Actual Organ Donors Research Articles

Knowledge, Attitudes, and Beliefs Toward Organ Donation Registration Among Asian Americans: Development and Pilot-testing of Educational Intervention Video.

Organ donation registration rates in the United States are lowest among Asian Americans. This study aimed to investigate the reasons for low organ donation registration rates among Asian Americans and develop educational material to help improve organ donation rates and awareness. We conducted a 2-phase study. In phase 1, a cross-sectional observational survey was distributed in-person on an iPad to members of the Asian community in Queens, New York, to investigate their knowledge, attitudes, and beliefs toward organ donation. Based on the results, an educational video was developed, and the efficacy of the video was assessed with an independent cohort of participants in phase 2 using a pre-/post-video comprehension assessment survey. Among 514 Chinese or Korean Americans who participated in the phase 1 survey, 97 participants (19%) reported being registered organ donors. Registered donors were more likely to have previously discussed their organ donation wishes with their family (adjusted odds ratio [aOR], 4.77; 95% confidence interval [CI], 2.56-8.85; P < 0.01), knowledge of the different registration methods (aOR, 2.57; 95% CI, 1.24-5.31; P < 0.01), or know a registered organ donor (aOR, 2.62; 95% CI, 1.39-4.95; P < 0.01). For the educational video efficacy assessment given pre-/post-video, the majority (90%) of the respondents reported learning something new from the video. After watching the video, there was a significant improvement in the mean knowledge score regarding organ donation (63% versus 92%; P < 0.01) and an increase in intention to have discussion regarding organ donation with family. We found varies factors associated with low organ donation registration rates among Asian Americans and demonstrated the potential of our educational video to impart organ donation knowledge to viewers and instigate the intention to have family discussions regarding organ donation. Further research is needed to assess the impact of videos in motivating actual organ donation registration.

Current Data on Organ Donation and Transplantation in Poland: Poltransplant Activity 2017 to 2022

In this paper, we present organ donation and transplantation activities in Poland from 2017 to 2022. Data came from registries maintained by the Polish Transplant Coordinating Center Poltransplant and consisted of the national waiting list, deceased donor registry, transplant registry, and the live donor registry. Poltransplant is the Competent Authority in Organs, with tasks related to preparing assessments, analyses, information, and reports in transplantation medicine and publishing and disseminating these results in the country and abroad. Poltransplant edits the Poltransplant Bulletin on its web pages and presents its activities at Polish Transplantation Society congresses, published consecutively as professional papers.

Organ Donation: Willingness, Attitude, and Knowledge among General Population of Western India – A Cross-sectional Study

Background: The issue of organ donation is complex and multifactorial involving ethical, legal, medical, organizational, and societal factors. There is a wide gap between the required number of donations and actual donations in India. There is a need to identify the reasons for this wide gap from the community perspective. Methods: A cross-sectional study was done among relatives of patients attending the outpatient department at a tertiary care center. Data were collected using a pre-designed semi-structured questionnaire. For the assessment of knowledge, relevant questions were asked. Attitude toward organ donation was assessed using 22 items on a 5-point Likert scale. Data were entered into Excel sheet and analyzed using SPSS software. Average knowledge, attitude, and practice scores were calculated and compared with religion, gender, and other sociodemographic variables. A Chi-square test of association was applied between sociodemographic variables and their willingness to sign the donor card. P &lt;0.05 was considered statistically significant. Their suggestions for improving organ donation practices were also documented. Results: The average knowledge score among participants was 8.06. Good, average, and poor attitude toward organ donation were found among 3 (0.77%), 339 (87.37%), and 46 (11.86%) participants, respectively. Good, average, and poor practice toward organ donation were observed among 1 (0.26%), 65 (16.75%), and 322 (82.98%) participants, respectively. Discussion: When deciding whom to donate their organs, 156 (40.21%) said that the health status of the recipient and his/her chances of survival will be the most important factor. Age and poor health status were the major barriers toward organ donation among participants. Still, many participant’s motivation toward organ donation was that they want to help others and 190 (49.0%) participants were willing to be part of awareness group and promote organ donation activity in the society. Solving their barriers/reasons for refusing organ donation may help to improve organ donation in the society. Conclusion: Knowledge has an impact on changing person’s attitude and practice; even our study has shown significant results of association between knowledge and attitude, knowledge and practice as well as attitude to their practice toward organ donation. Age and poor health status were the major barriers toward organ donation among participants.

