Experience Of Organ Donation Research Articles

Knowledge, Attitudes, Willingness, and Associated Factors to Organ Donation Among Intensive Care Unit Health Care Workers: Findings of a Cross-Sectional Study

The lack of donor organs is a major barrier to the advancement of organ transplantation. This study aimed to understand the current status of knowledge, attitudes, and willingness to donate organs among intensive care unit (ICU) health care workers and analyzed the influencing factors to provide a scientific basis for improving the situation of a serious imbalance between the ratio of organ supply and demand. From November 2021 to March 2022, 160 ICU health care workers from 3 level 3A hospitals in Huzhou City, Zhejiang Province, China were chosen as subjects by the cluster sampling method. A cross-sectional study of the participants was carried out using a general information questionnaire, Organ Donation Knowledge Scale, Organ Donation Attitude Scale, and Organ Donation Willingness Scale. The determinants of ICU health care workers' knowledge, attitudes, and willingness toward organ donation were examined using multiple linear regression analysis. A total of 150 ICU health care workers completed the survey within the prescribed time, and the recovery rate of this questionnaire was 93.75%. The score on the Organ Donation Knowledge Scale was 7 (5, 7) points, and the full score was 10 points. The score on the Organ Donation Attitude Scale was (3.87 ± 0.93), and the full score was 7. The Organ Donation Willingness Scale score was 2 (2, 3) out of 5. The results of the multiple linear regression analysis revealed that several factors significantly influenced the score of organ donation knowledge. These factors were identified as the professional title and persuasive experience related to organ donation. Additionally, the score of organ donation attitude was found to be influenced primarily by the persuasive experience of organ donation. Furthermore, the score of organ donation willingness was influenced by 3 main factors: marital status, professional title, and persuasive experience in the context of organ donation. Although the level of ICU health care workers' knowledge and attitudes toward organ donation was above the median level, they still needed to be improved. The current status of ICU health care workers' desire to donate organs is not optimistic; thus, relevant departments should take specific actions to improve the situation.

Impact of the COVID-19 pandemic on Canadian transplant journeys: a mixed methods study

BackgroundNavigating the organ donation and transplantation system in Canada can be challenging for individuals on transplant journeys. Although it is likely that the COVID-19 pandemic has further contributed to these...

臓器提供経験施設への実態調査研究に基づく新たな体制構築に関する提言（Ver. 1）(Recommendations for building a new system based on fact–finding research on organ donation experience facilities (Ver. 1))

要旨世界的な新型コロナウイルス感染症（COVID–19）の蔓延により，本邦でも残念ながら多くの重症患者が発生するに至り，COVID–19による医療提供体制のひっ迫は救急・集中治療に深刻な影響を与えている。しかし臓器提供は終末期を迎えた患者の最期の権利であり，続く臓器移植は臓器不全の患者の生命を救うことができる医療であることから，たとえコロナ禍であっても患者・家族の臓器提供の意思を最大限尊重するべきである。本研究班では，「新型コロナウイルス感染症蔓延下における救命救急センターに対する臓器提供の実態調査」および「コロナ禍で臓器提供を経験された施設に対する実態調査」においてCOVID–19蔓延下における救急・集中治療の実態と，実際にコロナ禍で臓器提供を経験した施設の現状を調査した。本研究は令和2年度厚生労働行政推進調査事業費補助金により実施された一部である。

Organ donation in a developing Caribbean country: a single centre experience in Trinidad and Tobago

