Although women who experience perinatal loss can donate breastmilk to milk banks, psychological and psychosocial effects on them remain understudied. Understanding these impacts is crucial for delivering comprehensive, person-centered care throughout the donation process. This qualitative systematic review aims to fill this knowledge gap by synthesizing experiences from relevant qualitative studies. We conducted comprehensive searches of multiple databases, including PubMed, Web of Science, the Cochrane Library, EMBASE, CINAHL, CNKI, Wanfang Data, VIP, and SinoMed. The review covers qualitative empirical studies published from database inception through March 2024. A meta-synthetic methodology was employed to synthesize the included studies. Five synthesized findings were derived: (a) diverse motivations for donating breastmilk; (b) positive experiences in the process of donating breastmilk; (c) negative experiences in the process of donating breastmilk; (d) facilitators and barriers to breastmilk donation; (e) reconstructing meaning after perinatal loss. The results of this study emphasize that sustained attention should be paid to the experiences of breastmilk donation among women experiencing perinatal loss to guide healthcare professionals in providing more individualized bereavement support and breastmilk donation programs. Trial Registration: CRD42024508866.

The LifeGift Organ Donation Website is a web-based application developed to simplify and improve the process of organ donation. In traditional systems, lack of coordination, manual record keeping, and delays often result in difficulty in finding suitable donors on time. This system provides a centralized platform where users can register as organ donors and recipients can search for available organs easily. The application maintains a digital database of donor information, which helps in quick access and efficient management. It improves communication, reduces errors, and saves time. By using modern web technologies, the system enhances transparency and increases awareness about organ donation. Overall, the proposed system helps in faster decision-making and contributes to saving human lives.

The Hospital Organ Donation Performance Score: A human and artificial intelligence/machine learning collaborative solution to the current nationwide puzzling state of organ donation metrics.

ABSTRACT Non-Governmental Organizations (NGOs) are essential in delivering social support and community services, but many existing management systems still face issues such as limited transparency, delayed donation processing, and inefficient resource coordination. To address these challenges, this paper presents NGONexus, a web-based NGO management platform designed to streamline donation handling, event coordination, and reporting. The proposed system supports both monetary and material donations, including food, clothes, and books, through a centralized and user-friendly interface. It integrates secure online payment through Razorpay API, automated digital receipt generation using jsPDF, and location-based NGO discovery with Google Maps API. The system is developed using ReactJS for the frontend, Node.js/JSP-Servlets for backend services, and MySQL for secure data storage. By enabling real-time donation tracking, faster transaction processing, and transparent reporting, NGONexus improves operational efficiency and strengthens trust between donors and NGOs. Keywords: NGO Management System, Donation Tracking, Web-Based Platform, Real-Time Monitoring, Resource Management, Transparency, Event Management

ObjectiveThis study investigates how privacy, distraction, and comfort in blood donation environments affect donors' stress and motivation, addressing critical challenges posed by ongoing blood shortages.BackgroundThe reluctance to donate blood is associated with donors' experience exacerbated by stress during the donation process and the quality of the donation environment. Despite known physical environmental influences on patient well-being in healthcare settings, its influence within blood donation settings remains underexplored.MethodsUsing an online survey with a virtual visualization technique, 400 college-aged participants rated their preferences and emotional responses to eight simulated blood drive bus environment settings.ResultsSettings combining privacy, positive distraction, and comfort significantly reduced stress and increased motivation compared to those with fewer interventions. Female and less experienced donors (nondonors, first-timers) particularly benefited from enhanced comfort and distraction, reporting lower fear and greater positive emotions. Cultural differences also influenced experiences.ConclusionsFindings highlight the potential of well-designed blood donation environments to reduce stress and enhance motivation, especially among younger, female, and less experienced donors, improving donation experiences and addressing critical blood shortage.

Complex cases and coordination: Reports from organ donation specialists in Canada.

According to the databases utilized by the organ procurement organization, whose donation service area is Georgia (LifeLink Foundation of Georgia), Irwin, Ben Hill, and Coffee counties reported disproportionately low organ donation rates relative to other counties within the state of Georgia. The three counties have an aggregate population of about 70,000 citizens, and there have been roughly 50 cases or less of organ donation within the most recent decade (Data USA, 2024, https://datausa.io/ ). This is a qualitative study of rural Georgians' perspectives on organ donation. This study identifies cultural and religious beliefs that influence perspectives and explores lines of rationale that people demonstrate regarding hesitancy to organ donation in these communities. 21 one-on-one interviews were conducted with the participants. The interviews were recorded and transcribed. Data analysis, adopted from A Step-By-Step Guide to Qualitative Data Coding, involved manual coding of interview transcripts to gather insights and identify trends with intent to establish themes (A step-by-step guide to qualitative data coding, Taylor & Francis Group, 2019). After analyzing the data, four themes were identified: (1) little knowledge and promotion suggestions, (2) religious ambiguity, (3) overall positivity despite skepticism and misconceptions about the donation process, and (4) limited awareness of organ donation.

