Increase Organ Donation Research Articles

Nova Scotia's Deemed Consent for Deceased Organ Donation: Family Member Perspectives and Experiences in the ICU Setting.

The purpose of this study was to explore the experience of family members of potential organ donors in the intensive care unit following the change to deemed consent legislation in Nova Scotia. This was a qualitative study with semistructured, in-depth interviews with 17 family members who were asked to make an organ donation decision on behalf of patients admitted to the intensive care unit in Nova Scotia. We analyzed themes using a descriptive approach. Participants were recruited from the organ donation organization in Nova Scotia, Canada. Participant awareness and knowledge of the Human Organ and Tissue Donation Act legislation varied from individuals having no awareness and knowledge of the bill to those who had awareness and optimism that the legislation would be beneficial for increasing organ donation rates in the province. Other themes emerging from the interviews included (1) COVID context, (2) quality of healthcare professional care, (3) family support, and (4) barriers to donation (waiting, consent questionnaire, and patient transfers). The Human Organ and Tissue Donation Act legislation included enhanced support, which was viewed positively by family members. There is a need for continued evaluation as most participants felt it was too early to see the tangible impacts of the newly implemented legislation.

Analysis of Attitudes Towards Opt-Out Organ Donation Consent: A Cross-Sectional Study Among Saudi Arabian Residents

ObjectiveThe study aims to investigate public opinion on opt-out organ donation registration in Saudi Arabia, addressing a gap identified in existing research that reveals varied attitudes and intentions among the population, as indicated by studies in Qatar and Saudi Arabia. MethodsThis study employed a secondary analysis approach, utilizing data from a cross-sectional survey conducted online among 1397 residents of Saudi Arabia. The survey utilized a GoogleTM form questionnaire adapted from a previous study in Qatar. The questionnaire comprised three sections, gathering socio-demographic information, assessing general awareness about organ donation, and exploring participants' agreement with opt-out consent and beliefs related to organ donation using the Theory of Planned Behaviour (TPB) model. ResultsAmong the participants, 44.4% supported opt-out consent, with 25.7% females and 39.1% Saudi citizens. Females and diploma/graduation-level education were significantly associated with opt-out support (p<0.001, p=0.012, respectively). 98.06% of opt-out supporters were familiar with organ donation. 93.05% agreed to promote organ donation, 98.38% believed registration saves lives, and 81.91% were willing if family had no objections. 86.75% were ready with more information, and 85.78% if informed about their religion's perspective. 92.25% believed living and posthumous donation positively impact life after death. Concerns included inadequate care (33.44%) and bodily disfigurement (28.43%) postmortem. Majority felt healthy (45.56%) and appropriate in age for donation (57.67%). Among opt-out supporters, 20.84% expressed interest, 8.4% conveyed disinterest, while 36.34% remained undecided regarding organ donation registration. ConclusionThe study reveals a considerable openness among Saudis toward adopting an opt-out organ donation system, suggesting a potential avenue for increased organ donation rates. While acknowledging cultural nuances, particularly familial influences, targeted interventions are vital to overcome specific barriers and ensure the successful implementation of an opt-out policy.

Impact of catastrophic brain injury guidelines on organ donation rates: Results of an EAST multicenter trial.

