metrics by OPO were 0.004 (range, 0.002-0.012) donors per death, 0.89 (range, 0.68-1.30) donors per eligible death, and 0.72 (range, 0.57-0.86) eligible donors per eligible death. The OPOs in the upper quartile of the overall eligible donors per eligible death metric were in the upper quartile of annual rankings on 90 of 140 occasions (64.3%). There was little overlap in top-performing OPOs between metrics; an OPO in the upper quartile for 1 metric was also in the upper quartile for the other metrics on 37 of 570 occasions (6.5% of the time). The median donor eligibility rate, defined as the number of eligible donors per donor, was 0.79 (range, 0.61-0.95) across OPOs. Age (eg, 65 to 84 years, coefficient, -0.55 [SE, 0.03]; P < .001; vs those aged 18 to 34 years), sex (male individuals, -0.09 [SE, 0.02]; P < .001; vs female individuals), race (eg, Black individuals, 0.35 [SE, 0.02]; P < .001; vs White individuals), cause of death (eg, central nervous system tumor, 0.48 [SE, 0.08]; P < .001; vs anoxia), year (eg, 2016-2017: -0.10 [SE, 0.03]; P < .001; vs 2008-2009), and OPO were associated with the use of ineligible donors; OPO was a significant factor associated with performance in all metrics (χ256, 500.5; P < .001; coefficient range across individual OPOs, -0.15 [SE, 0.09] to 0.75 [SE, 0.09]), even after accounting for population differences. Female and non-White individuals were significantly less likely to be used as ineligible donors.Conclusions and relevanceWe demonstrate significant variability in OPO performance rankings, depending on which donation metric is used. There were significant differences in OPO performance, even after accounting for differences in potential donor populations. Our data suggest significant variation in use of ineligible donors among OPOs, a source for increased donors. The performance of OPOs should be evaluated using a range of donation metrics.
| S-EPMC7711570 | biostudies-literature
Project description:ObjectivesIntensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker's mindset. This focused on: (1) how decisions compare when made on behalf of a relative (vs the self); and (2) confidence in decisions made for family members.DesignCross-sectional survey in Singapore.SettingParticipants were recruited from community settings via door-to-door sampling and community eateries.Participants973 adults who qualified as organ donors in Singapore.ResultsAlthough 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative's organs. Using machine learning, we found that consistency was predicted by: (1) religion, and (2) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative's were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives' wishes on death.ConclusionsThese findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker's mindset (eg, overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.
| S-EPMC8596040 | biostudies-literature
Project description: Not available
| S-EPMC11921857 | biostudies-literature
Project description:BackgroundThe perception of organ donation and brain death among Syrian population has not been previously explored. The goal of this study is to evaluate the attitude and knowledge of organ donation among Syrians and the willingness of this population to donate their organs.MethodsWe conducted a survey-based cross-sectional study in four hospitals in Aleppo, Syria in November 2019. Patient demographic, awareness of brain death; and attitude toward organ donation were collected and analyzed.ResultsA total of 350 individuals were invited to participate in the survey among whom 303 (197 females, 106 males) agreed to participate in the study (87% response rate). The majority of our participants (n = 249, 82%) heard about organ donation with television (n = 166, 55%), social media (n = 77, 25%), and the internet (n = 77, 25%) being the most common sources of information. When assessing knowledge about brain death, only 40% (n = 116) answered 3 or more questions (out of 5) correctly. Fifty-eight percent (n = 176) of respondents agreed with the idea of organ donation and 183 (62%) would like to donate their organs one day. The leading motivation to organ donation was the desire to help (n = 234, 77%), while the most common reason to refuse donation was the refusal to disfigure a dead body by removing an organ (n = 125, 41%). Religious reasons were cited as motivation for organ donation by 43% of participants (n = 130), and a reason for refusing to donate organs by 24% (n = 71). Most respondents (n = 261, 88%) were unaware of the laws and legislations related to organ donation in Syria. When asked if religion and law were encouraging organ donation, 76% of respondents (n = 226) would donate their organs. Although more positive attitude was found in those with better brain death knowledge (score ≥ 3), this did not translate into more willingness to donate organs in this group of participants.ConclusionsThe promotion of organ donations from deceased donors is a necessity given the rising shortage of organs. The information provided by this study could help policy makers build future strategies to promote deceased organ donation programs and overcome current obstacles preventing such initiatives from achieving their goals.
| S-EPMC7727146 | biostudies-literature
Project description:This study aimed to examine the barriers and facilitators of the public toward deceased organ donation in Chandigarh, and Chennai, India, from three major religious groups, Hinduism, Islamism, and Christianity. Twenty-five focus groups were conducted (n = 87) stratified by study region, religion, sex, and age. Data were analysed using framework analysis. The results revealed that individuals were primarily willing to donate their organs. However, their religious views regarding death, after-life beliefs, funeral ritual practices, and lack of knowledge regarding their religion's position toward deceased organ donation created tension and ambiguity in the decision-making. However, younger age groups (18-30 years) appeared more open and positive toward deceased organ donation. The conclusion demands a clear need for religious leaders and stakeholders to address their religion's stance, which creates tension and ambiguity in any uncertainties surrounding cultural and religious-based views among the Indian population.