Whole-blood donation and apheresis are the only ways to obtain blood components for human use. Tools are being developed to improve the efficiency of blood donation systems by reducing waste, increasing donations and preventing shortages. These tools also help manage the storage and distribution challenges posed by blood products with different expiry dates. The proposed approach focuses on identifying inefficiencies in the 'blood transfusion chain' and presents a renewed, practical model that differs from other theoretical ones. It outlines 11 processes across three periods: before donation (promotion), during donation and after blood processing. The goal is to optimize each process, reduce inefficiencies and propose improvements based on current scientific knowledge. While changes to healthcare policies are outside of its scope, the model aims to streamline existing donation processes. This paper emphasizes the need for a 'vein-to-vein' system, which tracks blood from donor to recipient, managed by a single entity controlling the blood centre's data infrastructure. Though limitations exist due to incomplete control over the transfusion chain, future work will demonstrate the model's application, focusing on areas like scheduling and monitoring pre-donation haemoglobin levels for better optimization. Comprehensive tracking, including of the recipient, is essential for full system optimization.

Abstract Background In deceased donor kidney transplantation, the process of donation, transportation and transplantation exposes grafts to ischemia-reperfusion injury (IRI). Machine perfusion (MP) has increased in popularity to ameliorate IRI compared to conventional static cold storage (SCS). Perfusion preservation can be performed at different temperatures (hypothermic versus normothermia), with or without oxygen, either during transport plus at the recipient centre (continuous) or only at the recipient centre (end-ischemic). This study assessed the effectiveness of various MP strategies on kidney transplant outcomes. Methods This Bayesian network meta-analysis (NMA) included randomised trials from our recent Cochrane review that specified the MP type and timing (continuous versus end-ischemic). NMA allows comparisons across multiple interventions even without direct head-to-head trials. Rankograms were used to obtain the probability of each intervention occupying specific ranks. Results Oxygenated continuous hypothermic MP (cHMPO2) was the top-ranked technique for 1-year graft survival (probability of cHMPO2 being rank 1 = 92%; probability of cHMP being rank 2 = 80%), delayed graft function and acute rejection, followed by non-oxygenated cHMP. Results for patient survival and primary non-function were less certain due to small number of events and resulting imprecision. In contrast, oxygenated end-ischemic HMP (eiHMPO2) and end-ischemic normothermic MP (eiNMP) showed no clear benefit over SCS for any outcome. Conclusions cHMPO2 was consistently ranked as the most effective renal ex-situ machine perfusion strategy across multiple outcomes. However, head-to-head trials comparing cHMPO2 and cHMP in DBD and younger DCD transplants are needed, as current randomised evidence is limited to older DCD transplants.

To determine whether key institutional and clinical differences exist between highly and moderately active hospitals in Japan with respect to brain-dead organ donation practices. Retrospective multicenter cohort study. Sixteen tertiary emergency and critical care centers across Japan. All brain-dead organ donors from participating institutions who had at least one organ procured and transplanted between July 17, 2010, and December 31, 2023. Hospitals were categorized as highly active (≥ 14 donations) or moderately active (≤ 13 donations) during the study period. None. Institutional donation practices were compared, including donor management strategies, use of vasopressors and corticosteroids, time intervals in the donation process, and frequency of multidisciplinary team meetings. A total of 204 donors were included; the median age was 47 years (interquartile range, 37-56), and 92 (45.1%) were female. Donor characteristics were similar between groups. Vasopressin was used in nearly all donors, though dosing protocols varied. Corticosteroid use was significantly higher in highly active hospitals compared with moderately active ones (58.3% vs. 38.0%; p = 0.004). Time from admission to coordinator notification was similar; however, time to family consent (median, 8 vs. 5 d; p < 0.001) and time to organ procurement (median, 12 vs. 9 d; p = 0.006) were longer in highly active hospitals. These hospitals also conducted more multidisciplinary meetings during donor management (median, 2 vs. 0; p < 0.001). Highly active hospitals demonstrated more intensive donor management practices, longer timeframes for key donation steps, and greater multidisciplinary engagement. Standardization of donation practices may enhance efficiency and support broader dissemination of effective institutional strategies to improve brain-dead organ donation rates in Japan.

