Psychological profile of teenagers toward organ donation: a multicentric study in Spain.

BACKGROUND: It is important for teenagers to have a favorable attitude toward organ donation and transplantation (ODT) in order to increase the number of future donors. To determine the attitude of teenagers in the South East of Spain toward ODT and to analyze the psychosocial variables related to this attitude. METHODS: The study population consisted of young teenagers in the South East of Spain. A stratified sample was selected by geographical location, sex and age (n = 4, 117). Attitude was assessed using a validated questionnaire about ODT (PCID-ODT Ríos). Statistical analysis: Student's t-test, Chi-squared test and a multivariate analysis. RESULTS: The questionnaire completion rate was 87% (n = 3572). Attitude toward ODT was favorable in 46% of cases (n = 1633) and undecided in 43% (n = 1543). Several psychosocial variables had a favorable effect on donation: believing that one has good information about ODT (Odds Ratio [OR] 1.706); discussing the subject with the family (OR 1.543) and friends (OR 1.818); carrying out pro-social activities (OR 1.642); having a favorable attitude toward cremation (OR 1.466) and autopsy (OR 1.470); and, finally, not being afraid of scars (OR 4.184). CONCLUSIONS: Teenagers in the South East of Spain are not currently inclined to support organ donation. This attitude is related to many psychosocial factors, mainly connected to not having good information about the subject, not discussing it in social circles and the fear of body mutilation. It would be appropriate to create educational interventional strategies in this group to prevent a negative impact on future donation rates.

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain.

INTRODUCTION: Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion. OBJECTIVE: To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude. MATERIAL AND METHODS: Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain. STUDY POPULATION: Students studying a degree in medicine enrolled in Spain (n = 34,000). SAMPLE SIZE: A sample of 9598 students (confidence of 99% and precision of ±1%), stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ donation and transplantation (PCID-DTO RIOS) was self-administered and completed anonymously. RESULTS: The questionnaire completion rate was 95.7% (n = 9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio = 1.739); being in the sixth year of the degree (OR = 2.506); knowing a donor (OR = 1.346); having spoken about the subject with one's family (OR = 2.132) and friends (OR = 1.333); having a family circle that is in favour, more specifically, having a father (OR = 1.841), mother (OR = 2.538) or partner in favour (OR = 2.192); being a blood donor (OR = 2.824); acceptance of the mutilation of the body if it were necessary (OR = 2.958); and being an atheist or an agnostic (OR = 1.766). CONCLUSIONS: Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.

Medical students faced with related and unrelated living kidney donation: a stratified and multicentre study in Spain.

INTRODUCTION: The attitude of medical students towards living kidney donation (LKD) is of great interest given that they will become promoters of this technique in the near future. OBJECTIVE: To analyse the attitude of Spanish medical students towards related and unrelated LKD and to determine the factors affecting this attitude. MATERIALS AND METHODS: Type of study: A sociological, interdisciplinary, multicentre, and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34.000). SAMPLE SIZE: A sample of 9598 students (99 % confidence and precision of ±1 %), stratified by geographical area and academic year. Measurement instrument: A validated questionnaire (PCID-DVR RIOS) was administered and completed anonymously. RESULTS: There was a completion rate of 95.7 % (n = 9275); 93 % (n = 8630) were in favour of related LKD, and 30 % (n = 2784) were in favour of unrelated LKD. The following factors were associated with this attitude: (1) age (p = 0.008); (2) sex (p < 0.001); (3) year of university degree (p < 0.001); (4) a belief that a transplant might be necessary in the future (p < 0.001); (5) attitude towards deceased organ donation (p < 0.001); (6) a willingness to accept a kidney from a living donor (p < 0.001); (7) attitude towards living liver donation (p < 0.001); (8) a partner's attitude towards donation (p < 0.001); (9) having spoken about the subject with one's family (p < 0.001), or friends (p < 0.001); (10) pro-social behaviour (p < 0.001); (11) the respondent's religious attitude (p < 0.001); and (12) fear of possible mutilation of the body after donation (p < 0.001). CONCLUSIONS: The attitude of medical students towards LKD is very favourable when it is the related kind of donation, and it is associated with factors of general knowledge about organ donation and transplantation and social interaction and religion.

Latin Americans in Spain and their attitude toward living kidney donation.

INTRODUCTION: The Latin American (LA) population in Spain is ever increasing in size and is perfectly integrated into the social structure. The objectives were to analyze the attitude of citizens, born in Latin America and living in Spain, toward living kidney donation (LKD) and to determine the psychosocial variables affecting this attitude. MATERIAL AND METHODS: A sample of LA residents living in Spain was obtained randomly in 2010 and stratified according to the respondent's nationality (n = 1314). Attitude was evaluated using a validated questionnaire ("Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Renal" Ríos). The survey was self-administered and completed anonymously. RESULTS: The questionnaire completion rate was 86% (n = 1.132). A total of 89% (n = 1003) were in favor of related living donation, and 30% if the donation were unrelated. The variables associated with attitude toward LKD were as follows: sex (p = 0.043); marital status (p = 0.013); previous experience of organ donation (p = 0.009); attitude toward deceased organ donation (p < 0.001); a respondent's belief that he or she could be a possible recipient of a future transplant (p < 0.001); knowledge of a partner's opinion (p = 0.021); family discussion about organ donation (p = 0.001); knowledge of the view of one's religion toward donation (p < 0.001); concern about "mutilation" after donation (p = 0.004); and evaluation of the risk from living donation (p = 0.036). CONCLUSIONS: The attitude of LA citizens residing in Spain was favorable both toward related LKD and unrelated living donation.

Circadian temperature rhythm in breeding sows: differences between days in oestrus and anoestrus after weaning.