One third of organ donors suffer catastrophic brain injury (CBI). There are no standard guidelines for the management of traumatic CBI prior to brain death, and not all trauma centers have institutional CBI guidelines. In addition, there is high variability in management between institutions with guidelines. Catastrophic brain injury guidelines vary and may include various combinations of hormone therapy, vasopressors, fluid resuscitation, and other practices. We hypothesized that centers with CBI guidelines have higher organ donation rates than those without. This prospective, observational EAST-sponsored multicenter trial included adult (18+ years old) traumatic-mechanism CBI patients at 33 level I and II trauma centers from January 2022 to May 2023. Catastrophic brain injury was defined as a brain injury causing loss of function above the brain stem and subsequent death. Cluster analysis with linear mixed-effects model including UNOS regions and hospital size by bed count was used to determine whether CBI guidelines are associated with organ donation. A total of 790 CBI patients were included in this analysis. In unadjusted comparison, CBI guideline centers had higher rates of organ donation and use of steroids, whole blood, and hormone therapy. In a linear mixed-effects model, CBI guidelines were not associated with organ donation. Registered organ donor status, steroid hormones, and vasopressin were associated with increased relative risk of donation. There is high variability in management of CBI, even at centers with CBI guidelines in place. While the use of institutional CBI guidelines was not associated with increased organ donation, guidelines in this study were not identical. Hormone replacement with steroids and vasopressin was associated with increased donation. Hormone resuscitation is a common feature of CBI guidelines. Further analysis of individual practices that increase organ donation after CBI may allow for more effective guidelines and an overall increase in donation to decrease the long waiting periods for organ transplant recipients. Prognostic; Level III.

Knowledge and Attitude Toward Organ Donation and Transplantation Among the Adult Population in Bisha, Saudi Arabia

Background and ObjectiveOrgan donation is a procedure in which an organ is surgically removed from a human to be transplanted into another. The need for organ transplantation is increasing with time, and thus, the gap in the awareness of organ donors about the process must be recognized. This study aims to raise awareness and perceptions regarding organ donation and transplantation among the adult population. MethodsBetween May 2021 and April 2022, we conducted an analytical cross-sectional study involving residents of Bisha. We used a vetted, well-structured questionnaire distributed on media for data collection. We gathered sociodemographic data from the participants and evaluated their awareness and perspective on organ donation. ResultsA total of 417 responses were recorded, and out of them, 65.7% had an average to good level of knowledge about organ donation, and 69.8% were shown to have a positive attitude toward organ donation. Mass media, comprising television, newspapers, magazines, and radio, accounted for the primary information source, constituting 29%. Participants who were willing to donate chose "to save someone's life" and "out of compassion and sympathy" as reasons for donation 71.7%. Meanwhile, those who disagreed to donate were hesitant due to the fear of health complications 56.6%. ConclusionsThe level of awareness and willingness to donate are correlated, especially regarding knowledge regarding the procedure outcomes from the donor side. So, improving the knowledge and attitude is crucial to face the shortage and increasing organ donation and transplantation demands.

Do ethical views of end-of-life patients' family members impact organ donation decisions?

Background: The relatives of patients who decide to donate their loved one's organs experience dilemmas about organ donation and are affected by culture, religion, and individual views.Aim: The aim of this study was to determine the relationship between the ethical position and personal characteristics of the family members of the patients receiving end-of-life care and their thoughts about organ donation in Turkey.Research design and participants: The study was completed with 158 family members. For data collection, a personal information form and the Ethics Position Questionnaire were used.Ethical considerations: This study was obtained from the ethics committee of the faculty of medicine in Turkey. It was based on voluntary participation, informed consent, confidentiality, and anonymity.Results: All participants in the study shared the same faith and were Muslims. The idealism and relativism tendencies of the participants tended to be high. The number of children, the participants have, participants' status of waiting for an organ transplant, the view that the clergy and health personnel will increase interest in organ donation were identified as factors associated with idealism tendencies. Participants' status of having children, the number of children participants have, participants' status of organ transplant waiting, the view that the health personnel will increase interest in organ donation were identified as factors associated with relativism tendencies (p < 0.0.5).Conclusion: The results of this study demonstrated a relationship between participants' idealism and relativism tendencies, among those with a large number of children, waiting for organ donation, advocating for clergy guidance to increase organ donations, and believing healthcare professionals need not guide to increase organ donations. In light of this finding, it may be recommended to establish a multidisciplinary team, including healthcare professionals and clergy, and to inform the society with accurate information to increase the number of organ donations.

