Concept Of Brain Death Research Articles

Deaths that save lives: the complexities of medical care for patients with suspected brain death

The objective of this study was to understand how physicians at the largest emergency department in a large Brazilian city orient care for critical patients with suspected brain death and who are potential organ donors. This ethnographic study was conducted in an emergency care hospital, a reference in traumatology in Latin America, located in downtown Belo Horizonte, Minas Gerais State. The institution took pioneering steps in Brazil with a specific sector where patients with suspected brain death are referred. The fieldwork was performed over the course of nine months, based on targeted observations and interviews with 43 on-duty staff physicians (25 men and 18 women), from 28 and 69 years of age. Data analysis followed the "signs, meanings, and actions" model. The ethnography revealed the process of medical care for patients with suspected brain death, including: intensive care, adherence to protocol, and communicating the patient's status to the family. In the latter case, the dialogue reveals the controversies in the concept of brain death, the sociocultural context, and the emergency care context. It became clear that this process of medical care extrapolates merely normative issues, entering into a complex web of elements, especially the professional's role as mediator of a myriad of interwoven elements and tensions. Between confirmation of the brain death and communicating the situation to the family, ambivalent perceptions emerge, both for the physicians and the family members. The study evidenced how the tenuous definition of what constitutes life and death touches on all of the medical act, with direct implications on care for patients/potential donors and their families.

Knowledge of the Brain Death Concept in Dominican Immigration Residents in Spain and Florida

The Latin American population has a double way of immigration, one toward the United States by proximity and another toward Spain by sociocultural affinity. This population increase is affecting organ donation and transplantation in receiving countries. ObjectiveTo analyze the brain death (BD) concept knowledge in the Dominican Republic immigrant population in Florida (United States) and Spain. MethodPopulation under study: Population born in the Dominican Republic, resident in Florida (United States) and in Spain. Inclusion criteria: Population older than 15 years stratified by age and sex. Assessment instrument: Donation attitude questionnaire PCID-DTO-Ríos. Fieldwork: Random selection based on stratification. Immigration support association collaboration in Florida and Spain was needed to locate potential respondents. Completion was anonymous and self-administered, with verbal consent. ResultsA total of 123 respondents, 57 residents in Spain and 66 in Florida, have been included in the study. The 27% (n = 33) of the respondents knowledgeable of the BD concept consider it the death of an individual. Of the remainder, 52% (n = 64) do not know about it, and the remaining 21% (n = 26) believe it does not mean the death of a patient. No differences were observed regarding migration countries (P > .05). There was no association of the BD concept with other psychosocial factors analyzed or with the attitude toward organ donation. ConclusionsKnowledge of the BD concept among the Dominican immigrant population is similar in Spain and Florida, and, unlike most studies, there is no objective association with the attitude toward organ donation.

A Conceptual Justification for Brain Death.

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that paralleled advances in intensive care unit treatment. The century-old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death.

Sensitization Toward Organ Donation Among Medical Students in Spanish Regions With More Than 50 Donors Per Million Population

The awareness of organ donation among health professionals is important at the time of transplant promotion. In this sense, the training and awareness of the professionals in training is fundamental. ObjectiveTo analyze the differences in the attitude toward organ donation and the factors that condition it among medical students of regions with donation rates >50 donors per million population (pmp) with respect to those with rates <40 donor pmp. MethodPopulation under study: medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: Group 1 (n = 1136): students in universities of regions with >50 donors pmp. Group 2 (n = 2018): university students in regions with <40 donors pmp. Assessment instrument: attitude questionnaire for organ donation for transplant PCID-DTO-Ríos. ResultsThe attitude toward organ donation for transplantation is similar among students from the autonomous communities with >50 donors pmp and with <40 donors pmp. In group 1, 79% (n = 897) of students are in favor compared with 81% (n = 1625) of group 2 (P=.29). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): sex, having discussed transplantation with family and as a couple, considering the possibility of needing a transplant, involvement in prosocial activities, attitude toward the manipulation of corpses, knowledge of the brain death concept, and religion. ConclusionsThe awareness of organ donation in Spanish medical students is quite homogeneous and is not related to the local donation rates of each region.