Introduction: Inappropriate medicine donations during health emergencies remain a global challenge, particularly for resource-limited nations. Despite its prevalence, little research has explored this issue from an interdisciplinary or systems perspective. Understanding the motivations, effects, and outcomes of these donations is essential for developing strategies to mitigate negative consequences and build local capacity. A deeper understanding of the complexity and interconnectedness of the problem is necessary before solutions can be proposed. Methods: This study explores the stakeholders involved and the complexity of their relationships regarding medicine donations in response to health emergencies for resource-limited countries. It aims to identify, characterize, and map key stakeholders involved in the donation process—including governments, organizations, charities, pharmaceutical companies, and community organizations—across six countries: Japan, Canada, the United Kingdom, Nigeria, Rwanda, and Uganda. Results: The study follows a three-step stakeholder analysis framework. First, stakeholders will be identified using a snowball sampling method, leveraging partner organizations to ensure diverse perspectives. Second, an online questionnaire will assess each stakeholder’s influence, attitudes, interests, capacity to contribute, and perceived barriers to participation in the medicine donation process. The questionnaire will also evaluate their desired level of involvement and identify other key players within the donation process. Third, stakeholders’ attributes will be mapped in a matrix, categorizing them by their levels of influence and interest. Stakeholder relationships (i.e., level of collaboration) will be analyzed using social network analysis (SNA). Conclusion: This analysis will provide insights into the key actors and dynamics in medicine donation, offering a foundation for future studies aiming to investigate and curb inappropriate donations in future health emergencies.

Thoracoabdominal normothermic regional perfusion: The debate and ethical considerations for nurses.

Background/Objectives: A persistent mismatch between organ supply and transplant demand affects healthcare systems worldwide, particularly in underdeveloped and transitional systems. Intensive care units (ICUs) represent the primary setting for donor identification following brain death, placing intensive care physicians at the center of organ donation pathways. This nationwide cross-sectional survey aimed to evaluate Romanian intensivists' knowledge, attitudes, and reported clinical practices regarding brain death determination, communication with families, and system-level barriers to organ donation, to identify modifiable factors relevant to transplant policy development. Methods: A prospective, nationwide, questionnaire-based survey was conducted among intensive care physicians in Romania. The structured questionnaire explored their knowledge and attitudes regarding brain death, communication with families, involvement in donation processes, ethical perceptions, and views on the organization of the transplant system. The survey was distributed through the Romanian Society of Anesthesia and Intensive Care, and descriptive exploratory analyses were performed. Results: A total of 117 ICU physicians participated (mean age 41.0 ± 9.9 years). Although 84.6% agreed with the current brain death diagnostic criteria, and 83% considered the protocol sufficiently clear. The mean number of brain-dead patients managed annually was 8.25 ± 12.90. 69.3% of respondents perceived communication competencies as insufficient. 77.8% considered family consent decisive in donation decisions, while 87% supported the establishment of a national donor registry and 77% favored a donor card system. Organ procurement was reported as a priority in only 38.5% of ICUs. Institutional prioritization of organ procurement and structured training was inconsistent. Conclusions: This nationwide survey identifies key educational, organizational, and systemic barriers limiting organ donation performance in Romania. Targeted training, improved communication strategies, integration of donation pathways into routine intensive care practice, and the adoption of national consent instruments represent essential clinical and policy priorities for low-performing transplant systems.

Brain death (BD) is defined as the irreversible loss of all brain functions resulting from non-recoverable brain injury. The aim of this study was to evaluate the knowledge, practices, and challenges encountered by pediatric neurology (PN) and pediatric intensive care (PIC) specialists in Turkey regarding BD diagnosis and related processes. Cross-sectional, descriptive study based on a structured online survey. Nationwide multicenter study involving hospitals across seven geographical regions of Turkey. A total of 100 specialists (54 PN and 46 PIC) participated in the study. An online survey comprising 41 questions on diagnostic procedures, organ donation processes, and family communication was administered to PN and PIC specialists. Eighty-six percent of respondents had previously declared BD. The median annual pediatric BD declaration was 5, with 67.4% of centers performing organ transplantation. However, 42.4% reported no organ donations in the past year. While 81.4% of PIC specialists considered their training adequate, only 53.5% of PN specialists agreed (p < 0.001). Multiple centers (69.8%) had transplant coordination services, but 25.6% of respondents reported insufficient support in this regard. The view that a single apnea test is sufficient for BD diagnosis was held by 83.7% of PIC and 65.1% of PN specialists (p = 0.045). When apnea testing was unfeasible, 88.4% of PIC and 65.1% of PN specialists considered cerebral blood flow studies adequate for BD confirmation (p = 0.011). Of the participants, 72.1% routinely used neuroimaging, with CT angiography being the most preferred method (77.9%). In patients designated as potential donors, 53.5% of PIC specialists refrained from initiating additional therapies. This is the first systematic comparison of expert opinions on the pediatric BD diagnostic process in Turkey. The findings underscore an urgent need for the development of multidisciplinary guidelines and nationwide standardization.