Normothermic Machine Perfusion and Normothermic Regional Perfusion of DCD Kidneys Before Transplantation: A Systematic Review.

To overcome organ shortages, donation after circulatory death (DCD) kidneys are being increasingly used for transplantation. Prior research suggests that DCD kidneys have inferior outcomes compared with kidneys donated after brain death. Normothermic machine perfusion (NMP) and normothermic regional perfusion (NRP) may enhance the preservation of DCD kidneys and improve transplant outcomes. This study aimed to review the evidence surrounding NMP and NRP in DCD kidney transplantation. Two independent reviewers conducted searches for all publications reporting outcomes for NMP and NRP-controlled DCD kidneys, focusing on delayed graft function, primary nonfunction, graft function, graft survival, and graft utilization. Weighted means were calculated for all relevant outcomes and controls. Formal meta-analyses could not be conducted because of significant heterogeneity. Twenty studies were included for review (6 NMP studies and 14 NRP studies). Delayed graft function rates seemed to be lower for NRP kidneys (24.6%) compared with NMP kidneys (54.3%). Both modalities yielded similar outcomes with respect to primary nonfunction (NMP 3.3% and NRP 5.6%), graft function (12-mo creatinine 149.3 μmol/L for NMP and 129.9 μmol/L for NRP), and graft utilization (NMP 83.3% and NRP 89%). Although no direct comparisons exist, our evidence suggests that both modalities have good short- and medium-term graft outcomes and high graft survival rates. Current literature demonstrates that both NMP and NRP are feasible strategies that may increase donor organ utilization while maintaining acceptable transplant outcomes and likely improved outcomes compared with cold-stored DCD kidneys. Further research is needed to directly compare NRP and NMP outcomes.

Increased Donor Organ Size and Age is Associated with Reduced Survival in Female Lung Transplant Recipients

BackgroundOrgan selection in lung transplantation (LTx) is still controversial. We here analyze the impact of mismatches in size, age, and gender on early and long-term outcome after LTx. MethodsRetrospective analysis of donor and recipient characteristics of patients who underwent double lung transplantation (DLTx) between 03/2003 and 12/2021. Statistical analysis was performed using SPSS and GraphPad software. Results203 patients were included (94 female and 109 male). In the whole cohort, oversizing donor organs 10%-20% compared to the recipients’ predicted total lung capacity (pTLC) led to a decreased incidence of severe primary graft dysfunction (PGD2/3) (15% vs. 41%, p=0.03), and further oversizing >20% was associated with reduced long-term survival (HR 2.33, p=0.011). Analysing donor and recipient age, we found that increased donor age correlated with reduced long-term survival (p=0.013). In this cohort, female recipients received older organs (median 57 vs. 46 years, p=0.0003) and had a higher incidence of >20% oversizing (13% vs. 4%, p=0.019) of donor lungs which resulted in a significantly reduced long-term survival (p=0.02) compared to male recipients. Median LAS scores were similar in both groups. ConclusionMismatch of donor age and size can be important for organ function and survival in lung transplant recipients. Particularly female recipients seem to have a higher risk for unfavourable long-term outcome when transplanting organs of increased size and age. Multicentre studies are warranted to further address this question.

Perception and Willingness Regarding Organ Transplantation/donation among Medical Students of Maharajgunj Medical Campus: A Cross-sectional Study.

