Increase In Organ Donation Rates Research Articles

A Cross Sectional Study on Knowledge and Attitude towards Organ Donation among Medical Students

Background: The organ donation in India was very low when compared to other countries. As the medical students were future health care professionals who were the first contact of potential donors family, the knowledge and attitude of medical students towards organ donation is of utmost important for the success of the organ donation program in a country. Objectives: This study aimed to assess the knowledge and attitude of medical students regarding organ donation at Government Medical College, Ananthapuramu, Andhra Pradesh, India. Methodology: This is a descriptive cross-sectional study, conducted among third year medical under graduate students of a Government Medical College between January to March 2023. Data was collected by structured, self-administered questionnaire from 141 third year MBBS students who were selected by convenient sampling. A structured, self-administered questionnaire consisting of 25 questions was used, which includes details on socio demographic characteristics, knowledge, attitude and practice towards organ donation. Results: The findings showed that a majority (90%) of the students had satisfactory knowledge regarding organ donation, 80% of the medical students expressed their willingness to donate their organs. Which implies there was a gap between knowledge and attitude. Conclusion: The study indicates that there is a need to introduce this topic into the curriculum, and by conducting frequent Continuing Medical Education (CME), they can become future donors and they motivate their patients, which can lead to an increase in organ donation rate.

Cost-Effectiveness and Budget Impact Analysis of Implementing a 'Soft Opt-Out' System for Kidney Donation in Australia.

IntroductionThere is a severe shortage of donor organs globally. There is growing interest in understanding how a 'soft opt-out' organ donation system could help bridge the supply and demand gap for donor organs. This research aims to estimate the cost-effectiveness and budget impact of implementing a 'soft opt-out' organ donation system for kidney donation.MethodsA decision-analytic model was developed to estimate the incremental costs from a health system’s perspective, quality-adjusted life-years (QALYs), and death averted of people who have kidney failure, comparing a ‘soft opt-out’ organ donation system to an 'opt-in' system. This study analysed three scenarios where the 'soft opt-out' system generated a 20%, 30%, and 40% increase in deceased organ donation rates over 20 years. A 5-year time horizon was adopted for the budget impact analysis.ResultsA 20% increase in organ donation rates could have a cost saving of 650 million Australian dollars (A$) and a 10,400-QALY gain. A 20% increase would avert more than 1500 deaths, while a 40% increase would avert 3200 deaths over a time horizon of 20 years. Over the first 5 years, a 20% increase would have a net saving of A$53 million, increasing to A$106 million if the donation rate increases by 40%.ConclusionA 'soft opt-out' organ donation system would return a cost saving for the healthcare system, a net gain in QALYs, and prevention of a significant number of deaths. Advantageous budgetary impact is important, but understanding the aversion for a ‘soft opt-out’ system in Australia is also important and remains a priority for further research.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40258-022-00747-8.

A COMPARATIVE STUDY OF ISLAMIC AND SOUTH AFRICAN LAW ON LIVING AND CADAVERIC ORGAN DONATIONS: CONSENSUS AND DIVERGENCE

Religion plays a pivotal role in people’s attitude to organ donation. Generally, practising Muslims (adherents of the Islamic faith) are unlikely to consent to organ donation because they believe it is not in keeping with the tenets of Islamic law (Sharī`ah). Although there is a wealth of information on organ donation with reference to both South African and Islamic law, there has not been a study comparing the two sets of laws. The purpose of this article is to develop the literature on living and cadaveric organ donation by drawing a comparison between Islamic law and South African law on this issue. Apart from a few minor differences inherent in each set of laws, there is a startling consensus in South African law and Sunnī (mainstream) Islamic law on the issue of organ donation. This research is also significant in that it provides legal and medical professionals, academics and practitioners with an informed position from which to advise clients and/or patients. This may in turn raise awareness among clients and/or patients, which could result in a desirable increase in organ donation rates among Muslims in South Africa. This article makes a number of recommendations in this regard.

