Assessing tumor response to neoadjuvant chemoradiation in rectal cancer with rectoscopy and 18F-FDG PET/CT: results from a prospective series.

INTRODUCTION: rectoscopy and 18F-FDG PET/CT as a diagnostic algorithm for the assessment of tumor response in rectal cancer after neoadjuvant chemoradiation therapy (CRT) is very useful. MATERIAL AND METHODS: this was a prospective longitudinal study in patients with locally advanced rectal cancer treated with neoadjuvant CRT. Patients were assessed after CRT completion with a digital rectal examination, proctoscopy and 18F-FDG PET/CT. Patients were subdivided as clinical (cCR) or radiologic (rCR) responders and non-responders according to tumor response. Clinical and radiological re-assessment was compared with the surgical specimen. Pathological tumor regression (pCR) grade was determined according to Mandard's classification. Of the 68 patients included, 15 (22 %) presented pCR in the surgical specimen and tumor persistence (non-PCR) was detected in the remaining 53 (78 %). Clinical assessment (DRE+ rectoscopy) identified 15 patients as cCR and 53 as non-cCR, two were false positives and two were false negatives. The overall accuracy was 94 %. 18F-FDG PET/CT identified 18 patients as rCR and 50 as non-rCR, one was a false positive and four were false negatives. The overall accuracy was 92 %. A combination of clinical findings and 18F-FDG PET/CT resulted in an accuracy of 96 %. The combination of clinical findings + 18F-FDG PET/CT was able to correctly identify all cases of pCR, with the exception of one case that presented a tumor regression of 80 %. In this series, 18F-PET-CT and clinical assessment had excellent accuracies in differentiating PCR from non-PCR after CRT completion. PET-CT combined with clinical assessment had a better accuracy than both modalities independently. 18F-FDG PET/CT is a valid tool that complements the clinical assessment of tumor response.

Endoscopic treatment of postoperative esophagogastric leaks with fully covered self-expanding metal stents.

BACKGROUND: the management of postoperative esophageal leaks is a huge therapeutic challenge. Thanks to the advances in endoscopy, treatment with esophageal stents has been proposed as a valid option. AIMS: the main objective of the study was to evaluate the effectiveness and safety of the use of fully covered esophageal metal stents in the treatment of postoperative esophageal leaks. METHODS: a retrospective observational study was performed in patients with postoperative esophageal leaks, treated with fully covered self-expandable metal stents between June 2011 and May 2018. RESULTS: twenty-five patients were evaluated and 34 stents were placed. The closure of the leak was observed in 21 patients after removal of the stent, with an overall technical success rate of 84 %. The mean time with a stent placed for closure of the fistula was 55.7 ± 27.11 days/patient (mean of 39 ± 24.30 days/stent). The most frequent complication was a partial distal stent migration (7/34 stents), followed by five cases of complete migration into the stomach. CONCLUSIONS: endoscopic treatment with fully covered self-expandable metal stents seems to be an effective and safe first-line treatment for postoperative esophageal leaks, according to the experience in our center.

Severe COVID-19 after liver transplantation, surviving the pitfalls of learning on-the-go: Three case reports.

BACKGROUND: The novel coronavirus 2019 (COVID-19) pandemic has dramatically transformed the care of the liver transplant patient. In patients who are immunosuppressed and with multiple comorbidities, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with increased severity and mortality. The main objective of this report is to communicate our experience in the therapeutic management of SARS-CoV-2 infection in 3 liver transplant patients. Secondly, we stress the management and investigation of the contagious spreading into a liver transplant ward. CASE SUMMARY: The patients were two women (aged 61 years and 62 years) and one man (aged 68 years), all of them having recently received a liver transplant. All three patients required intensive care unit admission and invasive mechanical ventilation. Two of them progressed severely until death. The other one, who received tocilizumab, had a good recovery. In the outbreak, the wife of one of the patients and four healthcare professionals involved in their care were also infected. CONCLUSION: We illustrate in detail the evolution of a nosocomial COVID-19 outbreak in a liver transplant ward. We believe that these findings will contribute to a better understanding of the natural history of the disease and will improve the treatment of the liver transplant patient with COVID-19.

Differences in Attitude Toward Organ Donation in the Three Main Cities of Cuba.