ABSTRACT Objectives The National Organ Transplant Unit was established in 2006 with the aim of providing renal and corneal transplants services. This study assessed the current state of the National Organ Transplant Unit and the organ donation experience at a single centre intensive care unit in Trinidad. Methods A review of legal, human and material resources and a retrospective chart review of the current status of organ donation and transplantation in Trinidad and Tobago was conducted. Data were collected from medical records of deceased donors for the period January 2006 to December 2020. The organ donor experience in the Adult Intensive Care Unit at a tertiary care hospital in Trinidad was also evaluated. Data were collected from medical records of all patients in the adult intensive care unit for the period October 2016 to December 2016. Results Trinidad and Tobago has four donor hospitals, one transplant centre, and one surgical team consisting of three surgeons, approximately 100 trained Transplant Procurement Managers and one trained laboratory technician. The deceased donation rate was 0.77 donor per million population in 2006, peaked in 2014 at 3.85 and then remained at 0.77. Donor potentiality for the adult intensive care unit was 66.7% with a donation rate of 5.3%. Conclusions Organ donation in Trinidad and Tobago mostly relies on living donors. Despite increases in organ donation and conversion rates, the country has not yet achieved self-sufficiency. The implementation of a taskforce dedicated to developing action plans to improve organ donation services may assist the country in achieving self-sufficiency.

POS-783 ORGAN DONATION IN A DEVELOPING CARIBBEAN COUNTRY: THE TRINIDAD AND TOBAGO EXPERIENCE

Patients diagnosed with end stage organ failure often benefit from organ transplantation, however, the global shortage of available organs for transplant is unable to meet the demand. In Trinidad and Tobago, Chronic Kidney Disease is the fourth leading cause of death with an estimated 1,800 patients receiving dialysis. The National Organ Transplant Unit (NOTU) was established in 2006 with the aim of providing renal and corneal transplants services. This study assessed the current state of NOTU and the organ donation experience at a single center intensive care unit in Trinidad.

Level and determinants of willingness to donate organs among the general public: A cross-sectional survey in China.

This study aims to assess the level and determinants of the general public's willingness to organ donation. We conducted a population-based cross-sectional study of 4261 participants in China. The primary outcome was the willingness to donate organs. Logistic regression modelling was used to determine the factors that affect willingness to donate organs. Overall, the proportion of participants who showed a willingness to donate organs was 47.45% (95%CI: 0.46, 0.49) in this study. Logistic regression modelling showed participants from Western (OR = 1.33, 95%CI = 1.11-1.59) and Eastern China (OR = 1.40, 95%CI = 1.19-1.65) were more willing to donate organs compared with those from Central China. The odds of being willing to donate organs was higher in females than males (OR = 1.35, 95%CI = 1.17-1.55); and was higher in those participants with experience of organ donation (OR = 1.58, 95%CI = 1.13-2.21), experience of caring for organ transplant patients (OR = 1.45, 95%CI = 1.01-2.07), and those undertaking related voluntary activities (OR = 1.67, 95%CI = 1.45-1.94), than those without. The general public's level of willingness to organ donation was not high in this study. Geographical region, gender, experience of organ donation related activities, taking care of organ transplant patients and volunteering in related activities were independently associated with participants' willingness to donate organs.

Aboriginal and Torres Strait Islander peoples’ experience of organ donation and transplantation

The Transplant Journal of Australasia is published three times per year and is exclusive to members of the Transplant Nurses Association Inc. Articles are sourced from within Australia and from leading practitioners and institutions abroad to keep members abreast of trends and best practice.

Medical Students’ Attitudes Toward Deceased Organ Donation in China: A Cross Section Cohort Study

BackgroundInfluenced by traditional culture and lack of knowledge among Chinese, China has a low rate of organ donation after death. The aims of this study were to assess the attitude toward deceased organ donation among medical students in China and to identify the possible factors related with this attitude. MethodsAn anonymous, self-administered questionnaire comprising 15 questions was distributed to 1500 first-to-fifth grade medical students, with 300 students in each grade. ResultsThe response rate was 90.9% (n = 1363). The level of knowledge about organ donation and the level of knowledge about the transplantation law were positively related with the seniority (P < .001). The attitude was favorable in 62.7% (n = 855) and against in 37.3% (n = 508) of the respondents. The attitude was related with family discussion about organ donation (P = .002), experience of blood donation (P = .004), willingness to accept a donated deceased organ (P < .001), and the decision of donating the organs of a family member (P < .001). No evidence of relation was detected for age, sex, grade, being an only child, coming from a city or village, knowledge of organ transplantation, knowledge of the transplantation law, and experience of organ donation and transplantation. ConclusionsMost medical students in China had a favorable attitude toward deceased organ donation. This attitude was positively related with family factors, experience of blood donation, and willingness to accept a donated deceased organ. This attitude did not increase with seniority and a rising level of medical knowledge.