Organ transplant is the procedure of replacing a failing or damaged organ with a functioning one. Positive attitude and awareness about donation are a must for donor organs to be available. This study explored the level of knowledge, perception and willingness regarding organ donation among medical students in Nepal. A descriptive cross-sectional study was conducted with 180 medical students using a self-administered questionnaire. Descriptive statistics were used, and Pearson correlation was applied to examine the relationship between knowledge and perception of organ transplantation. Independent samples t-test and ANOVA was used to compare scores among year of study and gender. Results indicated that 86.1% of participants were aware of the need for organ donation, and 83.3% knew that both living and deceased individuals could be donors. While 93.9% believed in the need for effective laws, 72.8% perceived risks for donors. However, only 74.4% were willing to donate their organs, though 91.7% expressed willingness to promote organ donation among friends and family. Participants showed a positive perception towards organ donation. Despite a high level of awareness and knowledge regarding organ donation, participants exhibited a lower level of willingness to donate organs. Perceived risks for donors and a lack of robust laws and regulations presented significant barriers. Nevertheless, an inclination to promote organ donation was observed. This underlines the need for enhanced education and policy reform to increase organ donation rates.

The learning curve of COVID-19 and organ donation: Potential missed opportunities in the COVID era

BackgroundEarly in the COVID-19 pandemic, positive COVID-19 status often disqualified potential organ donors due to perceived risks, despite limited evidence. Subsequent studies have clarified that the COVID-19 status of donors, particularly when incidental and not the cause of death, does not adversely affect non-lung transplant outcomes. This study quantifies the potential loss of eligible organ donors and the corresponding impact on organ availability during the initial phase of the pandemic. MethodsIn this retrospective analysis, we examined deceased donor referrals to a major organ procurement organization from June 2020 to January 2022. Referrals were categorized as All Referrals, Medically Ruled Out (MRO), or Procured Donors (PD). We used Chi-square tests for categorical comparisons and logistic regression to model additional donors and organs, contrasting COVID-negative and positive cases within age-matched cohorts. ResultsAmong 9478 referrals, 23.4 % (2221) were COVID-positive. Notably, COVID-positive referrals had a substantially higher MRO rate (80.6 % vs. 29.6 %, p < 0.01) and a markedly lower PD rate (0.2 % vs. 8.2 %, p < 0.01). Potential missed donations of 103 organs from COVID-positive referrals were identified. ConclusionThis OPO-level study demonstrates a substantial impact of COVID-19 status on organ donation rates, revealing significant missed opportunities. Improved management of donor COVID-19 status could potentially increase organ donations nationwide, taking into account evolving evidence and vaccine availability changes.

Moving Boundaries for Improving Organ Transplant Availability.

This brief overview is designed to address the options for increasing organ transplant rates to between 100 and 120 transplanted organs per million population globally. The focus of this review is the data produced through the World Health Organization's Global Observatory on Donation and Transplantation, with consideration for the issues that different countries need to address to achieve higher transplant rates. Without both optimized living donation and optimized deceased donation, rates of transplant are not sufficient to provide for a level of self-dependency for transplant therapy. Deceased donation comprises both donation from donors declared dead after cessation of all functions of the brain and donors declared dead from irreversible cessation of circulation of the blood. The preservation strategies that hold the greatest chance of increasing the utility of marginal and older donors involve normothermic circulation to prevent ischemic damage and potentially restore function of damaged organs. Normothermic in situ perfusion of abdominal organs has demonstrated utility, and consideration must be given to normothermic perfusion of the thoracic organs to improve heart and lung transplants, but this may challenge the legal definitions of death. Each nation must endeavor to increase organ donation capacity across the spectrum of donor types and must address the opportunities that normothermic perfusion of organs at retrieval may offer to alleviate shortages of organs for transplant and provide selfdependency for the communities.

Increasing Organ Donor Registrations in Motor Vehicles Offices Through Health Communication

ABSTRACT Health communication research has played a prominent role in the body of scholarship seeking to meaningfully increase the number of life-saving organs available to waitlisted patients. The current paper builds on earlier work in communication seeking to promote organ donation to individuals in community and organizational settings. The goal of this essay is to review health communication-based interventions seeking to meaningfully increase organ donation registrations in motor vehicles’ offices (DMV) transactions in the USA. For convenience, I use the acronym DMV, although it is understood different states use different titles for this office. Before describing the nature and impact of communication interventions and their impact in DMV contexts, I will provide context for the problem and briefly review the role of DMV registrations in relation to demand for organs in the United States.