Die neue Gesetzgebung zur Organspende – Wirkung, Potenzial und Grenzen aus der Sicht klinisch tätiger Ärzt:innen

HintergrundDie neuen Gesetze zur Organspende von 2019 und 2020 umfassen Regelungen zur Steigerung der Organspenderate. Dazu zählen Strukturverbesserungen, die Einführung eines Online-Registers zur Dokumentation der Entscheidung zur Organspende und die verbesserte Aufklärung der Bevölkerung. Zur Einschätzung der Maßnahmen durch unmittelbar betroffene klinisch tätige Ärzte ist bislang wenig bekannt.MethodeEs wurde eine zweistufige Sequential-mixed-method-Studie durchgeführt. Im Rahmen einer Online-Umfrage nahmen deutschlandweit 1235 Ärzte von über 90 Kliniken teil.ErgebnisseKlinisch tätige Ärzte benennen größtenteils strukturelle Defizite als Ursachen für die niedrige Spenderrate in Deutschland. Weniger als die Hälfte der Ärzte, die mit Organspende in Kontakt kommen, findet sich ausreichend über Organspende ausgebildet. Ärztliche Aufklärungsgespräche haben wesentlichen Einfluss auf die Entscheidungsfindung von Patienten, werden aber kaum geführt. Da Patienten und Angehörige sich zu Lebzeiten zu wenig mit den Themen Tod und Organspende auseinandersetzten, führt die individuelle Entscheidungssituation oft zu Überforderung. Hausärzten kommt eine Schüsselrolle bei der Aufklärung zu. Von der Einführung eines Online-Registers erwarten nur wenige Befragte einen Einfluss auf die Organspenderate.SchlussfolgerungMit der neuesten Gesetzgebung wurde ein Großteil der von Ärzten benannten strukturellen Defizite aufgegriffen. Eine zusätzliche Steigerung der Organspenderate könnte durch professionalisierte Angehörigenbetreuung erreicht werden. Eine stärkere Thematisierung von Tod und Organspende in der Gesellschaft könnte im individuellen Fall die Entscheidungsfindung von Angehörigen erleichtern.

Are motorcycles really “donorcycles”? Examining organ donation rates between unhelmeted and helmeted motorcyclists

Introduction: Motorcycles are colloquially referred to as “donorcycles” among medical staff. However, the actual impact of helmet laws and helmet use on organ donation is unknown. Michigan’s 35-year-old universal helmet law (UHL) was repealed in April 2012 and replaced by a partial-helmet law. We hypothesized that there would be an increase in organ donation rates from unhelmeted motorcyclist fatalities. Methods: Michigan's Gift of Life Michigan organ donation database was queried from April 2008 through May 2015 in conjunction with the Michigan Trauma Quality Improvement Program database from the same time period. All in-hospital motorcycle crash fatalities were examined. Results: A three-fold increase was found in the rate of organ donation for unhelmeted motorcyclists compared to helmeted motorcyclists (p = 0.006). Motorcycle crash fatalities tended to be younger in age after the UHL repeal with an average age of 32.8 years versus 40.8, however, this finding was not statistically significant (p = 0.071). Additionally, there was no significant difference in organ donation rates pre-UHL repeal (2008–2012) versus post-repeal (2012–2015). Conclusions: This is the first study to demonstrate an increased rate of organ donation among unhelmeted motorcyclist fatalities compared to helmeted rider fatalities. There was no significant increase in the rate of organ donation following the Michigan UHL repeal. However, we identified that some motorcycle crash fatalities were from illegally unhelmeted riders in the past, prior to the repeal. Practical Application: Unhelmeted motorcyclists are three times more likely than helmeted riders to become organ donors, possibly due to the well documented increase in severe traumatic brain injuries in this population. From a public health perspective, helmets should be required for all motorcyclists and efforts to advocate in favor of helmet legislation should be supported by trauma systems and health professionals.

Is Education Enough for Improving Organ Donation or Something Even More Important is Missing?