EXPERIENCES OF ORGAN AND TISSUE DONATION COORDINATORS DURING COVID-19: A QUALITATIVE STUDY

This study was intended to examine the experiences of Organ and Tissue Donation Coordinators (OTDCs) in Turkey involved in the cadaveric donor process during the COVID-19 pandemic. This was a descriptive qualitative study conducted with 12 OTDCs working in nine different regions in Turkey. Consolidated criteria for reporting qualitative research (COREQ) guidelines were used to ensure transparency. Six themes emerged regarding the experiences of OTDCs: 1) intensity in intensive care units, 2) negative effects of the COVID-19 pandemic on OTDCs, 3) changes in the donor diagnostic process, 4) communication difficulties with family, 5) the reduction in potential donors, and 6) a decrease in organ donation activities of OTDCs. The findings emphasized that there were prolongations and changes in the coordination process due to increased patient density in intensive care units, which negatively affected the OTDCs. In addition, it was emphasized that the changes in the diagnostic process, communication difficulties with family members, and fewer potential donors led to a decrease in the number of cadaveric donors. This study highlights important issues experienced by OTDCs in Turkey during the COVID-19 pandemic. The findings also explain the decrease in organ donors during the pandemic. Our study revealed insufficient action plans, guidelines, and communication tools regarding the cadaveric donation process during this time.

Impact of Capacity Building in the Organ Donation Activity During an International Society of Nephrology The Transplantation Society Sister Transplant Center (ISN-TTS STC) Partnership.

This article explores the impact of a partnership program involving the International Society of Nephrology-The Transplantation Society, the Southern Philippines Medical Center, and the University of Barcelona. The program included capacity building and partnership with the Donation and Transplant Institute, leading to the creation of 5 Intermediate Transplant Procurement Management courses for Southern Philippines Medical Center's healthcare professionals. The study analyzed organ donation activity and training records from 2016 to 2022, dividing the periods pre- and postSister Transplant Center partnership, and further subdividing to assess the impact of the COVID-19 pandemic. Results showed an increase of 474.39% in donor referrals by 2019, which then dropped significantly during the COVID-19 pandemic. In 2022, a reimplementation of training opportunities led to a 657% increase in referrals. Capacity building through education, training, and partnerships has a direct and positive impact on organ donation activity, even in the face of challenging circumstances like a global pandemic.

Donor Evaluation Tool: A New Technology Improves Donor Enrolment on ICU.

Uncertainties on the intensive care unit (ICU) regarding the eligibility of a patient to be a potential deceased organ donor may prevent their referral and enrolment in the pathway for organ donation. Healthcare staff may exclude potential donors for medical reasons, which are no longer applicable. Hence, Swisstransplant implemented a digital donor evaluation tool (DET) in 2021, which allows the local hospital's organ donation coordinator to send a direct request to medical advisors (MA) of the organ procurement organization before excluding potential donors. All 156 requests entered in 2022 were analyzed. 117 patients (75.0%) were primarily accepted by the MA as potential donors. Of those 60 patients (51.3%) became actual organ donors. Main reasons for using the DET were questions regarding malignancies (n = 33, 21.2%), infectious diseases (n = 35, 22.4%) and age/co-morbidities (n = 34, 21.8%). The average age of the actual "DET donor" compared to the regularly enrolled, actual "Non-DET donor" was 65.3 ± 15.8 vs. 56.8 ± 17.5years, respectively (p = 0.008). On average 1.9 ± 1.1 organs compared to 3.2 ± 1.3 organs were retrieved from DET vs. Non-DET donors. In summary, this new digital donor evaluation tool supports reporting and facilitates eligibility decisions in uncertain, complex donor cases, potentially increasing the number of organ donations.