342.3: Nurse anaesthetists: The organ donor’s advocate throughout the organ donation process in the perioperative setting.

Introduction: In a situation where a possibility to organ donation (OD) occurs, the bed-side professionals (physicians, nurses) are expected to act to realize the OD due to their professional ethics. Perioperative nurses play a vital role in the OD process which includes acting as the donor’s advocate, as well as upholding values to provide the best quality nursing for the donor during the organ procurement. Perioperative nurses work collaboratively within surgical teams by providing intraoperative assistance to procurement teams at the time these procedures are required. The research covering perioperative nurses work situation while participating in OD is limited. The aim of this study was to describe Swedish Nurse Anesthetists’ (NA) experiences and conceptions of participating in the OD process with brain-dead (BD) donors. Methods: A qualitative study was chosen; analysis of the semi-structured interviews was carried out with Phenomenography. Informants: 21 NA (4 male, 17 female); all had experience of OD from BD donors. In addition, 12 NA had experience of organ transplantation. Age 34-64 y (years); work experiences as NA 1,5-41 y; experience of OD 1 - >30 donors. Results: OD was performed with a professional approach but was associated with some challenges e.g. when there was a child donor. To trust and understand BD and to be aware of that the patient is dead was conceived as crucial. All NA had no doubt in the BD concept and the declaration of death, but some described that it was challenging to relate to death when the body was warm, and the heart was beating: “The patient was seen as dead while the body was alive.” Knowledge and experience were essential factors to obtain a sense of safeness in these situations. The results illuminated the importance of routines, including the departments attitudes toward OD. The NA took pride in saving lives and acting as the donor’s advocate. A dignified approach during organ procurement reduced the sense of stress. Conclusions: The benefit of OD was conceived as undebatable. The professional ethics were seen in the NA core values of dignity and respect towards the donor, and to fulfill the donor’s wish to donate. The NA professional pride was illuminated in the conception of that it was positive to be able to contribute to the donors “gift of life”. Experience and knowledge supported the NA and provided safeness in their professional role. Focusing on the positive (the recipients), was conceived as the winning approach.

Posthuman Biopredicament: A Study of Biodystopia in Kazuo Ishiguro’s Never Let Me Go

Ishiguro’s Never Let Me Go is a novel that depicts a typical biodystopia. By recollecting the clones’ tragic experience of organ donation for the benefit of humankind, it discusses the bleak posthuman prospects of science, the double manipulation of life by power, and the metaphorical dimension of posthuman lifewriting. Ishiguro approaches the theme from the clones’ perspective, taking the clones as a metaphor to demonstrate the actual circumstances of human life, therefore the novel could be seen as a parable about human nature. This paper proposes to analyze, from the aspects of science, power and metaphorical lifewriting, Ishiguro’s unique art in creating a biodystopian narrative that reflects universal human conditions and reveals the posthuman biopredicament.

A narrative review of family members' experience of organ donation request after brain death in the critical care setting.

Family members of critically ill patients suffer from high levels of anxiety and depression in the ICU, and are at risk of developing post-ICU syndrome following ICU discharge. In the case of brain death, and potential organ donation, the family is at the center of the decision process: within a limited time frame, the family will be informed that the patient is brain-dead and will be approached about potential organ donation. Family experience with organ donation has been the topic of several research papers allowing one to gain knowledge about family members' experience of organ donation, emphasizing specific needs, adequate support, and pointing out gaps in current delivery of family-centered care. In this narrative review, experts, clinicians, and researchers present the various legal systems regarding family implication in organ donation decisions; describe factors that influence the decision-making process; highlight family perspectives of care and respect for potential donors in the ICU environment; describe the impact of organ donation discussions and decisions on post-ICU syndrome; and suggest communication skills and support to be developed in the future. A research agenda for the next decade is also encouraged. Overall, challenges remain and concern all persons involved in the process, ICU doctors and nurses, the organ procurement organization, family members, and, in some cases, the patients themselves. Looking at the big picture will provide opportunities for further improvements.