BACKGROUND: Cuba is one of the Latin American countries with the highest rates of organ donation. Social and cultural differences among the population throughout the country may also affect attitudes toward donation. Knowledge of these characteristics would facilitate awareness of the population most reluctant to donate and transplant. OBJECTIVE: We sought to analyze the differences in attitudes toward organ donation among Cubans living in the main capitals of Cuba. MATERIALS AND METHODS: Study population. The study group was the Cuban population living in the cities of Cienfuegos (n=636), Havana (n=920), and Santiago de Cuba (n=455), extracted from the database of the International Collaborative Donor Project. Sample of the population. Participants were older than 15 years, and data were stratified by geographic area, age, and sex. Assessment instrument. We used a validated questionnaire of attitude toward organ donation for transplant (PCID-DTO-Ríos), anonymously filled in and self-administered. STATISTICS: Student t test was applied together with the χ2 test, complemented by an analysis of the remainders. RESULTS: The favorable attitude among inhabitants in Cienfuegos was 71.2% (n=453), 68.3% (n=628) among those in Havana, and 69.5% (n=316) among those in Santiago de Cuba (P < .05). The psycho-social profile of respondents favoring organ donation was similar in the 3 cities. CONCLUSIONS: The attitude toward organ donation among the population of the main cities of Cuba was favorable and similar in all of them. The psycho-social profile toward organ donation was similar in the 3 cities.

Exploring Health Science Students' Notions on Organ Donation and Transplantation: A Multicenter Study.

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. METHODS AND DESIGN: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. RESULTS: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). CONCLUSION: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.

Resilience Related to Quality of Life Perceived in Elderly Patients With Orthotopic Liver Transplant for More Than 10 Years.

INTRODUCTION: Resilience is the ability to recover or adequately face adverse situations. It acts as a protective factor against negative events and/or complex stages of life, such as a chronic and complex disease requiring liver transplant. Age can also have an effect on a patient's ability to deal with liver transplant, resilience here being a predictor of well-being. OBJECTIVE: To analyze the level of resilience and its relationship with health-related quality of life (HRQoL) in patients over 60 years of age who underwent an orthotopic liver transplant (OLT) more than 10 years ago. MATERIALS AND METHODS: We conducted a cross-sectional descriptive study at the Hospital Clínico Virgen Arrixaca. INSTRUMENT: 1. To analyze resilience we used the Connor-Davidson Resilience Scale (CD-RISC 17) which measures 3 dimensions (tenacity/self-efficacy, personal control, and social competence). 2. To evaluate HRQoL, we used the Short Form-36 Health Survey (SF-36) questionnaire which covers 8 dimensions and produces 2 summary scores. Variables included age, sex, and post-OLT survival. Non-parametric statistical analysis was performed (P < .05). RESULTS: We analyzed 47 patients, 68% men (n = 32). The average age was 70.85 ± 0.98 years and average post-OLT survival was 15.79 ± 0.78 years. In terms of resilience, men had higher scores in tenacity/self-efficacy (90.82 ± 2.71 vs 84.79 ± 3.49; P = .029) and personal control (82.5 ± 3.79 vs 69.33 ± 5.23; P = .023). The longer the post-OLT period, the less personal control (R = -0.298; P = .042). Regarding HRQoL, the dimension of personal control is positively related: physical function (R = 0.388; P = .007); general health (R = 0.429; P = .003); vitality (R = 0.560; P = .000); social function (R = 0.402; P = .005); mental health (R = 0.311; P = .034); and physical summary (R = 0.381; P = .008). Like social competence, it is related to mental health (R = 0.360; P = .013) and mental summary (R = 0.384; P = .008). CONCLUSION: These patients showed adequate levels of resilience. A greater resilience is related to greater general health, vitality, social functioning, and mental health.

Impact of Catholicism on the Attitude Toward the Donation of Organs Among African Residents in Spain.