Organ donation and transplantation in the Russian Federation in 2022. 15&lt;sup&gt;th&lt;/sup&gt; Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on data from the year 2022.Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. We performed a comparative analysis of data obtained over years from various federal subjects of the Russian Federation and transplant centers.Results. Based on data retrieved from the National Registry in 2022, 46 kidney, 31 liver and 16 heart transplant programs were existing in the Russian Federation as of the year 2022. Organ donation activity in 2022 was 5.2 per million population (p.m.p.), with a 73.7% multi-organ procurement rate and an average of 2.8 organs procured from one effective donor. In 2022, 2,555 organ transplants were performed in the Russian Federation, which included 1,562 kidney, 659 liver and 310 heart transplants. Same year, the number of transplant surgeries performed in the Russian Federation increased by 10.0% compared to 2021. In Moscow, organ donation activity was 26.3 p.m.p. The city of Moscow and the Moscow Oblast alone had a total of 12 transplant centers, accounting for 52.6% of all kidney transplants and 64.8% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation exceeds 150 p.m.p.Conclusion. The geographic distribution of transplant centers in the Russian Federation continues to expand. Five new centers were opened in 2022. Over the past year, the number of effective donors and organ transplants increased in the country. The resource potential of medical institutions has not been exhausted and this is set to further increase the number of organ transplants performed. Moscow is the powerhouse of Russian transplantology. However, other regional leaders have since appeared in the Russian Federation, such as in Kemerovo, Kazan, Rostov-on-Don, Tyumen, Irkutsk, and Volzhsky. In the Russian Federation, priority is being given to pediatric transplant care. It is expedient to implement a complex of measures aimed at identifying potential recipients.

Organ donation by children in Australia, 2000-2019: impact of the 2009 National Reform Program. Apopulation-based registry data study.

To assess the impact of the 2009 National Reform Program for organ donation in Australia on the number and characteristics of organ donors under 16 years of age. Retrospective observational time series study; analysis of Australia and New Zealand Organ Donation (ANZOD) registry data for all consented potential deceased organ donors under 16 years of age during 2000-2019, and of numbers of donors aged 16 years or more reported in ANZOD annual reports. Difference between 2000-2008 (pre-reform) and 2009-2019 (reform period) in annual organ donor rates (donors per million population), by age group (under 16 years, 16 years or more), reported as incidence rate ratio (IRR). Differences in child donor characteristics during 2000-2008 and 2009-2019. During 2000-2019, 400 children under 16 years of age were consented potential deceased organ donors, of whom 374 were actual deceased donors (94%): 146 during 2000-2008, 228 during 2009-2019. The median annual rate was 3.3 (interquartile range [IQR], 3.0-4.3) actual donors per million population during 2000-2008 and 4.2 (IQR, 3.6-5.2) donors per million population during 2009-2019 (IRR, 1.15; 95% confidence interval [CI], 0.93-1.42). In contrast, the difference between the two periods was statistically significant for donors aged 16 years or more, rising from 11.7 (IQR, 11.2-11.8) to 19.9 (IQR, 18.3-24.4) actual donors per million population (IRR, 1.75; 95% CI, 1.66-1.85). The median age of actual organ donors under 16 was similar during 2000-2008 (11 years; IQR, 7-14 years) and 2009-2019 (10 years; IQR, 4-14 years), as was the proportion of donors in this age group under 10 kg (2000-2008: four of 146, 3%; 2009-2019: 14 of 228, 6%). Despite its overall effect on organ donation rates, the National Reform Program was not effective in increasing the numbers of donors under 16 years of age. Relying on broad initiatives for adult donors may not be appropriate for achieving this aim.