Abstract PD-036: THE IMPACT OF PAEDIATRIC ORGAN DONATION ON CRITICAL CARE STAFF IN THE UK

Aims & Objectives: Despite the increased rate of organ donation in the UK, paediatric donation is still a relatively rare event. The death of paediatric patients has been shown to elicit post-traumatic stress disorder (PTSD) symptoms in up to 81% of staff, as well as moral distress in healthcare professionals. Organ donation should form part of end-of-life care, however, its impact on healthcare professionals is unknown. This study aimed to explore the impact that organ donation has on paediatric critical care healthcare professionals’ mental health. Methods A validated questionnaire about organ donation experience, containing PTSD and moral distress assessments, was distributed to PICU staff at University Hospital Southampton. The results were used to generate questions for a focus group to explore issues further. Data analysis included descriptive, statistical and thematic analysis as appropriate. Results Various healthcare professionals completed the questionnaire, yielding a response rate of 71% (90/126). 14% of participants (8/56) exhibited PTSD symptoms and 37% (17/46) reported above average moral distress relating to paediatric organ donation. A Mann-Whitney U test showed those with PTSD symptoms were also more likely to have higher moral distress scores (P=<0.05). Common themes that arose during thematic analysis included ‘organ donation as a positive experience’ and ‘emotional strain’. Conclusions Although the death of patients is upsetting, organ donation itself is viewed as a positive experience by PICU staff, with staff displaying PTSD symptoms less for a child undergoing organ donation than when they die without proceeding to donation. However, organ donation can cause staff moral distress.

Teenagers in Rural Areas Faced With Organ Donation and Transplantation

IntroductionIn rural areas it is common to find unfavorable attitudes toward organ donation, and therefore it is important to find out the attitude and profile of new generations for improving predisposition to organ donation in these areas. Our objective was to analyze the attitude toward organ donation and the related variables of teenagers in a rural area. Materials and methodsStudents in the final year of compulsory education (mostly 15–16 years of age) were selected from secondary schools in a rural area in southeastern Spain (n = 319; population density <300 inhabitants/km2). The instrument of measurement used was a validated psychosocial questionnaire. Completion was anonymous and self-administered. Descriptive statistical analysis, Student t test, χ2 test, and multivariate analysis were employed. ResultsThere was a completion rate of 96% (n = 306). Overall, 65% (n = 200) were in favor of donating their organs, 30% (n = 90) were undecided, and 5% (n = 16) were against. Attitude toward the donation of one's own organs was related with sex (P = .015), previous experience of organ donation or transplantation (P = .046), comment on the topic of organ donation within the family (P = .003; odds ratio 2.155), knowing one's mother's opinion about the matter (P = .021), knowing the correct concept of brain death (P = .012; odds ratio 2.076), and religion (P = .014). ConclusionsA favorable attitude of teenagers in rural areas toward organ donation is slightly higher than in the adult population and is determined by many psychosocial variables, above all family discussion about organ donation and transplantation and correct knowledge of the brain death concept.

Our organ donation experience in a braindead polycystic kidney disease patient: Case report

Our organ donation experience in a braindead polycystic kidney disease patient: Case report

Clinicians' Perception and Experience of Organ Donation From Brain-Dead Patients.

ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician's perceptions and experience of organ donation. Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression. Physicians and nurses. Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32-0.53; p < 0.001), more often potential organ donors (odds ratio, 1.92; 95% CI, 1.56-2.35; p < 0.001), less likely to describe inconsistency (odds ratio, 0.43; 95% CI, 0.23-0.8) or complexity (odds ratio, 0.55; 95% CI, 0.45-0.67) of their feelings versus their professional activity, less likely to report that organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55-0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37-2.14; p < 0.001). Professionals who felt organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34-2.54; p < 0.001), less often physicians (odds ratio, 0.58; 95% CI, 0.44-0.77; p < 0.001), more likely to describe shift from curative care to organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52-2.21; p < 0.001), care of relatives of brain-dead patients as complex (odds ratio, 1.59; 95% CI, 1.32-1.93; p < 0.001), and inconsistency and complexity of personal feelings about organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92-5.53; p < 0.001), and more likely to have little experience with caring for potential organ donors (odds ratio, 1.49; 95% CI, 1.09-2.04). Significant differences exist among ICU clinician's perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation.