Introduction To improve organ donation in Iran all of the OPU director and chief coordinator participated in a national and then an International (TPM) course in Tehran. Then we noticed that these 2 weeks education has not been enough for OPU directors to manage their OPU and have an acceptable rate of organ donation. So a well-designed 1 week course was established and a team of 6 experienced lecturers accompanied by 3 executive persons hold one week comprehensive education course named IrOSS (Iranian OPU Supporting System). Material and Methods Iranian society of organ donation developed a one-week educational program for deceased organ donation activity which was held in 8 provinces of Iran.It was a one week training course by a group of experts in different aspects of organ donation (detection, brain dead diagnosis and confirmation, donor maintenance, family interview, organ retrieval and preservation …). Target groups were 1. State authorities including the Mayor, TV director and main Religious leader 2. University director and authorities and the director of OPU and the coordinators, 3. brain dead confirmation team and forensics, 4 anesthesiologists and ICU specialists, 5 ICU nurses, 6 medical students and 7 volunteers. Organ donation rate during one year before and 6 months after the course were compared together. Results OPUs were compared for their director characteristics (physician or nurse, full time or part time, educated for organ donation or not and whether they established the system which they learned about that during IrOSS or not? Tthere were 4 different situations in these 8 States. 1. In the State that the director was full time and stablished the system there was 4.8 time more increase in pmp 2. In 4 states that the director was full time but didn’t establish the system, pmp improved 2-2.8 times. 3. Two states that their directors were not full time and didn’t establish the system completely, improved 1.4 and 1,5 times 4. In the State that OPU director was not full time and also didn’t establish the system, the rate of organ donation dropped 40%. Conclusion These data show that although the comprehensive educational courses like IrOSS is helpful but if a full time dedicated person doesn’t lead the OPU organization and doesn’t establish what he/she learned during the course, there won’t be any dramatic improvement. So selecting the responsible OPU director as a key person could lead to substantial increase in organ donation rate.

Liver transplantation in Ireland.

The Irish National Liver Transplant program commenced in 1993 in St. Vincent's University Hospital in Dublin. It is an adult-only program and is the only liver transplant program in Ireland. Pediatric recipients are referred to King's College Hospital in the United Kingdom. To date, almost 1000 adult liver transplants have been performed. Current 1-year patient survival is 93%, and 5-year survival is 79%. The program is fully funded by the government health service. There is a close collaboration with the United Kingdom Organ Donation and Transplant Directorate, and there is an arrangement for organ sharing for super-urgent transplants. Traditionally, organ donation rates have been high in Ireland. However, demand for liver transplant has increased over the past 20 years, and waiting lists are now lengthening. Deceased cardiac death donation is now being considered, but there are no plans for living related donor liver transplant. Donor coordinators have recently been appointed to the major hospitals in Ireland, and it is hoped that this initiative will lead to an increase in organ donation rates. Liver Transplantation 22 1014-1018 2016 AASLD.

Successful International Collaboration Improves Family Donation Conversations Resulting in Increased Organ Donation.

Purpose Increase donation rates by developing and implementing a customized, self-sustaining national training program designed to enhance family donation conversation (FDC) practices of health professionals (HP) and to influence HPs to adopt practice as FDC cultural norm. Methods A country's donation leaders concluded that to increase organ donation outcomes, health professionals conducting FDCs required support and specialized training. An international training institute with programs based on proven results was engaged to create and implement a customized training program to influence change in FDC practice and culture. To gain support and determine program suitability, two 1-day pilot trainings were provided to 45 donation leaders in 2011. Training was further customized with emphasis on creating changes to achieve and sustain desired results. A comprehensive national training plan was implemented over 18 months. Twenty-six 2-day FDC training workshops were held in eight cities (646 participants). Program evaluations and debriefings showed distinct shifts in perspectives and enthusiasm to implement new processes. In 2012-2013, an instructor program was developed to transition training facilitation. The training institute remains involved in development and training to build and sustain skill and expertise. Results A 22% increase in organ donors achieved in the two years since the FDC training has been delivered (2011-2013). Conclusion The integration of another organization's process poses distinct challenges. Thoughtful collaboration, sensitive to cultural aspects and family care, communication, and donation practices, can result in successful customized training that shifts perspectives, provides new skills and achieves and sustains an increase in organ donation rates. Donation leaders involved in development and delivery of the training feel confident that customized and improved national skills training has contributed to increasing organ donation outcomes.