The Incidence of Brain-Dead Donors Based on Screening and Management Led by Intensivists.

BACKGROUND This study aimed to compare the incidence of brain-dead (BD) donors and potential brain-dead (PBD) donors before vs after the introduction of intensivists. MATERIAL AND METHODS This longitudinal retrospective study was performed between January 2012 and December 2020 at Seoul Metropolitan Government-Seoul National University Boramae Medical Center. Four dedicated intensivists were introduced in January 2016. The periods before and after introduction of the intensivists were defined as the pre-introduction period (2012-2015) and post-introduction period (2016-2020), respectively. RESULTS During the study period, there were 2872 discharges in the Intensive Care Unit, of which there were a total of 113 PBD (3.93%) and 36 BD (1.25%) donors. The number of PBD and BD donors increased in the post-introduction period compared in the pre-introduction period (PBD, 47.84 vs 27.14 per 1000 discharges; BD, 13.59 vs 11.03 per 1000 discharges). Poisson regression analysis showed the annual incidence rate of PBD donors significantly increased post-introduction (PBD, 27.53% vs 48.11%, P=0.044), while those of BD donors were similar between the 2 groups (BD, 11.41% vs 13.9%; P=0.743). The annual incidence rate of the total number of organ donations, multi-organ donations (>3 organs), and donation of organs (heart, lung, and kidney) increased in the post-introduction period compared to that in the pre-introduction period. CONCLUSIONS Our findings suggest a beneficial role of a dedicated intensivist, not only in improving actual organ donation and discovering PBD donors, but also in affecting the yield of the heart and lung transplantation in actual organ donation compared to donors without a dedicated intensivist.

The impact of COVID-19 on organ donation and transplantation in the UK: lessons learned from the first year of the pandemic.

The COVID-19 pandemic had a major impact on UK deceased organ donation and transplantation activity. We used national audit data from NHS Blood and Transplant to explore in detail the effects of the pandemic in comparison with 12 months pre-pandemic, and to consider the impact of the mitigating strategies and challenges placed on ICU by 'waves' of patients with COVID-19. Between 11 March 2020 and 10 March 2021, referrals to NHS Blood and Transplant of potential organ donors were initially inversely related to the number of people with COVID-19 undergoing mechanical ventilation in intensive care (incident rate ratio (95%CI) per 1000 patients 0.93 (0.88-0.99), p = 0.018), although this pattern reversed during the second wave (additional incident rate ratio (95%CI) 1.12 (1.05-1.19), p < 0.001). Adjusted numbers of donors (incident rate ratio (95%CI) 0.71 (0.61-0.81), p < 0.001) and organs retrieved (incident rate ratio (95%CI) 0.89 (0.82-0.97), p = 0.007) were inversely dependent on COVID-19 workload, though weekly numbers of transplants were unrelated (incident rate ratio (95%CI) 0.95 (0.86-1.04), p = 0.235). Non-COVID-19 mortality fell from 15,007 to 14,087 during the first wave (rate ratio (95%CI) 0.94 (0.92-0.96), p < 0.001) but climbed from 18,907 to 19,372 during the second wave (rate ratio (95%CI) 1.02 (1.00-1.05), p = 0.018). There were fewer in-hospital deaths from cardiac arrest and intracranial catastrophes throughout (rate ratio (95%CI) 0.83 (0.81-0.86), p < 0.001 and rate ratio (95%CI) 0.88 (0.85-0.91), p < 0.001, respectively). There were overall fewer eligible donors (n = 4282) when compared with pre-pandemic levels (n = 6038); OR (95%CI) 0.58 (0.51-0.66), p < 0.001. The total number of donations during the year fell from 1620 to 1140 (rate ratio (95%CI) 0.70 (0.65-0.76), p < 0.001), but the proportion of eligible donors who proceeded to donation (27%) was unchanged (OR (95%CI) 0.99 (0.91-1.08), p = 0.821). The reduction in donations and transplantation during the pandemic was multifactorial, but these data highlight the impact in the UK of a fall in eligible donors and an inverse relationship of referrals to COVID-19 workload. Despite the challenges faced, the foundations underpinning the UK deceased organ donation programme remained strong.