INTRODUCTION: The African population is one of the largest immigrant groups in Europe. Religious beliefs are deeply rooted in most African societies and condition their attitude toward organ donation. OBJECTIVE: We sought to analyze the influence of Catholicism in the attitude toward organ donation among Africans residing in Spain. MATERIALS AND METHODS: Study participants were born in Africa and were residents in Spain. Data were obtained from the database of the International Donor Collaborative Project, which includes a sample of the population for 15 years, stratified by those who were born in Africa, as well as age and sex. The instrument used was a validated attitude questionnaire toward living kidney donation (PCID-DTO-Ríos). RESULTS: Of the population under study, 13% are Catholics (n = 475) and 80% (n = 2896) are Muslims. The favorable attitude toward the donation of cadaver organs is 53.7% (n = 255) among Catholics compared with 25.6% (n = 742) among Muslims (P < .001). On the contrary, 17.7% of Catholics have an unfavorable opinion (n = 84), while 45.5% (n = 1280) of Muslims have an unfavorable opinion; 28.6% of Catholics and 29.2% of Muslims are undecided. In addition, among Catholics who believe that their doctrine accepts organ donation and transplantation, 70.6% (n = 132) are in favor of donating a corpse compared to those who believe that Catholic doctrine is against (P < .001 ), with only 35% (n = 7) in favor of the donation. CONCLUSIONS: Africans who have converted to Catholicism have a more favorable attitude toward donating their own organs than those who continue in Islam.

Analysis of the Socio-Personal Profile of Latin Americans Living in Spain and the United States: Does It Justify the Differences in Attitude Toward Organ Donation?

INTRODUCTION: There are differences in the attitude toward organ donation between Latin Americans living in Spain and those living in the United States. OBJECTIVE: We sought to analyze the socio-personal factors that can condition the difference in attitude toward donation between Latin Americans living in the United States and those living in Spain. MATERIALS AND METHODS: Participants in the study were Latin Americans living in Spain (group A; n=1237) and the United States (Florida) (group B; n=1450), extracted from the database of the International Collaborative Donor Project (PCID). Inclusion criteria were a sample population stratified by area, country of birth, age, and sex. The instrument used was a validated attitude questionnaire toward living kidney donation (PCID-DTO-Rios.) Participants were randomly selected to be surveyed according to stratification. RESULTS: The attitude in favor of Latin Americans residing in Spain (group A) was 60% (n=745) vs 33% (n=485) of residents in the United States (group B) (P < .001). The socio-personal profile of the Latin Americans in Spain compared with those in the United States indicates that they are mainly women (63.5% vs 43.7%, respectively), younger (31.78 vs 37.31 years, respectively), have more secondary education (21.2% vs 16.3%, respectively) and university studies (11% vs 6%, respectively), are of South American origin vs those who are Mexican and Central American, respectively, and there is a higher percentage of atheists/agnostics (8.1% vs 3.7%). However, the personal profile toward donation is similar in both groups, both for and against organ donation. CONCLUSIONS: The personal social profile of the Latin American resident in Spain is different from that of the resident in the United States. However, the psycho-social profile for and against organ donation is similar in both countries.

Ecuadorian Population Residing in Spain and Their Knowledge of Brain Death Concept.

BACKGROUND: The Ecuadorian population forms the largest Latin American immigrant group in Spain. However, their knowledge about the brain death (BD) concept and the relationship with the attitude toward organ donation has been little analyzed. The objective of the study is to analyze the knowledge of the BD concept among the Ecuadorian population resident in Spain. METHODS: The population under study was the population born in Ecuador and resident in Spain. Inclusion criterion was age older than 15 years stratified by age and sex. The assessment instrument was PCID-DTO-Ríos, a validated questionnaire of attitude toward donation and organ transplantation. Field work involved random selection of respondents based on stratification. The support of immigration support associations was required to obtain sample locations. The completion was anonymous and self-administered. RESULTS: Of the 461 respondents, 22% (n =102) know the BD concept and accept it as the death of the person; 61% (n = 283) do not know it; and for 17% (n = 76) it does not mean the death of the person. The variables related to the correct knowledge of BD are age (P = .007) and marital status (P = .028), with age persisting in the multivariate study (odds ratio, 1.036; P = .008). There is no objective relationship with the attitude toward organ donation. Thus, 60% of those who know the concept are in favor of donating (n = 61), and 59% of those who do not know it are in favor (n = 210; P = .813). CONCLUSIONS: The BD concept is little known among Ecuadorians residing in Spain, and it is not associated with the attitude toward donation.

Knowledge of the Brain Death Concept Among the Puerto Rican Population Residing in Florida.