Successful International Collaboration Improves Family Donation Conversations Resulting in Increased Organ Donation

IntroductionAustralian donation leaders recognized that to increase organ donation outcomes, health professionals conducting family donation conversations (FDCs) required support and specialist training. An international training institute with programs based on proven results was engaged to create and implement a customized training program to influence change in FDC practice and culture. The goal was to increase donation rates by developing and implementing a customized, self-sustaining training program to enhance FDC practices of health professionals. Other goals included providing training and communications skills to lead FDC, supporting families in making decisions, and influencing health professionals to adopt FDC practices. Materials and MethodsTo gain support and determine program suitability, two 1-day pilot training sessions were provided to 45 Australian donation leaders in 2011. Training was further customized with an emphasis on creating changes to achieve and sustain desired results. A comprehensive national training plan was implemented over 18 months. Twenty-six 2-day FDC training workshops were held in 8 cities (646 participants). Program evaluations and debriefings showed distinct shifts in perspectives and an enthusiasm to implement new processes. In 2012 to 2013, an instructor program was developed to transition training facilitation. The training institute remains involved in development and training to build and sustain skill and expertise. ResultsThere was a 58% increase in organ donors in Australia from 2009 to 2013 (data reflect 2013 Australian end-of-year organ donation information). This represents a 36% increase in organ donors (2009–2011); the remaining 22% increase was achieved in the 2 years since the FDC training was implemented in Australia (2011–2013). ConclusionsImproved skills training in the conduct of FDCs seem to have contributed to improved donation outcomes in national identification, request, and consent rates. The integration of another organization's process poses distinct challenges; thoughtful collaboration, sensitive to cultural aspects and family care, communication, and donation practices, can result in successful customized training that shifts perspectives, provides new skills, and achieves and sustains an increase in organ donation rates.

Preliminary Marked Increase in the National Organ Donation Rate in Israel Following Implementation of a New Organ Transplantation Law

Israel's organ donation rate has always been among the lowest in Western countries. In 2008 two new laws relevant to organ transplantation were introduced. The Brain-Respiratory Death Law defines the precise circumstances and mechanisms to determine brain death. The Organ Transplantation Law bans reimbursing transplant tourism involving organ trade, grants prioritization in organ allocation to candidates who are registered donors and removes disincentives for living donation by providing modest insurance reimbursement and social supportive services. The preliminary impact of the gradual introduction and implementation of these laws has been witnessed in 2011. Compared to previous years, in 2011 there was a significant increase in the number of deceased organ donors directly related to an increase in organ donation rate (from 7.8 to 11.4 donors per million population), in parallel to a significant increase in the number of new registered donors. In addition the number of kidney transplantations from living donors significantly increased in parallel to a significant decrease in the number of kidney transplantations performed abroad (from 155 in 2006 to 35 in 2011). The new laws have significantly increased both deceased and living organ donation while sharply decreasing transplant tourism.

The effectiveness of interventions to manage treatment adherence in adult heart transplant patients: a systematic review protocol

The effectiveness of interventions to manage treatment adherence in adult heart transplant patients: a systematic review protocol

Increase in Organ Donation Rate in a Swedish Region After Implementing a New Angle of Approach

In the Swedish Västra Götaland region (1.65 million inhabitants), we have implemented, as from January 1, 2006, a new concept to improve the organ donation rate, which in 2005 was 13.9 per million population (PMP). There are two cornerstones in the project: a new, active role for the transplant coordinators and the establishment of a uniform policy for the care of potential donors as well as criteria for the decision to offer intensive care in various critical conditions. The coordinator is now contacted at an early stage and is in place when the brain death diagnosis is underway or completed. The coordinator is thereafter a resource for all aspects of the care of the potential donor/donor, and also in the contact with the relatives. To date (May 2006) the donation rate has reached 23.6 PMP annually (a 70% increase).