P11.08: International Registry in Organ Donation and Transplantation (IRODAT) – 2021 Worldwide Data

Introduction: IRODaT is the first registry in this field, which contains statistics of deceased/living donors and transplants. Out of the 111 countries with organ donation or transplantation (D&T) activity, 86 national reporters have submitted data to IRODaT during the last 19 years. Methods: Each participant country inserts their own data to the website and all data are validated. The information registered follows the definition of “The Critical Pathway of Deceased Donation (1)”, ensuring uniformity throughout the registry and aiding correct interpretation of the data by the scientific community. The data could be verified contacting the official reporter when it is needed. The compilation of all this information worldwide can be accessed by the whole community. Results: Currently twenty one countries have summited the database from 2021 at the IRODaT registry. Although organ D&T rates mostly dropped as expected due to the emergency of COVID-19 worldwide, some countries had the highest improvement in deceased donation (DD) compared to 2020 data, such as: Spain (from 37,97 to 40,2 pmp), USA (from 38,03 to 41,88 pmp), Italy (from 21,6 to 22,52 pmp); Czech Republic (from 23,3 to 25,06 pmp), Argentina (from 9,82 to 13,13 pmp) and Iceland (from 13,33 to 29,35 pmp); while Australia, Austria, Denmark and Estonia reported a downward trend with16 from 18 pmp; 20,26 from 23,9 pmp;16,90 from 21,38 pmp and 15,79 from 24,83 pmp and respectively. The increase in the DD activity of Saudi Arabia and United Arab Emirates is significant by 150% and 400% compared to the previous year. Regarding Brazil and Portugal preliminary data, the numbers collected included only the first semester of 2021 and are excluded in the figure 1. Six countries have reported an increase in Donation After Cardiac Death (DCD type III) including Spain, the US and Italy, in which DCD donation represents more than 30% of their total number of deceased donations. Thus far, thirteen countries have reported living donation activity (LD) led by Saudi Arabia (37,4 ppm), the US (19,75 ppm) and Cyprus (11,59 ppm). The number of LD performed was affected significantly since many programs were deferred. Conclusions: In 2021, the challenges hospitals faced, including restrictions, flight reductions and border closures affected national programs worldwide as reflected above. Nevertheless, coordination and transplant teams have minimized the impacts of the pandemic and while health resources were globally disproportionally affected, certain countries managed to increased D&T rates.

P11.12: Global and Country-Level Growth in Deceased Organ Donation Over Two Decades

Background: Organ shortage remains the main challenge to organ donation and transplantation worldwide. Given the limited number of deceased donors (DD), consolidated efforts were made in the past two decades to legislate and facilitate brain death donation and further increase its public acceptance. To better understand the impact of these strategies, we describe the global and country-level change in deceased organ donation activities between 2000-2019. Methods: Using data from the Global Observatory of Donation and Transplantation (GODT) for the years (2000 to 2019), we screened all WHO countries (n=194) and included 75 countries with available data on deceased donation activities (DD data for ≥ 5 years). We obtained the annual number of DD in each country, including donors after brain death (DBD) and donors after circulatory death (DCD), and reported in absolute numbers in addition to the adjusted per million population (PMP) numbers. The average annual percentage change (AAPC) in the number of donors PMP was calculated using the JoinPoint Software of the National Cancer Institute. Results: In a sample of 75/194 countries with available data on deceased donation activities, the absolute number of DD increased by 265.3% (from 11181 in 2000 to 40841 in 2019), or 0.11 to 0.4 DD, PMP with an AAPC of 7% (95% CI [4, 10.1]). This increase was predominantly driven by the rise in DBD, which increased by 228.2% (from 9703 in 2000 to 31842 in 2019), or 0.1 to 0.32 DBD, PMP with an AAPC of 6% (95% CI [4.6, 7.4]). However, temporal trends in the number of DD adjusted for the population varied considerably among countries (Figure 1), such that significant growth in DD was seen in 60 (80%) of the nations (AAPC 7.5%; 95% CI [5.6, 9.5]), while the remaining 15 countries were more likely to feature a decline over time (AAPC -1.6%; 95% CI [-3.1, -0.1]). Conclusion: In this global sample, the number of DD increased by four folds between 2000-2019, mainly driven by donations after brain death. However, only 4 in 5 countries maintained growth in their deceased donation activities over time. Future research is needed to understand the variation in donation activities worldwide.