The Main Features of DCD Donors in China (Hunan province experience)

Introduction The shortage of organ resources is considered a significant problem in countries all over the world. How to promote organ donation after citizen death (DCD) has become one of the key issues of organ transplantation. The objective of this paper is to analyze the main features of DCD donors in China. Based on the experience of organ donation in our transplantation center, we aim to explore the improvement of the organ donation in China within recent years. Method We collected 221 cases of successful donation from our transplantation center and analyzed the data by SPSS. In this paper, we comprehensively analyzed the key features of organ donors in China from various aspects, including age, sex, educational level, occupation, cause of death, and family structure. Result Our center, one of the pioneers of DCD work in China, has been devoted to DCD work since 2010. Among more than one thousand potential donors, 221 successfully donated. From 2010 to 2016, our rate of successful donation increased by 16.5 folds. The annual average increase rate is as high as 74.8%. Among the 221 cases, 177 were male donors and 44 were female. All donors were divided into 3 groups according to their age. In the young age group (under 18 years old, n = 30), more than half died of tumors (n = 21). In the middle age group (between 19 and 49 years old, n = 142), 87.32% were male (n = 124). 73.94% of donors in this group received primary and junior school education (n = 105), while 85.9% of them were farmers or urban migrant workers whose jobs were highly instable (n = 122). Their death mainly resulted from craniocerebral trauma by traffic accidents and occupational injuries (n = 90). 54.22% of them were either unmarried, divorced, or has suffered from loss of spouse (n = 77). In the old age group (between 50 and 65 years old, n = 38), 68% of donors died of spontaneous intracerebral hemorrhage or brain tumors (n = 26). Conclusion Based on the data above, the organ donors in China were younger than those in developed countries, and mainly were male. Farmers or urban migrant workers with instable jobs, low education levels, and a simple family structure composed the largest part of organ donation. Meanwhile, the main cause of adult donor death is craniocerebral trauma from traffic accidents and occupational injuries. The study was funded by Wu Jieping Medical Foundation (320.6750.15070) and Natural Science Foundation of Hunan Province (2016JJ4105).

Organ Donation and Transplantation From Donors With Systemic Infection: A Single-Center Experience.

Donors with bacteremia and sepsis are often considered to be controversial for organ retrieval due to potential transmission of an infectious agent to the recipient. Herein we report our initial experience of organ donation and transplantation results from donors with systemic infection. From January 2013 to December 2014, 125 cases of donation were completed in our organ procurement organization including 90 cases of donation after brain death (DBD) and 35 cases of donation after circulatory death (DCD). The results of bacterial culture of the donor's peripheral venous blood (PVB), blood from central venous catheter (BCVC), urine, bronchial aspiration, and tip of central venous catheter (TCVC; Maki's semiquantitative culture) were retrospectively reviewed. All liver transplant recipients received specific antibiotics according the susceptibility profiles of the PVB cultures, and all kidney transplant recipients received specific antibiotics according the susceptibility profiles of the PVB and urine cultures. Bacterial infection diseases transmission from donors of the liver and kidney transplant recipients were also retrospectively reviewed. The positive rates of the bacterial culture of the donor's bronchial aspiration, PVB, BCVC, TCVC, and urine were 46.4% (39/84), 20.2% (24/119), 15.8% (12/76), 11.1% (3/27), and 7.0% (8/115), respectively. Only 28.1% (9/32) of donors with positive cultures of PVB or urine received specific antimicrobial therapy before harvesting. Twenty-two livers and 46 kidneys from donors with systemic infection (positive PVB culture) were transplanted, and no case of bacterial infection diseases transmission occurred in the recipients. In the circumstance of donor systemic infection with positive bacterial culture of PVB, the liver and kidney can be transplanted safely with prophylactic antibiotics. Donors with systemic infection are not a contraindication for organ donation.