There Is Great Ignorance About the Brain Death Concept Among the Population in Santiago de Cuba (Cuba)

IntroductionThe knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation. ObjectiveTo analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it. MethodsFrom the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ2, Fisher, and logistic regression analysis were used. ResultsForty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation. ConclusionThere is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors.

Knowledge of Brain Death Among the Nigerian Residents in Spain

IntroductionThe Nigerian population, an emerging group in Europe, has not been studied in terms of its knowledge of the concept of brain death (BD) and its relationship with organ donation and transplantation (ODT). ObjectiveTo analyze knowledge of the BD concept among Nigerians living in Spain. MethodA sample of Nigerians who are ≥15 years of age and living in Spain were stratified by age and sex and interviewed. The assessment instrument is the attitude questionnaire for donation and transplantation, Proyecto Colaborativo Internacional Donante sobre Donación y Trasplante de Órgano (in Spanish) Ríos, which was self-administered and anonymously completed. The statistics used were descriptive, χ2 test, Student t test, and a logistic regression analysis. ResultsThe questionnaire was completed by 362 Nigerians. Eighteen percent (n = 66) know the concept of BD and accept it as a person's death. Of the rest, 58% (n = 210) do not know it and 24% (n = 86) have a misconception. Those who know the BD concept have a more favorable attitude toward organ donation after death than those who do not know it (29% vs 13%, P < .001). Couples' opinions about organ donation (P < .001) and level of studies (P = .039) are related to the knowledge of the BD concept. In the multivariate analysis, the following persist as independent variables: the attitude in favor (P < .001, OR = 3.925) and the opinion of the couples toward donation (P <. 001, OR = 6.776). ConclusionsKnowledge of the BD concept is anecdotal among the Nigerian population in Spain.

Do the Senegalese Who Immigrate to Southern Europe Know About the Brain Death Concept?

IntroductionThe Senegalese population is migrating massively to southern Europe, especially Spain, France, and Italy. The ignorance of the concept of brain death (BD) is one of the main factors that condition organ donation. ObjectiveTo analyze the knowledge of the BD concept among the Senegalese population who currently reside in Spain. MethodA sample of the population born in Senegal who are ≥15 years of age and currently living in Spain, stratified by age and sex, were surveyed. The assessment instrument is the questionnaire of attitude toward donation and transplant—Proyecto Colaborativo Internacional Donante sobre Donación y Trasplante de Órgano (in Spanish) RIOS—which is self-administered, with anonymous completion and prior verbal consent. The statistics used were descriptive, χ2 test, Student t test, and a logistic regression analysis. ResultsThe survey included 468 people. Of these, 25% (n = 115) know about the BD concept and accept it as the death of a person. Of the rest, 57% (n = 266) do not know the meaning of the BD concept, and 18% (n = 87) have a misconception. Those who know the concept have a more favorable attitude toward the donation of their own organs after dying than those who do not (41% vs 14%, P < .001). Having talked about the transplant (P < .001), a couple's opinion about organ donation (P < .001), and religion (P < .001) are related to knowledge of the BD concept. In the multivariate analysis, the association with the attitude in favor of cadaver organ donation (P < .001, OR = 3.848) and religion (P < .001, OR = 12.332) is maintained. ConclusionsThe lack of knowledge of the BD concept in the Senegalese population has a negative effect on the attitude toward organ donation.

Attitude Toward Organ Donation in the Population of Cienfuegos, Cuba

IntroductionThe sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns. ObjectiveTo analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba. MethodPopulation under study: Population who reside in Cienfuegos, Cuba. Inclusion criteria: Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant—PCID–DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study. Statistics: Student t test, χ2, Fisher, and a logistic regression analysis. ResultsA sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation. ConclusionsThe attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors.

Reader response: An interdisciplinary response to contemporary concerns about brain death determination.