Organ donation and transplantation in the Russian Federation in 2021. 14th Report from the Registry of the Russian Transplant Society

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on data from the year 2021. Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. We performed a comparative analysis of data obtained over years from various federal subjects of the Russian Federation and transplantation centers. Results. Based on data retrieved from the 2021 Registry, 45 kidney, 29 liver and 17 heart transplantation programs were existing in the Russian Federation as of the year 2021. The kidney transplant waiting list in 2021 included about 10.5% of the 60,000 patients receiving dialysis. Organ donation activity in 2021 was 4.5 per million population, with a 78.4% multi-organ procurement rate and an average of 3.0 organs procured from one effective donor. In 2021, there were 9.5 kidney transplants per million population, 4.2 liver transplants per million population and 2.0 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation increased by 18.3% compared to the year 2020, reaching the level of 2019. In Moscow, organ donation activity was 23.7 per million population, that of 2019. In 2021, the city of Moscow and the Moscow region accounted for 12 functioning organ transplant centers, performing 57.7% of all kidney transplants and 70.5% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation has exceeded 140 per million population. Conclusion. In 2021, donor activity and volume of transplant care in Russian regions recovered. This was after the decline in 2020 that resulted from the new coronavirus disease (COVID-19) pandemic. In addition, 7 new transplant programs were established. Further development of regional organ donation and transplantation programs, improvement in their efficiency, increase in the activity of transplant centers and development of inter-regional collaboration are expected in the Russian Federation in 2022.

Knowledge and Attitude of MBBS Students Regarding Organ Donation

Background: The organ donation rate in India is much lower than the developed countries, which leads to long waiting for the recipient. Religious beliefs, misconceptions, and lack of awareness were a few of the reasons. The study was undertaken to assess the knowledge and attitude of undergraduate medical students regarding organ donation. Methodology: The study was conducted in a tertiary care center in eastern India from February to April 2019. A total of 285 undergraduate students were randomly selected and interviewed by using a pretested structured questionnaire. The data were entered and analyzed. Categorical data were presented as proportion or percentages. Results: Among the participants, 98.6% were aware of organ donation and television was the major source of knowledge for most of them. The participants were found to have a good knowledge regarding organ donation. However, their knowledge was poor regarding the legal framework. Despite knowledge, the attitude toward organ donation was poor among the students. Conclusion: Lack of complete knowledge among health-care providers and particularly doctors can affect the organ donation activity. In a country like India, where the organ donation rate is poor, health-care providers need to take initiative to encourage people. The subject of organ donation should be incorporated into the medical curriculum to improve the knowledge of medical students.