INTRODUCTION: Puerto Rican and Cuban populations constitute the largest immigrant groups in Florida. This leads to an increase in their involvement in the organ donation and transplantation process (ODT); however, there is very little understanding about their attitude toward and knowledge of related key aspects such as brain death (BD). OBJECTIVE: Analyze knowledge of the BD concept among the Puerto Rican population residing in Florida. MATERIAL AND METHODS: The population under study is born in Puerto Rico and residing in Florida. Inclusion criteria was the population over 15 years stratified by age and sex. The assessment instrument was a validated questionnaire of attitude toward donation and organ transplantation "PCID-DTO-Ríos." A random selection of people was surveyed according to stratification. Support from immigration assistance associations in Florida was needed to locate potential respondents. Survey completion was anonymous and self-administered. RESULTS: Of the 259 respondents, 35% (n = 90) know the BD concept and consider it the death of an individual, 44% (n = 113) do not know it, and 21% (n = 56) do not consider them death. Variables significantly related to the correct knowledge of BD are as follows: sex (P = .012); marital status (P = .043); and couple's opinion (P = .001) and religion (P < .001). In the multivariate analysis, the variables that persist as significant are being married (odds ratio [OR] = 5.231; P = .002); to know the organ donation and transplantation couple attitude as favorable (OR = 4.819; P = .001) and not being Catholic (OR = 4.090; P < .001). CONCLUSIONS: Only one third of the Puerto Rican population residing in Florida knows the concept of BD and accepts it as the death of a person.

Organ Donation Related With Attitude Toward the Law of Presumed Consent: Spanish University Medical and Nursing Students Study.

INTRODUCTION: Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT. METHODS: and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study. RESULTS: Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000). CONCLUSION: Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.

Attitude Toward Related Living Donation Among Patients on Waiting List for Liver Transplantation.

INTRODUCTION: In liver transplantation, living donation shows better and better results. However, rates of living liver donation (LLD) are low. OBJECTIVE: To analyze the attitude towards LLD among patients on the waiting list for liver transplantation. METHOD: Study population: Patients included in the waiting list for liver transplantation who are not in code 0 and do not present with encephalopathy above grade I. PROTOCOL: After being included in the waiting list, they are informed of the study and they are cited in the Psychology Consultation. INSTRUMENTS: attitude questionnaire towards LLD, carried out in the Psychological Care consultation. RESULTS: Of the 147 patients included in the waiting list, 112 fulfilled the inclusion criteria in the study. After being cited in the consultation, 100% of respondents are in favor of living liver donation. However, when considering the related LLD, 80% of the respondents indicated that they would not accept a living donation from a family member and therefore did not want to complete the questionnaire. Of the remaining 20% who completed the study, 11% would accept it from any family member, 8% only from some family members (mainly excluding children and grandchildren), and the remaining 1% would accept it but excluded all their family members. CONCLUSION: Currently, there is a disconnect between patients' intentions in favor of living liver donation and the real attitude when they are on the waiting list and related living donation is raised.

Is the Population of Santiago de Cuba Sensitized to Xenotransplantation? A Multivariate Analysis.

INTRODUCTION: New transplant-related therapies such as xenotransplantation of solid cells, tissues, and organs are still poorly understood, especially in countries without preclinical xenotransplantation programs. OBJECTIVE: Analyze the attitude toward xenotransplantation among the population of Santiago de Cuba. METHOD: Type of study. Cross-sectional observational study. SAMPLE: Random sampling of 455 individuals residing in Santiago de Cuba. Assessment instrument. Validated questionnaire of attitude toward the xenotransplant, "PCID-XenoTx-Ríos." Field work. Random selection based on stratification. Anonymous and self-administered completion. RESULTS: A total of 49.9% would accept a solid organ xenotransplant if they needed it and the results were similar to those currently obtained with human organs, 27.5% have doubts, and the remaining 22.6% would not accept it. They are presented as statistically significant variables (P < .05): level of studies; comment with the family about the donation; opinion of a partner; religion; opinion of religion; performing prosocial activities; attitude toward donation; previous relationship with the organ donation and transplant; favorable attitude toward live kidney donation. In the multivariate analysis, the following persist: 1. level of university studies: odds ratio (OR) = 5.076; 2. not having a partner: OR = 5.154; 3. belonging to another religion: OR = 2.061; 4. favorable attitude toward organ donation: OR = 5; and 5. favorable attitude toward living donation: OR = 3.759. CONCLUSIONS: The population of Santiago de Cuba is less sensitized toward xenotransplantation, possibly due to ignorance of the issue due to lack of preclinical trials in their countries.

Nicaraguan Population Residing in Florida Attitude Toward Different Types of Organ Donation.