ABSTRACT 189

Background and aims: Nowadays, children continue to die because of scarcity of available organs for transplants. Policies to increase the notification of brain death (BD) impact positively the process of organ donation for transplantations in pediatric patients. Aims: To describe the evolution of BD diagnosis and organ donation experience in a reference general hospital PICU in an interval of 6 years. Methods: Were selected for a retrospective study the medical records of children (<18years) admitted in a referral Brazilian PICU between 2007 and 2012 that had confirmed the diagnosis of BD. Demographic data, cause of death, organ donation, cause for not donation. The local Ethical and Research committee approved the study. Results: BD represented 12% (34/238) of all deaths in the period, with median age of 30 months (IQR 12 – 84), 67% males. The main etiology of BD was acute neurosurgical lesion (47%). Only 50% of the deceased patients were medically suitable for organ donation. Oncological and infectious diseases were the main contra-indications to organ donation. Familiar consent to organ donation occurred in six (35%) of the 17 suitable cases. After consent was granted, organs were procured from all six donors, for an average of 2.8 organs transplanted per donor. Conclusions: Even in a referral hospital for transplants it is observed a high refusal rate for organ donation. Based on these results new local policies were implemented (2013) aiming to increment the local rate of organ donation.

Pro-Donation Behaviours of Nursing Students from the Four Countries of the UK

BackgroundThe effectiveness of the organ donation system depends on the health professionals involved in procurement and in dealing with donors and their families. Concerns about lack of knowledge and experience of organ donation have been expressed among such professionals but there is a paucity of literature to indicate the basis of such concerns and where knowledge may be lacking. Given that regional variations in organ donation rates exist in the UK, this study investigates knowledge about and attitudes towards organ donation among student nurses in different countries of the UK and examines regional variations.MethodsA questionnaire was distributed to 667 student nurses (female:male = 582∶85) aged 18 to 50 years (mean [SD] 25.4 [7.1] years) recruited from a total of five Universities (Scotland, Wales, Northern Ireland, England) during the period of January to September 2011.ResultsRegistration behaviour among participants was shown to vary depending upon many different factors that include birthplace, residency, fear of death and concerns of medical distrust.ConclusionsRegional variations in organ donation behaviour in the UK were found in the cohorts of student nurses who participated in this study. These variations include willingness to register and to donate specific body parts and not others. The relationship between attitude and behaviour and how this may influence the decision making process of organ donation, as well as the underlying factors that result in regional variations, require further investigation.

Knowledge and Attitudes of Military Nursing Student Toward Organ Donation

Introduction: Transplantation is still the acceptance to treatment organ failure. Like other countries Thailand also has organ shortage problem. Increasing the number of organ donors is essential among young generation. The knowledge and attitude of future nursing student are importance to increase organ donors. Objective: The purpose of this descriptive research was to study the relationships between knowledge and attitude of military nursing student toward organ donation. Methods: The target population were 862 nursing students from the Royal Thai Arm Forced (RTAF) Nursing College. The research instruments were three forms of questionnaire; the personal data, the knowledge and attitude toward organ donation. The reliability was accepted as 0.80 and 0.86. The data were analyzed by using descriptive statistic, Chi-square test and Pearson's Product Moment Correlation Coefficient. Results: The knowledge of organ donation was significantly associated with the age (p< 0.001), year of studying (p< 0.001), experience of knowing someone in family donate liver (< 0.01), and data or information of donation receiving from relatives (p< 0.05). Attitudes toward organ donation was significantly associated with gender (p< 0.05), carrying donor card (p< 0.001), the experience of knowing someone in family was a deceased donor (p< 0.05) or living liver donation (p< 0.001). The correlation between knowledge and attitude toward organ donation are significant positive correlation (p< 0.01). Conclusion: Nursing students need the knowledge and gain experience of organ donation to help and change attitude toward organ donation.