We read with interest the Contemporary Issues by Lewis et al.1 Previously, Dr. Bernat defended the whole-brain concept of brain death (BD),2 and the US President's Commission recommended its adoption by all US states.3 In 2015, Wijdicks stated, “the irreversible absence of functions of the brainstem is the necessary and sufficient component of brain death.”4 This view fully pertains to brainstem death, and not to the whole-brain criterion.5 The American Academy of Neurology summit concluded that “BD is defined by irreversible loss of consciousness and brainstem function,” according to the whole-brain criterion.1

Editors' note: An interdisciplinary response to contemporary concerns about brain death determination

“An interdisciplinary response to contemporary concerns about brain death determination” generated several readers' responses. Commenting on the paper, Verheijde et al. argue that cardiopulmonary death is not the equivalent to brain death and add that public trust in brain death requires that there be zero false-positive determinations of death. Dr. Sethi suggests that lawsuits related to brain death may be linked more to breakdowns in communication between the medical teams and patient families rather than validity of determination of death by neurologic criteria. Machado et al. suggest that ancillary tests should have a decisive role in helping to delineate the brain death concept since clinical evaluation might have pitfalls. Finally, Dr. Shabtai feels that it is an error to frame the debate as one of religious or moral beliefs vs science, and suggests continued discussion, including broad public debate. Authors Lewis et al. defend their article citing several prominent American medical societies who support that brain death is equivalent to cardiopulmonary death. They add that when the American Academy of Neurology guidelines are appropriately applied, there are zero false-positive determinations of death. They suggest including a social worker, psychologist, palliative care specialist, chaplain, and religious figure in conversations about brain death. They explain that ancillary testing is recommended to assess for lack of intracranial blood flow or cerebral activity if a clinical evaluation cannot be completed, but the gold standard for determination of brain death is a full clinical evaluation. Further, they add that ancillary testing is imperfect and there are risks when performing testing and interpreting the results. Finally, they remind the reader that the 1981 President's Commission determined that death should be defined based on complete loss of function of the brain or the heart and lungs, but deferred to the medical community to establish the specific criteria for determination of death. They stress that it is the medical community's responsibility to ensure that it is clear what constitutes “accepted medical standards” for determination of death and that these criteria are adhered to consistently and accurately. “An interdisciplinary response to contemporary concerns about brain death determination” generated several readers' responses. Commenting on the paper, Verheijde et al. argue that cardiopulmonary death is not the equivalent to brain death and add that public trust in brain death requires that there be zero false-positive determinations of death.

Klasyfikacja dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia

Na początku ery transplantacji większość narządów pobierano od dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia. W późniejszym czasie szeroka akceptacja koncepcji i kryteriów diagnozy śmierci mózgu sprawiły, że donacja narządów od dawców po śmierci mózgu szeroko zastąpiła donację od dawców po śmierci krążeniowej, stając się wreszcie standardem. Ponowne zainteresowanie donacją od dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia rozpoczęło się w latach dziewięćdziesiątych XX w., co wynikało z nieustannego niedoboru narządów do przeszczepów od dawców po śmierci mózgowej. Donacja po śmierci krążeniowej utorowała już swoją drogę w praktyce klinicznej i na świecie odnotowuje się jej coraz częstsze wykorzystanie, sięgające nawet 30-40% działalności w zakresie pozyskiwania narządów. Jednakże, brak jednolitych wytycznych odnośnie do donacji po śmierci krążeniowej, wzbudza wśród profesjonalistów wiele wątpliwości etycznych, prawnych czy medycznych. Problemy dotyczą między innymi kwestii opieki paliatywnej i fazy jej wycofania, jak i samej definicji śmierci. Zarówno legislacja, jak i praktyka donacji po śmierci krążeniowej różnią się znacząco pomiędzy państwami. Stąd też pojawiła się konieczność wypracowania konsensusu i opracowania wytycznych, które zmierzyłyby się z problemami etycznymi, prawnymi, organizacyjnymi i technicznymi. Służyć ku temu miało między innymi opracowanie klasyfikacji kategorii dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia. Niniejsze opracowanie przedstawia i omawia klasyfikacje dawców zmarłych w mechanizmie nieodwracalnego zatrzymania krążenia.