Organ transplantation is often the only treatment for end-stage organ failure. Treatment, however, is either delayed or restricted due to a shortage of donors. To address the shortage of donors in the Republic of Ireland, the government introduced new national legislation for organ donation. To determine practicing ICU nurses' knowledge, confidence, beliefs and attitudes towards organ donation and the organ donation process. A cross-sectional survey research design was used. Data were collected using an online anonymous questionnaire. Participation was voluntary for all ICU nurses who fulfilled the inclusion criteria (n = 500), across four ICUs in large teaching hospitals across the Republic of Ireland. Ethical approval was granted for each site. Data were analysed using SPSS ver27 software. The response rate was 36% (n = 181). All nurses were in support of organ donation and 85% reported they would become organ donors. Nurses' beliefs and attitudes towards organ donation were positively correlated with country of training, role in ICU, further education in critical care and greater experience with organ donation. Nurses were least confident in speaking to family about organ donation and their knowledge of recent changes to national legislation. Nurses' knowledge and confidence had positive correlations with length of time working in ICU (p < 0.001), nurses' role in ICU (p < 0.001), completing further education in ICU (p < 0.001), completing training in organ donation (p < 0.001) and experience in organ donation (p < 0.001). Although attitudes to organ donation are influenced by society, culture and religious factors, nurses' education and experience caring for organ donors and their families are also important influencing factors. Providing specific training in organ donation and opportunities to build clinical experience in the area of organ donation will help ensure nurses have the knowledge and confidence to effectively contribute to the organ donation process.

Objective: To describe bereavement experiences among families who went through the process of organ and tissue donation, based on evidence from national and international literature. Method: An integrative literature review was conducted across five databases (CINAHL, LILACS, SciELO, PubMed, and VHL), utilizing descriptors related to bereavement, organ donation, and family experiences. The guiding research question was: what bereavement experiences are described in the national and international literature among families who experienced organ and tissue donation? The search was carried out in August 2024, covering the period from 2001 to 2024. The data were analyzed using conventional content analysis. Results: Nine studies were included, and the evidence was organized into three categories: (1) Stressors in bereavement; (2) Protective factors in grief; (3) Post-donation actions directed at families. Findings indicate that bereavement in this context is shaped by emotional, social, and institutional dimensions. Conclusion: Bereavement among families involved in organ and tissue donation is complex and influenced by factors that may either exacerbate or mitigate suffering. Qualified support, empathy, active listening, and understanding of brain death can foster healthier grieving processes. However, gaps remain in the literature, particularly in Latin American countries, highlighting the need for further studies to guide interventions, professional training, and the development of care protocols for families undergoing this experience.

ABSTRACTPasteurised donor human milk is a vital resource for vulnerable preterm infants. As demand continues to grow, the sustainability of milk banking services relies not only on recruiting donors but also on fostering positive donor experiences. Satisfied donors are more likely to contribute consistently and advocate for the service, enhancing its visibility and community support. A total of 588 formal milk bank donors who donated to Australian Red Cross Lifeblood milk programme between January 2024 and April 2025 were invited to participate in a survey. The survey aimed to explore factors that make milk donors feel valued, evaluate their satisfaction with different aspects of the donation process, and identify barriers that may hinder continued donation. The survey included Likert‐scale questions and optional open‐text responses. The survey was completed by 257 donors (43.7% response rate). Most (72.4%) felt highly valued by Lifeblood, especially due to receiving milk bags, and having supportive, personal interactions with donor coordinators. However, some donors felt undervalued due to a lack of post‐donation communication. Whilst satisfaction with the donation process was high, some respondents found the screening process repetitive and time‐consuming. The most reported barrier was limited freezer space (67.7%), followed by time constraints, illness in the household, and the burden of cleaning and sterilising equipment for milk expression at home. Milk banks should adopt donor‐centred practices, including streamlining processes to minimise time and effort required for donors, reduce costs incurred by donors where feasible, and enhance post‐donation transparency and engagement.