Transmission and Non-transmission of Melanoma From Deceased Solid Organ Donors to Transplant Recipients: Risks and Missed Opportunities.

Biovigilance concerns are in tension with the need to increase organ donation. Cancer transmission risk from donor to recipient may be overestimated, as non-transmission events are rarely reported. We sought to estimate melanoma transmission risk in deceased organ donation and identify missed opportunities for donation in an Australian cohort with high melanoma prevalence. We used a population-based approach and linked deceased organ donors, transplant recipients, and potential donors forgone, 2010-2018, with the Central Cancer Registry (CCR), 1976-2018. We identified melanomas using ICD-O-3 classification, assessed the probability of transmission, and compared suspected melanoma history in potential donors forgone with melanoma notifications in the CCR. There were 9 of 993 donors with melanoma in CCR; 4 in situ low-risk and 5 invasive high-to-unacceptable risk. Four were unrecognized before donation. Of 16 transplant recipients at risk, we found 0 of 14 transmission events (2 recipients had insufficient follow-up). Of 35 of 3588 potential donors forgone for melanoma risk alone, 17 were otherwise suitable for donation; 6 of 35 had no melanoma in CCR, 2 of 35 had in situ melanomas and 9 of 35 had thin invasive melanomas (localized, ≤0.8 mm thickness). Our findings contribute to current evidence that suggests donors with melanomas of low metastatic potential may provide an opportunity to safely increase organ donation and so access to transplantation.

Potential for organ donation after controlled circulatory death: a retrospective analysis.

Despite the discrepancy between demand and availability of organs for transplantation, controlled circulatory death donation has not been implemented in Portugal. This study aimed to estimate the potential increase in organ donation from implementing such a program. All deceased patients within the intensive care medicine department at Centro Hospitalar Universitário de São João, throughout the year 2019, were subjected to retrospective analysis. Potential gain was estimated comparing the results with the number of donors and organs collected during the same period at this hospital center. Differences in variables between groups were assessed using t tests for independent samples or Mann-Whitney U tests for continuous variables, and chi-squared tests were used for categorical variables. During 2019, 152 deaths occurred after withdrawal of life-sustaining therapies, 10 of which would have been potentially eligible for donation after controlled circulatory death. We can anticipate a potential increase of 10 prospective donors, a maximum 21% growth in yearly transplantation activity, with a greater impact on kidney transplantation. For most patients, the time between withdrawal of organ support and death surpassed 120 minutes, an outcome explained by variations in withdrawal of life-sustaining measures and insufficient clinical records, underestimating the potential for controlled circulatory arrest donation. This study effectively highlights public health benefits of controlled circulatory arrest donation. Legislation allowing donation through this method represents a social gain and enables patients who will never meet brain death criteria to donate organs as part of the end-of-life process in intensive care medicine, within a framework of complete ethical alignment.

The Fear of Personal Death and the Willingness to Commit to Organ Donation

In three studies, with samples from different countries (the United States and Israel) and religions (Christians and Jews), we found that individual levels of fear of death significantly predicted lower willingness to register as organ donors (Studies 1 and 2). Moreover, after being asked about their organ donation status (i.e., whether they are registered as donors), fear of death significantly increased among unregistered people. This did not occur among registered people, who had already faced the decision to become donors in the past (Study 2). Finally, providing non-registered (non-religious) people with a defense strategy to manage their fear of death increased their willingness to sign an organ donation commitment, partially by increasing their feelings of hopefulness. The implications of these findings for increasing organ donation registration are discussed.

Organ and Cadaver Donation; Student Opinions from Different Cultures.