Ambiguity, death determination, and the dead donor rule

The dead donor rule states that organ donors must be declared dead before any vital organs are removed. Recently, scholars and physicians have argued for the abandonment of the dead donor rule, based on the rule’s supposed connection with the concept of brain death, which they view as a conceptually unreliable definition of death. In this essay, I distinguish between methods of death determination and the question of whether or not the dead donor rule should be a guiding principle of organ transplant ethics. In principle, the dead donor rule does not rely on any one definition of death, but only prohibits the taking of vital organs before a patient is declared dead. In light of this distinction, I argue that even if the dead donor rule is tied to brain death in practice, conceptual disagreement about brain death does not provide grounds for rejection of this rule. I then present evidence in support of the consistency and reliability of the diagnosis of brain death. I show that, when performed carefully and under specific clinical circumstances, the diagnosis of brain death is considered by most neurologists to be reliable. Finally, I argue that, without the dead donor rule, organ transplantation programs would become susceptible to violations of the ethical principle of respect for persons.

Donation after brain death followed by circulatory death, a novel donation pattern, confers comparable renal allograft outcomes with donation after brain death

BackgroundOrgan donation after brain death (DBD) is the standard strategy for organ transplantation; however, the concept of brain death is not universally accepted due to cultural beliefs and barriers amongst billions of people worldwide. Hence, a novel donation pattern has been established in China which outlines the concept of donation after brain death followed by circulatory death (DBCD). Differently from any current donation classification, this new concept is formulated based on combination of recognizing brain death and circulatory death. Should approval be gained for this definition and approach, DBCD will pave a novel donation option for billions of people who cannot accept DBD due to their cultural beliefs.MethodsA multi-center, cohort study was conducted from February 2012 to December 2015. 523 kidney transplant recipients from four kidney transplant institutions were enrolled into the study, of which, 383 received kidneys from DBCD, and 140 from DBD. Graft and recipient survivals following transplantation were retrospectively analyzed. Postoperative complications including delayed graft function,, and acute rejection, were also analyzed for both groups.ResultsDBCD could achieve comparable graft and recipient survivals in comparison with DBD (Log-rank P = 0.32 and 0.86,respectively). One-year graft and recipient survivals were equal between DBCD and DBD groups (97.4% versus 97.9%, P = 0.10;98.4% versus 98.6%, P = 1.0, respectively). Furthermore, DBCD did not increase incidences of postoperative complications compared with DBD, including delayed graft function (19.3% versus 22.1%, P = 0.46) and acute rejection (9.1% versus 8.6%, P = 1.0). Additionally, antithymocyte globulin as induction therapy and shorter warm ischemia time decreased incidence of delayed graft function in DBCD group (16.8% on antithymocyte globulin versus 27.2% on basiliximab, P = 0.03; 16.7% on ≤18 min versus 26.7% on > 18 min group, P = 0.03).ConclusionsKidney donation through DBCD achieves equally successful outcomes as DBD, and could provide a feasible path to graft availability for billions of people who face barriers to organ donation from DBD.

BRAIN DEATH — A CURRENT PROBLEM OF OUR TIME

The concept of brain death is a complex philosophical and medical construct which, despite the passage of time and strictly defined deadlines, is incomprehensible and unacceptable for a section of society. The diagnosis of brain death allows one not only to end the pursuit of persistent therapy, but also to collect organs for transplantation and thus help people who have been condemned to death so far. The purpose of this article is to show the public’s fears about stating the death of the brain, to realize that the death of the brain is equal to the death of an individual and a reminder of the criteria and rules for the recognition of death by doctors.

