Abstract
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.
Highlights
Liver transplantation is a surgical procedure accomplished to help replace a diseased part of a liver with a healthy one from a different individual
Liver donor allocation nowadays follows the Model for End-Stage Liver Disease (MELD), which relies on an algorithm targeting urgency, or a high-risk patient approach [9]
When asked about the criteria defining a successful liver transplantation, most of the respondents believed that success is defined as a gain in both lifetime and quality of life (84.8%)
Summary
A total of 402 students were included (54.5% men and 49.4% women). The mean (SD) age of the participants was 21.81 (1.5) years. Regarding the shortage of organs, we asked the participants “As a patient on the waiting list, at what probability of dying within one year after transplantation would you accept a rejection?”; 30.1% agreed to 60%-80%; 28.4% chose 40%-60%; 16.4% chose 80%-100%; 13.2 chose 20%-40%, and 11.9% said they would accept the rejection if the probability of death was 0%-20%. We asked the participants whether the urgency of the case or the prospect of success of the transplantation should determine who receives the organ. Participants' thoughts on determining who receives the organ, urgency of the case, or the prospect of success of the transplantation. The results showed that 165 (41%) of the students were willing to donate, 162 (40.3%) did not know, and 75 (18.7%) said they would not donate They were asked if their decision to donate was affected by the prospect of success of the transplantation or not. Regarding the students’ opinions on how to handle patients with alcohol-related cirrhosis, 57,7% agreed that they would accept them on the waiting list after having been abstinent for six months; 19,4% said they would never accept these patients, and 22,9% said they would always accept a patient on the waiting list
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