Objective: Despite organ donations, the need for organs is increasing daily, and efforts to increase organ donation continue without slowing down. Cadaver donation, necessary for medical education, is an issue waiting to be supported worldwide. In our study, a questionnaire was applied to measure the knowledge and attitudes of Turkish and international students toward organ and cadaver donation. Material and Methods: A total of 305 students, including 236 Turkish citizens and 68 international students, participated in the study. Students accessed the prepared questionnaires via a Google form. Results: It was determined that there was a statistical difference between Turkish and international students regarding their knowledge about organ donation compared to cadaver donation (Turkish students 78.8 % (n=186) yes, international students 57.,4 % (n=39) yes). In the social circles of Turkish and international students, organ donations were more common than cadaver donations, and a statistically significant difference was found for both groups (Turkish students 42.8 % (n=101) yes, international students 48.5 % (n=33) yes). The reasons for donating their bodies (Turkish students 48.3% (n=114) ''For use in organ transplantation'', international students 35.3 % (n=24) ''Because your body is useless after death and decays''), and organs (Turkish students 35.6 % (n=84), international students 32.4 % (n=22) ''For use in organ transplantation'') of Turkish and international students differed significantly. Conclusion: Based on the answers given by the students, it has been concluded that donations will increase when information is provided about the importance of organ and cadaver donation.

Organ Donation After Out-of-Hospital Cardiac Arrest: A Scientific Statement From the International Liaison Committee on Resuscitation

Aim of the reviewImproving rates of organ donation among patients with out-of-hospital cardiac arrest who do not survive is an opportunity to save countless lives. The objectives of this scientific statement were to do the following: define the opportunity for organ donation among patients with out-of-hospital cardiac arrest; identify challenges and opportunities associated with organ donation by patients with cardiac arrest; identify strategies, including a generic protocol for organ donation after cardiac arrest, to increase the rate and consistency of organ donation from this population; and provide rationale for including organ donation as a key clinical outcome for all future cardiac arrest clinical trials and registries. MethodsThe scope of this International Liaison Committee on Resuscitation scientific statement was approved by the International Liaison Committee on Resuscitation board and the American Heart Association, posted on ILCOR.org for public comment, and then assigned by section to primary and secondary authors. A unique literature search was completed and updated for each section. ResultsThere are a number of defining pathways for patients with out-of-hospital cardiac arrest to become organ donors; however, modifications in the Maastricht classification system need to be made to correctly identify these donors and to report outcomes with consistency. Suggested modifications to the minimum data set for reporting cardiac arrests will increase reporting of organ donation as an important resuscitation outcome. There are a number of challenges with implementing uncontrolled donation after cardiac death protocols, and the greatest impediment is the lack of legislation in most countries to mandate organ donation as the default option. Extracorporeal cardiopulmonary resuscitation has the potential to increase organ donation rates, but more research is needed to derive neuroprognostication rules to guide clinical decision-making about when to stop extracorporeal cardiopulmonary resuscitation and to evaluate cost-effectiveness. ConclusionsAll health systems should develop, implement, and evaluate protocols designed to optimise organ donation opportunities for patients who have an out-of-hospital cardiac arrest and failed attempts at resuscitation.

Organ Donation After Out-of-Hospital Cardiac Arrest: A Scientific Statement From the International Liaison Committee on Resuscitation.