INTRODUCTION: The population of Nicaraguan immigrants is growing in North America; however, they have been little analyzed concerning their attitude toward donation and organ transplantation. OBJECTIVE: To analyze the attitude toward the different types of organ donation among the Nicaraguan population residing in Florida. METHODS: Study population. Nicaraguan population residing in Florida (USA). INCLUSION CRITERIA: Population sample over 15 years stratified by age and sex. Instrument valuation. Attitude questionnaires toward organ donation for transplantation "PCID-DTO-Ríos," "PCID-DVR-Ríos," and "PCID-XenoTx-Ríos." Setting for the study. Random selection of people to be surveyed according to stratification. The assistance of immigrant support associations in Florida was required to locate respondents. RESULTS: Sample composed of 89 participants. In the attitude toward donation of one's own organs after death, 22% (n = 20) were in favor, 41% (n = 36) were against, and 37% (n = 33) were undecided. Regarding the donation of living related organs, 76% were in favor (n = 68), 10% were against (n = 9), and 14% were undecided (n = 12). Finally, regarding attitudes toward the acceptance of organ xenotransplantation, if the results were similar to those obtained with human organs, they were not in favor, with 72% (n = 64) against and 28% (n = 25) doubtful. CONCLUSIONS: The attitude of the Nicaraguan population residing in Florida toward different types of organ donation is unfavorable.

Puerto Rican Population Residing in Florida: Attitude Towards Organ Xenotransplantation.

INTRODUCTION: Puerto Ricans are one of the majority immigration groups in Florida. However, little is known about their attitudes toward xenotransplantation (XenoTx), a still experimental technique, which is making significant progress. OBJECTIVE: To analyze the attitude toward XenoTx of organs among the population of Puerto Rican residents in Florida. METHODS: Population under study. Sample taken from the International Collaborative Donor Project and formed by the population born in Puerto Rico and resident in Florida. INCLUSION CRITERIA: Over 15 years stratified by age and sex. Instrument valuation. Validated questionnaire of attitude toward xenotransplantation "PCID-XenoTx-Ríos." Setting for the study. Random selection of people to survey based on stratification. Immigrant assistance associations in Florida were consulted to locate potential respondents. RESULTS: Of the 259 respondents, 16% are in favor of XenoTx if the results are similar to those obtained with human organs, 74% are against, and 10% are doubtful. If the results are worse than with human organs, only 2% are in favor, 74% against, and 24% undecided. The variables that are associated with this attitude are the following: sex (P = .001); marital status (P < .001); have offspring (P = .004); level of education (P < .001), opinion of a partner toward donation (P = .008), religious beliefs (P < .001), knowing the opinion toward donation of religion (P < .001), prosocial activity (P < .001), attitude toward donation (P ≤ .001), previous relationship with donation (P < .001), possibility of receiving a transplant in the future (P = .001), and attitude toward donation to a relative (P < .001). CONCLUSIONS: The Puerto Rican population residing in Florida does not hold a favorable attitude toward xenotransplantation.

Population of Cienfuegos (Cuba) and Their Knowledge About the Concept of Brain Death: Multivariate Analysis of the Associated Psychosocial Factors.

INTRODUCTION: The favorable knowledge of the concept of brain death (BD) is a determinant for organ donation. OBJECTIVE: To analyze the level of knowledge of the concept of BD in the population of Cienfuegos (Cuba) and determine the factors that condition it. METHODS: Sample of Cubans residing in Cienfuegos (n = 636) stratified by age and sex. The assessment instrument is the validated questionnaire of attitude toward donation and transplant, "PCID-DTO-Ríos," self-administered and anonymously filled out. STATISTICS: χ2, Student t test, and a logistic regression analysis. RESULTS: A total of 636 individuals completed the questionnaire. Fifty percent of participants understood the concept of BD and accept it as a person's death (n = 318). Of the rest, 13.4% (n = 85) did not understand it, and 36.6% (n = 233) had a misconception. The marital status (be married and / or with a partner) of the respondent is associated with the knowledge BD (P < .001) as are the following variables: level of education; offspring; having discussed the issue of donation and transplantation with the family; opinion of the couple toward donation and transplantation; religion; and favorable attitude toward the organ donation and transplant. In the multivariate analysis, the following are independent variables: 1. studies (odds ratio [OR] = 4.664; P = .002); 2. has no offspring (OR = 3.129; P < .001); 3. has commented on it in the family nucleus (OR = 2.759; P < .001); 4. despite having an opinion against (OR = 16.999; P < .001); 5. religion (OR = 1.878; P = .042); and 6. favorable attitude toward the donation of cadaver organs (OR = 2.026; P = .011). CONCLUSIONS: Half of the population of Cienfuegos knows and accepts the concept of BD as the death of an individual, associating said acceptance with a favorable attitude toward organ donation.