The 50-Year Legacy of the Harvard Report on Brain Death

This Viewpoint discusses the the ethical challenge of defining death in persons with irreversible coma, legalization of the definition of brain death in the 1981 Uniform Determination of Death Act, and current implications of the definition for decisions about life support, organ transplantation, and newer genetic technologies. On August 5, 1968, an ad hoc committee at Harvard Medical School published a landmark report that laid the groundwork for a new definition of death, based on neurological criteria.The authors, under the leadership of anesthesiologist Henry Beecher, stated that their primary purpose was to “define irreversible coma as a new criterion for death.” The concept of brain death has guided clinical practice for 50 years even though vigorous debate about its legitimacy has never ceased. History is full of ironies, and the 50-year legacy of the Harvard report is no exception. From one perspective, the report laid the foundation for laws that have both saved and improved the lives of hundreds of thousands of patients through organ and tissue donation. Conversely, decades of attempts to find a conceptual justification for linking this diagnosis to the death of the patient remain incomplete.

Addressing Religious or Cultural Opposition to Brain Death Diagnosis.

In 1968, the neurologic or "brain death" standard for declaration was introduced as an accepted standard for declaration of death in hospitals where heartbeat and breathing are being sustained by technology, but functions of the brain, including the brain stem, have ceased. For many people, this accepted ethical, legal, and medical definition of death by neurologic standards can seem to blur the line between life and death as the heart is still beating, the lungs are still moving air albeit by mechanical ventilation, and the body is still warm. As experts in end-of-life care, hospice and palliative care nurses must be knowledgeable about declaration of death by neurologic criteria, understand beliefs that do not support the concept, and collaborate with the health care team in providing compassionate end-of-life care. This article will use a case study to describe the legal and ethical challenges that ensue when religious and/or cultural beliefs result in rejection of the concept of brain death and propose ethically sound strategies to navigate these challenges within a framework of culturally congruent care that includes a 4-step process to progressively appreciate, accommodate, negotiate, and/or explicate the differences.

Secondary School Students' Orientation Toward Brain Death and Organ Donation in Southern Region of Saudi Arabia

ObjectiveTo measure the awareness regarding the concepts of brain death and organ donation among secondary school students within the age range of 12–18 years in the southern region of Saudi Arabia. MethodIn the southern region of Saudi Arabia, 10 secondary schools were randomly chosen to participate in this study for which all the tree levels of secondary schools were visited and a written questionnaire was distributed to a randomly selected student from all 3 levels. The questionnaire was filled and completed anonymously and then analyzed. ResultsAmong the 649 students surveyed, 47.22% were aware of brain death and 53.78% did not know anything about organ donation. Further, among those who had heard about these terms, 60% had received the information from informal sources like their friends or through casual web surfing; only a few had received the information from formal sources like television and the radio. The students' understanding of concepts regarding the nature of death and the causes of brain death was, as expected, inadequate and inappropriate. The Islamic perspective on brain death and the knowledge about the Sharia ruling on organ donation was also poor. Regarding the students' knowledge about organ donation, 21.57% of the students knew that organs can be donated from a brain-dead person. 24.6% knew that only living persons can donate organs, while the rest (53.78%) were not aware about organ donation at all. ConclusionThe knowledge of and attitude toward brain death and organ donation are very poor among the young Saudi population, and have not evolved over a period of time. The information regarding the religious fatwas has not been transmitted to the level of the educational institutions.

Analysis of the reasons for nurses' confusion in relation to the concept of brain death from clinical and legal points of view.