Improving rates of organ donation among patients with out-of-hospital cardiac arrest who do not survive is an opportunity to save countless lives. The objectives of this scientific statement were to do the following: define the opportunity for organ donation among patients with out-of-hospital cardiac arrest; identify challenges and opportunities associated with organ donation by patients with cardiac arrest; identify strategies, including a generic protocol for organ donation after cardiac arrest, to increase the rate and consistency of organ donation from this population; and provide rationale for including organ donation as a key clinical outcome for all future cardiac arrest clinical trials and registries. The scope of this International Liaison Committee on Resuscitation scientific statement was approved by the International Liaison Committee on Resuscitation board and the American Heart Association, posted on ILCOR.org for public comment, and then assigned by section to primary and secondary authors. A unique literature search was completed and updated for each section. There are a number of defining pathways for patients with out-of-hospital cardiac arrest to become organ donors; however, modifications in the Maastricht classification system need to be made to correctly identify these donors and to report outcomes with consistency. Suggested modifications to the minimum data set for reporting cardiac arrests will increase reporting of organ donation as an important resuscitation outcome. There are a number of challenges with implementing uncontrolled donation after cardiac death protocols, and the greatest impediment is the lack of legislation in most countries to mandate organ donation as the default option. Extracorporeal cardiopulmonary resuscitation has the potential to increase organ donation rates, but more research is needed to derive neuroprognostication rules to guide clinical decision-making about when to stop extracorporeal cardiopulmonary resuscitation and to evaluate cost-effectiveness. All health systems should develop, implement, and evaluate protocols designed to optimize organ donation opportunities for patients who have an out-of-hospital cardiac arrest and failed attempts at resuscitation.

Randomized intervention to assess the effectiveness of an educational video on organ donation intent among Hispanics in the New York metropolitan area.

The Hispanic community has a high demand for organ donation but a shortage of donors. Studies investigating factors that could promote or hinder organ donation have examined emotional video interventions. Factors acting as barriers to organ donation registration have been classified as: (1) Bodily integrity; (2) medical mistrust; (3) "ick"-feelings of disgust towards organ donation; and (4) "jinx"-fear that registration may result in one dying due to premeditated plans. We predict that by providing necessary information and education about the donation process via a short video, individuals will be more willing to register as organ donors. To determine perceptions and attitudes regarding barriers and facilitators to organ donation intention among Hispanic residents in the New York metro politan area. This study was approved by the Institutional Review Board at Northwell Health. The approval reference number is No. 19-0009 (as presented in Supplementary material). Eligible participants included Hispanic New York City (NYC) residents, 18 years of age and above, who were recruited voluntarily through Cloud Research and participated in a larger randomized survey study of NYC residents. The survey an 85-item Redcap survey measured participant demographics, attitudes, and knowledge of organ donation as well as the intention to register as an organ donor. Attention checks were implemented throughout the survey, and responses were excluded for those who did fail. Participants were randomly assigned two-between subject conditions: To view a short video on organ donation and then proceed to complete the survey (i.e., video first) and view the same video at the end of the survey (video last). No intra-group activities were conducted. This study utilized an evidenced-based emotive educational intervention (video) which was previously utilized and was shown to increase organ donation registration rates at the Ohio Department of Motor Vehicles. Results were analyzed using Jamovi statistical software. Three hundred sixty-five Hispanic individuals were included in the analysis. Once consent was obtained and participants entered the survey (the survey sample is presented in Supplementary material), participants were asked to report on demographic variables and their general impression of organ donation after death. The video depicted stories regarding organ donation after death from various viewpoints, including from the loved ones of a deceased person who died waiting for a transplant; from the loved ones of a deceased person whose organs were donated upon death; and, from those who were currently waiting for a transplant. Using a binomial logistic regression, the analysis provides information about the relationship between the effects of an emotive video and the intention to donate among Hispanic participants who were not already registered as donors. The willingness to go back and register was found to be significantly more probable for those who watched the emotive video before being asked about their organ donation opinions (odds ratio: 2.05, 95% confidence interval: 1.06-3.97). Motivations for participation in organ donation were also captured with many stating the importance of messages coming from "people like me" and a message that highlights "the welfare of those in need". Overall, the findings suggest that using an emotive video that addresses organ donation barriers to prompt organ donation intentions can be effective among the Hispanic populous. Future studies should explore using targeted messaging that resonates with specific cultural groups, highlighting the welfare of others. This study suggests that an emotive educational intervention is likely to be effective in improving organ donation registration intent among the Hispanic population residing in NYC.

Beliefs and Intention to Organ Donation in Saudi Arabia: An Online Cross-Sectional Survey.