| S-EPMC11576623 | biostudies-literature
Project description:BackgroundEuropean countries are increasingly harmonising their organ donation and transplantation policies. Although a growing number of nations are moving to presumed consent to deceased organ donation, no attempts have been made to harmonise policies on individual consent and the role of the family in the decision-making process. Little is known about public awareness of and attitudes towards the role of the family in their own country and European harmonisation on these health policy dimensions. To improve understanding of these issues, we examined what university students think about the role of the family in decision-making in deceased organ donation and about harmonising consent policies within Europe.MethodsUsing LimeSurvey© software, we conducted a comparative cross-sectional international survey of 2193 university students of health sciences and humanities/social sciences from Austria (339), Belgium (439), Denmark (230), Germany (424), Greece (159), Romania (190), Slovenia (190), and Spain (222).ResultsParticipants from opt-in countries may have a better awareness of the family's legal role than those from opt-out countries. Most respondents opposed the family veto, but they were more ambivalent towards the role of the family as a surrogate decision-maker. The majority of participants were satisfied with the family's legal role. However, those who were unsatisfied preferred to limit family involvement. Overall, participants were opposed to the idea of national sovereignty over consent policies. They favoured an opt-out policy harmonisation and were divided over opt-in. Their views on harmonisation of family involvement were consistent with their personal preferences.ConclusionsThere is overall division on whether families should have a surrogate role, and substantial opposition to granting them sole authority over decision-making. If European countries were to harmonise their policies on consent for organ donation, an opt-out system that grants families a surrogate decision-making role may enjoy the widest public support.
| S-EPMC9664433 | biostudies-literature
Project description:BackgroundAnatomical dissection of whole bodies donated for teaching and research purposes remains a cornerstone of medical education. However, evolving sociocultural and ethical landscapes have historically influenced this practice, necessitating ongoing research to inform and enhance donation programs. This study examines the Slovenian students' attitudes and factors influencing their decision-making regarding body and organ donation for medical education.Materials and methodsAn anonymous cross-sectional cohort study was conducted at the University of Ljubljana using a 28-item questionnaire to assess student attitudes toward post-mortem whole-body and organ donation, as well as their perceptions of anatomical dissection in medical training and research. A five-point Likert scale was employed to evaluate attitudinal responses and identify underlying influencing factors.ResultsAnalysis of 1528 student responses revealed significant differences in attitudes toward body and organ donation based on religious affiliation and anatomy course completion. Catholic students exhibited statistically lower levels of support and registration for donation compared to agnostic and atheist students (p < 0.001). A willingness to donate their bodies for teaching and research purposes was reported by 33.1% of participants. Notably, 26.3% would recommend whole-body donation to a family member, 27.9% to a friend, and 31.8% to a member of the general public. Students who had completed an anatomy course demonstrated a significantly higher likelihood of registering for organ donation (p = 0.003), yet were less inclined to donate their bodies for teaching and research due to concerns regarding the treatment of donated bodies.ConclusionDespite general support for organ and body donation, registration rates among Slovenian students remain low, including among those exposed to anatomy courses. We propose integrating end-of-life education, humanistic perspectives, and donor commemorative ceremonies into medical curricula to foster trust, ethical awareness, and advocacy for donation.
| S-EPMC11674541 | biostudies-literature
Project description:IntroductionResearch with deceased donor organs can provide an important platform for studying interventions to improve organ use and outcomes after authorization from the next-of-kin (NOK) or before death by the decedent (i.e., first-person authorization [FPA]). To date, information on authorization rates across donor subgroups is lacking.MethodsWe performed a retrospective chart review of all 690 deceased organ donors from January 2017 to December 2019 at a midsized Midwestern organ procurement organization (OPO). Multivariable logistic regression was used to assess associations between donor factors and research decline (adjusted odds ratio [aOR], 95% confidence interval [CI]).ResultsElectronic records for all 690 deceased donors were reviewed. Of these, 659 (95.5%) yielded at least one transplanted organ. Overall, research was declined in 10.8% of donations. Compared to White donors, research decline was higher for Black (16.0% vs. 8.9%; aOR, 1.87; 95% CI, 1.03-3.40; P = 0.04) and other non-White donors (24.0% vs. 8.9%; aOR, 4.21; 95% CI, 1.02-17.39; P = 0.05). Unadjusted research decline trended higher for Hispanic donors versus non-Hispanic donors (23.1% vs. 10.5%; P = 0.14). Compared to donors age <40 years, research decline trended higher for donors age ≥65 years (16.7% vs. 11.8%; aOR, 4.87; 95% CI, 1.12-21.05; P = 0.03), whereas research decline was 55% lower when donors provided FPA (7.3% vs 15.0%; aOR, 0.45; 95% CI, 0.27-0.76; P = 0.003).ConclusionsDeceased donor research authorization decline is higher for Black, other non-White, and older donors, but lower when the descendent provides FPA. Identification of disparities in research authorization may stimulate educational strategies to reduce barriers to scientific investigations directed at optimizing the outcomes of organ donation.
| S-EPMC8419128 | biostudies-literature