BackgroundNurses in intensive care units (ICU) play a key role in taking care of brain dead patients and they are often in contact with such patients given the high rate of brain deaths. Consequently, they are in a challenging and stressful condition, which may be aggravated due to the need for increased organ donation, and this may also affect the quality of care provided for these patients.ObjectiveThis review analyzes the different studies on the concept of brain death from both medical and legal points of view. The aim of this study was to identify the challenges the nurses face with the perception of the concept of brain death and its effects on the care provided for the patients suffering from brain death, as well as organ donation.MethodsThis Narrative review study summarizes the information obtained from relevant literature through a targeted search of library texts and electronic resources including Science Direct, PubMed, Google Scholar, Scientific Information Database (SID), IranMedex, and Magiran databases during 2000–2017 in English and Persian, on the subject of interest by keywords such as brain death, organ donation, care, legal, regulations and nursing. Finally, a total of 44 relevant articles were reviewed.ResultsNurses play an important role in taking care of brain dead patients; therefore, recognizing challenges can be the first step in taking accurate care of these patients and subsequently maintaining the organs’ health for transplants. Although there are clinical and legal uncertainties regarding the concept of brain death, nurses have an important effect on taking care of brain dead patients as well as the rate of organ donation.ConclusionNurses in intensive care units should have a clear understanding of the concept of brain death in order to be able to take care of brain dead patients by avoiding psychological effects. In this regard, it is recommended that a comprehensive educational program be designed on the dimensions of brain death. Therefore, the nurses’ awareness of brain death and their ability to clarify this concept to the patients’ relatives would have a great effect on the decrease in the challenges and the stress imposed on the nurses. Also, there would be an increase in the quality of the care given to brain dead patients and even the rate of organ donation.

Medical Students' Attitude Toward Organ Donation: Understanding Reasons for Refusal in Order to Increase Transplantation Rates

ObjectivesTo assess, among medical students, the willingness to donate their own organs or those of a family member, and to establish reasons for refusal. Materials and MethodsDuring the 2016 academic year, an anonymous survey was conducted among University of Buenos Aires School of Medicine second-year students. ResultsOf the total 1012 respondents, 81.92% would agree to donate and 18.08% would not. Thirty two percent would not authorize donation of a family member's organ. Almost all (94.1%) students reported they had little information about organ donation. Reasons for refusal included: fears about the possibility of not being really dead when considered for organ ablation (36.4%); lack of confidence in (25.8%) or lack of information about the organ procurement and transplantation system (14.6%); no interest in organ donation (9.3%); and religious reasons (6%). Brain death was considered irreversible by 59.7% of donors and by only 51% of non-donors (P = .036). Contact with a transplanted person was more frequent in the donor group (30.9% vs 21.3%, P = .01). More donors were found among the group who discussed the subject with their families than among the group who did not (69.1% vs 62.9%, P = .053). ConclusionsA considerable percentage of medical school students would not be willing to donate their own or a family member's organs. Main reasons are mistrust of the system, lack of information about donation programs, and poor understanding of the brain death concept. Contact with an organ recipient and discussing the subject in the family both favored donation.

Psychosocial Factors Affecting Attitude Toward Organ Donation in Santiago, Cuba

IntroductionAwareness about organ donation among the general population is fundamental to organ donation programs. It is important to determine the factors that influence attitudes toward organ donation within the general population in order to carry out cost-effective campaigns. ObjectiveTo analyze the attitude toward organ donation among Santiago, Cuba, citizens. MethodsThe study population encompassed residents in Santiago, Cuba. A sample population of residents older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation and transplant (PCID-DTO Ríos). Available census data were used. The survey was self-administered and completed anonymously. ResultsOf the 455 respondents, 70% of respondents are in favour of cadaveric donation, 16% are against, and 14% were undecided. Several variables were associated with having a more favorable attitude. And in the multivariate analysis, the following variables continue to feature as independent variables: 1. knowledge of the concept of brain death [OR = 2.386 (4.761–1.194); P = .014]; 2. being in favor of donating a family member's organs [OR = 3.067 (5.952–1.584); P = .001]; 3. a partner's favorable attitude [OR = 5.795 (1.477–22.731); P = .012]; 4. being an atheist/agnostic as the religious beliefs [OR = 1.845 (3.289–1.038); P = .037]; 5. not being concerned about the possible mutilation of the body after donation [OR = 7.437 (2.918–18.955); P < .001]; 6. not accepting other treatment options after death, such as inhumation [OR = 3.048 (5.714–1.626); P = .001]. ConclusionsThe attitude toward cadaveric organ donation among the Santiago, Cuba population is favorable and it is associated with several psychosocial factors.