Despite concerted and directed efforts to increase organ donation, the gap between the need for organs for transplantation and the lack of donors has been increasing globally. Studies have shown that donor rates in countries in the Middle East, such as Saudi Arabia, are particularly low despite a relatively advanced healthcare system and supportive government policies. There are multiple psychosocial, cultural, religious, and structural factors, that influence the increase in the organ donation rate, and some of them may be unique to a country such as Saudi Arabia. The theory of planned behaviour (TPB) is an important theory utilised to study how various types of attitudes, beliefs, and norms, influence organ donation intention and practice. In this study, we aimed to explore the normative, behavioural, and control beliefs, among residents of Saudi Arabia. The current study was a cross-sectional online survey performed from 6 June 2021 to 31 December 2021, using a questionnaire prepared in GoogleTM form among the residents of Saudi Arabia. The questionnaire asked demographic factors and questions to explore the normative, behavioural, and control beliefs, regarding organ donation. This study received 1245 valid responses. Among the study participants, only 19.6% were willing to register as an Organ/Tissue donors. The intention for organ donation showed a statistically significant positive association with beliefs that organ donation is a good thing (123.51, df 4, p < 0.001), could save somebody's life (81.38, df 4, p < 0.001), could have a positive impact on life after death (114, df 4, p < 0.001), and provision of better social support to family (of the deceased) can increase organ donation (68.43, df 4, p < 0.001). Those who expressed normative beliefs that their intention to donate organs strongly depend upon their family's lack of objection to allowing the donation of organs at the time of death (190.76, df 4, p < 0.001), their knowledge about the organ transplantation process (179.35, df 4, p < 0.001), their knowledge about the viewpoint of their religion regarding organ donation (120.345, df 4, p < 0.001), and their knowledge about the registration facilities (241.64, df 4, p < 0.001), were more willing for donating their organs. Perception of worry about the likelihood of getting lesser care from doctors in an emergency if registered as an organ donor (OR = 4.25, 95% CI 1.57-11.51), beliefs that provision of better social support to family (of the deceased) can increase organ donation (OR = 10.49, 95% CI 1.56-70.43), and concern for the emotions of their family members while organ are being taken (OR = 4.37, CI 1.57-12.23), were the strongest predictors influencing a definite intention for organ donation. This study found that most of the components under normative and behavioural beliefs showed positive correlation with a definite intention for organ donation, whereas most of the components under control beliefs showed negative correlation with a definite intention for organ donation, among Saudi population. Based on the study results, there is a need to promote awareness regarding the organ donation process, especially the religious permissibility of organ donation, among general public in order to promote organ donation.

H2S-Enriched Flush out Does Not Increase Donor Organ Quality in a Porcine Kidney Perfusion Model

Kidney extraction time has a detrimental effect on post-transplantation outcome. This study aims to improve the flush-out and potentially decrease ischemic injury by the addition of hydrogen sulphide (H2S) to the flush medium. Porcine kidneys (n = 22) were extracted during organ recovery surgery. Pigs underwent brain death induction or a Sham operation, resulting in four groups: donation after brain death (DBD) control, DBD H2S, non-DBD control, and non-DBD H2S. Directly after the abdominal flush, kidneys were extracted and flushed with or without H2S and stored for 13 h via static cold storage (SCS) +/- H2S before reperfusion on normothermic machine perfusion. Pro-inflammatory cytokines IL-1b and IL-8 were significantly lower in H2S treated DBD kidneys during NMP (p = 0.03). The non-DBD kidneys show superiority in renal function (creatinine clearance and FENa) compared to the DBD control group (p = 0.03 and p = 0.004). No differences were seen in perfusion parameters, injury markers and histological appearance. We found an overall trend of better renal function in the non-DBD kidneys compared to the DBD kidneys. The addition of H2S during the flush out and SCS resulted in a reduction in pro-inflammatory cytokines without affecting renal function or injury markers.