불교의 생명존중사상과 장기기증의 관계

The purpose of this study was to investigate the relationship between respect for life of buddhism and organ donation. The research problems of this study are as follows. First, what are the general characteristics of organ donors? Second, what are the motives for organ donation pledges? For this study, the attitude toward organ donation, the commitment attitude toward organ donation, the subjective knowledge about organ donation, and the issue involvement for organ donation were surveyed and questionnaires composed of open-ended questions about the motives for organ donation pledges were conducted. The data of 139 Buddhist believers were collected and analyzed by frequency analysis and descriptive statistics and the responses of qualitative questions were analyzed using CQR-M. The results of the study are as follows. First, as a result of examining the general characteristics of organ donors, The minimum age of organ donors is 20 years old, the maximum age is 63 years, and the mean age is 43.59 years, and the standard deviation is 13.057. In the case of gender, the female pledge is more than the male, and more than half are married. In terms of health status, normal, good, and very good were more than 90% of the total responses, and their health status was perceived as good. As a result of looking at the current residence type, living together with their spouse, parents, children, or spouse and children, spouse and parents was about 90%. In the case of the organ donation pledge period, 2008 was the oldest, and in particular, the number of pledges in 2015, 2016 and 2017 increased significantly. As a result of examining the descriptive statistics on the psychological characteristics related to organ donation by organ donors, organ donation attitude, organ donation pledge attitude, subjective knowledge of organ donation, and the issue involvement showed that the mean was all above normal(3.0). Second, as a result of searching for the motivation of organ donation pledge, six sub-categories were derived; publicity and providing sufficient information, connection with Buddhist monk, connection with Buddhism, impression from life of organ donated people, genuine respect for life, and mercy practice. In terms of frequency, practice mercy was the most, followed by publicity, sufficient information, and genuine respect for life. It is meaningful that this study provided basic information to enable organ donation activities based on Buddhism

Solid Organ Donation and Transplantation Activity in the Eurotransplant Area During the First Year of COVID-19.

Background.Transplantation activity during the first wave of the coronavirus disease 2019 (COVID-19) pandemic was severely affected worldwide. This retrospective analysis aimed to assess the impact of COVID-19 on organ donations and transplantations in the Eurotransplant region during the first 12 mo of the pandemic. Specifically, we compared donor and transplantation numbers during both waves to determine whether transplant systems adapted to this new reality.Methods.All reported organ donations and transplantations from March 1, 2015, to February 28, 2021, were collected from the Eurotransplant International Foundation registry. The observation period from 2020 to 2021 was divided into three 4-mo periods, which were then compared with the corresponding periods of the preceding 5 y. COVID-19 cases for Eurotransplant countries were retrieved from the OurWorldInData.org database.Results.Overall, the number of organ donors decreased by 18.3% (P < 0.0001) and the number of organ transplantations by 12.5% (P > 0.0001) compared with previous years. Pancreas transplantation was the most affected, followed by kidney, liver, heart, and lung transplant. In detail, during period 1, the number of organ donors decreased by 26.2% (P < 0.0001) and the number of organ transplantations by 16.5% (P < 0.0001), in period 2 by 5.5% (P < 0.0091) and 4.9% (P < 0.0001), and in period 3 by 23.1% (P < 0.0001) and 16.4% (P < 0.0001), respectively.Conclusions.Organ donation and transplantation decreased drastically also during the second wave; however, despite the severity of the second wave, the decline was comparable with that of the first wave.

Exploration on the Understanding of Organ Donation Activities Among Muslims in Kuantan

Introduction: A common treatment for patients nearing the end of their life expectancy is organ donation and transplantation. Organ donation can cure diseases and save the lives of those who need them. End-stage organ failure patients must have an organ transplant in order to survive and return to a normal life. The most common obstacle to organ donation is finding a donor willing to save other people's lives. Muslims are less likely to donate organs because of a lack of understanding of organ donation activities. To devise a strategy, it is necessary to gain a better understanding of organ donation activities. The purpose of this study is to examine the perceptions of Kuantan's Muslim population regarding organ donation. Methodology: Based on interviews, this study employs a qualitative approach. An in-depth interview was conducted with eight residents of Kuantan, Pahang, in a semi-structured manner. There was a thematic analysis of the data. Results: Among the topics discussed were understanding organ donation, decision-making factors, the current updates related to organ donation activities in Malaysia, awareness of Islamic guidelines related to organ donation, and a source of information. Conclusion: Due to misunderstanding and anxiety, the willingness to register as a donor is still lacking. As a result of awareness campaigns, family and friends can all positively influence organ donation. The Islamic view on organ donation should be conveyed to the public in an easy-to-understand manner by religious leaders.