Acceptance of Solid Organ Xenotransplantation by the Ecuadorian Population Residing in Spain.

INTRODUCTION: Ecuadorians are the largest immigrant group in Spain. In countries with preclinical programs of xenotransplantation (XenoTx), it is important to know the population attitude toward them; however, in the Ecuadorian population it is not known. OBJECTIVE: To analyze the attitude toward XenoTx of organs among the Ecuadorian population residing in Spain. METHODS: Population under study. Ecuadorians residing in Spain. INCLUSION CRITERIA: Sample of population over 15 years stratified by age and sex. Instrument valuation. Validated questionnaire of attitude towards xenotransplantation PCID-XenoTx-Ríos. Setting for the study. Random selection of people to survey based on stratification. RESULTS: Of the 461 respondents, 36% are in favor of XenoTx if the results were similar to those obtained with humans, 15% against, and 49% undecided. If the results were worse than with human organs, 11% would be in favor, 26% against, and 63% undecided. The variables associated with this attitude are age (P = .018), marital status (P = .026), studies (P < .001), comment with family (P = .001), couple attitude (P = .039), attitude toward cadaveric donation (P < .001), previous experience with donation (P = .001), consider the possibility of needing a transplant in the future (P < .001), and attitude toward related living donation (P < .001). In the multivariate analysis, these data persist: university studies (odds ratio [OR] = 3.875; P = .007); in favor of cadaveric organ donation (OR = 2.840; P < .001); previous relationship with donation and organ transplantation (OR = 1.901; P = .026); and consider the possibility of needing a transplant in the future (OR = 4.329; P = .002). CONCLUSIONS: The attitude toward XenoTx among Ecuadorian residents in Spain is unfavorable and is conditioned by different psychosocial variables.

Attitudes Toward Organ Donation: Differences Between Medical and Nursing Andalusian Students.

INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.

Confident Perception of Primary Care Physicians Correlates to the Attitude Toward Donation and Organ Transplantation: A Multicenter Study of Medical And Nursing Spanish Students.

A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population. OBJECTIVE: To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it. METHODS AND DESIGN: A sociologic, multicenter, and observational study. POPULATION: medical and nursing students in Spanish universities. DATABASE: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study. RESULTS: Completion rate: 90%. With respect to students' trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000). CONCLUSION: Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.

Are Ghanaians Residing in Spain Aware of the Donation of Living Related Kidney?

INTRODUCTION: The population of Ghana has an emerging migratory flow to Europe and especially to Spain. Therefore, there is an increase in waiting lists in kidney transplantation. OBJECTIVE: To analyze the attitude toward related living kidney donation (LKD) among the population born in Ghana and residing in Spain. MATERIAL AND METHODS: Population under study. Population born in Ghana and resident in Spain. INCLUSION CRITERIA: Sample of population over 15 years stratified by age and sex, according to census data and immigrant assistance associations. INSTRUMENT: Validated attitude questionnaire toward LKD "PCID-DVR-Ríos." Field work. Random selection of people to be surveyed according to stratification. RESULTS: A total of 237 respondents have been included in the study. 72% are in favor of LKD, not just related. The remaining 28% do not accept the related living donation or have doubts about it. Respondents in favor of the related LKD have a more positive attitude toward ODT (P < .001). The attitude toward related LKD is linked to socio-personal factors, knowledge factors about the donation and organ transplantation process, social interaction factors, attitude factors toward the body, religious factors, and the risk assessment that comes with a living donation (P < .05). In the multivariate analysis persists: the attitude toward the cadaveric OTD (odds ratio [OR] = 6.993), perform pro-social activities (OR = 14.084), fear of body mutilation (OR = 20.408) and renal risk (OR = 29.411). CONCLUSIONS: The Ghanaian population immigrating to Spain has an unfavorable attitude toward related LKD compared with existing studies of Western European and Spanish populations, which is conditioned by multiple psychosocial factors.