This study explores the lived experiences of spouses of altruistic kidney donors in faith-based communities in Israel. While not undergoing the surgical procedure themselves, spouses are deeply involved in the donation process, emotionally, relationally, and spiritually, yet their perspectives remain largely overlooked within healthcare systems and religious discourse. Drawing on interpretive phenomenological analysis and informed by an ecological framework, this study examines how individual, relational, communal, and institutional contexts shape spouses' experiences of donation. Findings indicate that spouses often assume extensive emotional and practical responsibilities while navigating complex moral tensions related to consent, faith, responsibility, and communal expectations. Although many expressed pride in their partners' altruistic acts, participants also described feelings of invisibility, emotional burden, and limited institutional recognition of their supportive role. These experiences reveal how altruistic donation, often framed as an individual moral act, is in practice embedded within intimate relationships and sustained through relational labor that remains largely unacknowledged. By foregrounding the voices of donors' partners, this study contributes to a more relational and ethically nuanced understanding of altruism in faith-based contexts. It highlights the need for greater institutional and pastoral awareness of spouses' experiences and calls for more inclusive approaches to care, support, and ethical engagement within religiously grounded medical practices.

Blood donation is crucial for healthcare systems worldwide, ensuring the availability of blood and its products for patients in need. Many regions struggle to maintain adequate blood supplies due to reliance on patient-related donations, leading to shortages and logistical challenges. Increasing voluntary, non-remunerated blood donations (VNRBD) is pivotal for a stable blood supply. Mobile blood donation campaigns have shown promise in enhancing voluntary donation rates by providing convenient opportunities for potential donors. This study aimed to evaluate donor satisfaction levels and compare experiences between first-time and repeat donors in a mobile blood donation campaign conducted at King Fahd Armed Forces Hospital (KFAFH) in Jeddah, Saudi Arabia. A cross-sectional study was conducted from October 12, 2023, to February 25, 2024, including 384 adult donors. Data were collected using a structured questionnaire assessing multiple aspects of the donation experience. Descriptive statistics were used to report frequencies, percentages, and mean ± standard deviation (SD) for overall satisfaction. Subgroup analyses compared satisfaction levels between repeat and first-time donors, and between male and female participants. Donors reported high overall satisfaction, with a mean satisfaction score of 4.5 ± 0.5 (Likert scale 1-5). The vast majority of donors (86.5%) were repeat donors, who reported slightly higher satisfaction (4.6 ± 0.5) compared to first-time donors (4.4 ± 0.6). High satisfaction was observed across all aspects of the donation process, including welcome, clarity of pre-donation survey questions, hygiene, and post-donation care. Both male and female donors reported similarly high satisfaction levels. The findings highlight the effectiveness of mobile blood donation campaigns in enhancing voluntary blood donations, fostering donor loyalty, and reducing dependency on patient-related donors. The campaign successfully provided a positive experience across donor subgroups, supporting donor retention and engagement.

There has been a surge in attention to ethical controversies associated with organ donation in the USA. The Neurocritical Care Society (NCS) Ethics Committee sought to understand member experiences and attitudes related to organ donation in the USA. We designed a survey of members who practice in the USA and have interacted with an organ procurement organization (OPO)/potential donor. The survey was disseminated by NCS from 1 June 2025 to 1 September 2025. Free-text responses were reviewed to identify themes. Of 2204 NCS members in the USA, there were 71 respondents who completed the survey and 37 respondents who provided free-text comments. Experiences and attitudes varied, but 59% of respondents indicated that they generally think that communication between the OPO and patient surrogates about donation after brain death/death by neurologic criteria seems appropriate, and 34% indicated that they generally think that communication between the OPO and patient surrogates regarding donation after cardiac death/death by circulatory-respiratory criteria (DCD) seems appropriate. Themes included (1) the need to improve education for the treatment team about organ donation; (2) blurred boundaries between patient care and care directed toward organ donation; (3) misalignment between OPOs and treatment team priorities; (4) loss of trust between patient surrogates and the treatment team based on interactions with OPOs; (5) suboptimal timing of communication between OPOs and patient surrogates; (6) concerns regarding a potential lack of transparency, empathy, and cultural sensitivity in communication between OPOs and patient surrogates; (7) opportunities for improvement in preoperative care before donation and palliation after extubation for DCD; and (8) changes in willingness to donate organs based on interactions with OPOs. Although the results from this survey reflect the experience and attitudes of a small percentage of NCS members in the USA, they indicate that there are opportunities for improvement in organ donation processes. Survey results will guide the NCS Ethics Committee in supporting members navigating ethical controversies related to organ donation.