Temporal Trends in Brain-Death Organ Donation in Asia: Results From the Global Observatory on Donation and Transplantation

Organ shortage is the main limiting factor for further dissemination of organ transplantation therapies; implementation of brain-death (BD) criteria for organ donation purposes is essential for overcoming this limitation. Investigating and characterizing the effects of this intervention on organ availability and subsequent orthotopic organ transplantation in Asia, the world's most populous continent, should shed light on a global issue. The aim of this study was to describe temporal trends in brain-death donors (BDDs) and deceased-donor transplants (DDTs) in the Asian continent. We used data from the Global Observatory on Donation and Transplantation (GODT), the world's most comprehensive source of data relating to organ donation and transplantation activities. Available data on the number of BDDs and DDTs in 48 Asian countries was collated and analyzed for the years 2000-2019. The number of BDDs in Asia increased progressively, from 25 BBDs in 2000 to 5357 in 2019. The number of DDTs increased concomitantly, albeit with an initial decline between 2004 and 2008, with an exponential increase in the number of kidney and liver transplants, followed by heart and lung transplants. Data from the latest year with complete data (2019) demonstrated 25,557 deceased-donor organs were transplanted, representing a >3-fold increase in the number of transplanted organs compared with the nadir in 2008. Although the Asian continent has noticed a rapid increase in BD transplantation activities during the past 2 decades, it is self-evident that further dissemination and adoption of BD donation are fundamental to reducing organ shortage gap.

Impact of Donation Physicians on Deceased Organ Donation: A Systematic Review.

Background:An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Objective:A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020.Methods:Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by 2 team members; all discrepancies were resolved by consensus. Two team members independently extracted data from studies.Results:A total of 1017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), 3 (25%) were cohort studies, and 3 (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8% to 143% (Mdn = 33%), an increase in actual organ donors from 15% to 113% (Mdn = 27%), an increase in donor consent rate from −3% to 258% (Mdn = 12%), and an increase in deceased donor transplants from 13% to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions:Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.

Strategies to Mitigate the Impact of COVID 19 Pandemic on Organ Donation and Kidney Transplantation in Latin America.

Purpose of ReviewCOVID-19 pandemics have severely affected Latin America. It has resulted in SARS-CoV-2-associated clinical adverse outcomes, but also in social and economic deterioration. Consequently, it generated a significant negative impact on organ donation and kidney transplantation (KTx) activity in our region, leading to a negative impact on these patients’ survival and quality of life. For this reason, this article aimed to describe applicable logistics, organizational and clinical strategies to mitigate the effect of the COVID-19 pandemic on kidney donation and transplantation in our region.Recent FindingsAbsenteeism to hemodialysis sessions in patients with end-stage renal disease has been described in up to 54% in Latin America. Not surprisingly, there was a reduction in organ donation and transplants between 21 and 59%. Also, there is a higher incidence of COVID-19 positive tests in the waiting list population than KTx recipients (9.9%). However, there was a higher mortality rate in KTx recipients than the waiting list population (32%).Additionally, 59% of living donor kidney transplant programs suspended the evaluation of new donors due to the COVID-19 pandemic.SummaryThroughout this manuscript, we summarize some practical tips to resume organ donation and KTx during pandemics in Latin America, such as selecting healthy donors and recipients, universal SARS-CoV-2 screening, implementing COVID-19 accessible pathways, and telehealth as a standard, and postpone all non-urgent visits.