BACKGROUND: Mammals are subject to circadian rhythms for the control of various physiological events. One of the parameters known to be subject to variations throughout the day is body temperature, which is also subject to influences such as environmental temperature. However, there are not many studies on these rhythms in breeding sows. The aim of this study was to determine the circadian parameters for body temperature in post-weaning sows during oestrus period, throughout the seasons in a warm climate. RESULTS: Differences were observed in inter-daily stability, intra-daily fragmentation and cycle length comparing the summer sows with the other seasons. Differences were also observed in the period that the sows were in oestrus compared to the non-oestrus period for intra-daily fragmentation, with these differences being more important in the warm seasons compared to the cold seasons. The parameters normalised by COSINOR also showed significant differences when comparing seasons, especially in the acrophase of the temperature maximum. Another significant finding was an increase in vaginal temperature during oestrus in sows monitored in summer compared to the other seasons. Correlations between body, vaginal and environmental temperature were observed. CONCLUSION: There is a seasonal influence on the circadian rhythm of temperature and summer is clearly the season with the greatest differences in circadian parameters when compared to the other seasons. The extreme summer conditions seem to definitely influence this rhythm and make the body and vaginal temperature of the sows different from the rest of the year. The increase in period robustness in both body and vaginal temperature during the days when sows are in oestrus could be related to the hormonal events of oestrus and ovulation and seems to be independent of weather since it occurs in all controlled seasons. However, this robustness is significantly higher in summer than in the other seasons both in the oestrus period and on days when sows are not in oestrus.

Optimization of cytotoxicity assay by real-time, impedance-based cell analysis.

This paper presents an optimized procedure for assessing an immune-mediated cytotoxicity, produced after the addition of human and baboon serum to transgenic porcine fibroblasts. This procedure is performed with the xCELLigence Real-Time Cell Analyzer (RTCA). The xCELLigence system measures the impedance variations in the culture media of a 96-well microelectronic plate, and shows the changes in cell number and morphology in a real-time plot. However, different factors need to be optimized before developing an RTCA assay. Thus, we studied the influence of several variables, such as the number of cells seeded, the time the cells were allowed to grow before the tests, the serum concentration and the addition of rabbit complement. The findings were confirmed by the WST-1 classical cytotoxicity test. The results showed that 7.5 × 10(3) cells seeded per well produced the adequate CI in 10 h. The area under the curve and the CImin versus concentration values showed a very high correlation index (r(2) = 0.966 and r(2) = 0.92 for the first 50 h after challenge, respectively), proving that CI variations are directly proportional to the quantity of serum added. The addition of complement resulted in lower CImin values. Therefore, both the cytolysis level with and without exogenous complement addition had to be assessed. There was a high correlation between the relative cytotoxicity assessed by WST-1 and the CI obtained by RTCA when exogenous complement was not added (r(2) = 0.827; p < 0.001). The correlation was average when rabbit complement was added (r(2) = 0.523; p = 0.046). In conclusion, culture conditions have an important influence on RTCA cytotoxicity assays.

Xenotransplantation and Risks: The Opinion of Veterinary Students at Spanish Universities.

BACKGROUND: Understanding the perception of the risks associated with xenotransplant, especially among professionals who will contribute to the care of the animals, is important for xenotransplant to become a clinical reality. The objective of this study was to analyze opinions regarding the risks of organ xenotransplant among veterinary university students in Spain. METHODS: The study population was 2683 veterinary students from different courses and universities in Spain. Instrument valuation: Validated self-administered questionnaire completed anonymously (PCID-XENOTx-Ríos). Consent to collaborate in the study was requested. Variables for the study: attitude toward xenotransplant and risks (infectious, immunologic, ethical/moral, philosophical, religious, other unspecified risks). STATISTICS: descriptive analysis, Student t test, χ2 test, and Fisher exact test. RESULTS: Of the total number of respondents, 2646 students answered this question, with a completion rate of 98.6%. They considered immunologic risk 78.4% (n = 2074), infectious risk 48.6% (n = 1286), ethical/moral risk 10.7% (n = 284), philosophical risk 5.2% (n = 137), religious risk 1.5% (n = 40), and other risks 3.9% (n = 104). Significant relationships were observed between immunologic risks (P < .001), ethical/moral risks (P < .001), and other risks (P = .002). CONCLUSIONS: Despite the consideration of different types of risks, the favorable attitude toward xenotransplant among veterinary students at Spanish universities is highly prevalent, and evidence-based information campaigns on the different risks associated with xenotransplant are important.

Attitude towards related living donation among candidates on the liver transplant waiting list.

OBJECTIVE: To analyze attitude of patients on the liver transplant waiting list toward living donation (LD). DESIGN AND PATIENTS: Patients on the transplant waiting list -2003-2005 (n = 164)- were selected. Attitude was evaluated using a validated questionnaire, completed by an independent healthcare professional. RESULTS: The questionnaire completion rate was 97% (n = 159). A total of 87% (n = 138) of patients stated that they would donate an organ while alive if a family member needed one. However, only 39% (n = 61) would be prepared to receive a liver donation from a living relative and 50% would prefer to wait on the list (n = 80). 90% accepted that living liver donation involves a certain amount of risk. This assumption was not associated with a willingness to accept related LD (p = 0.170). A willingness to accept LD was related to patient's knowledge of his or her family's attitude toward donating an organ to the patient (p = 0.027). CONCLUSIONS: Patients had a favorable attitude toward living liv-er donation. When there was a family base that is in favor of LD then this encouraged acceptance, and therefore, it is essential to carry out family screening of patients to detect those cases in which this type of LD can be successfully requested.

German citizens in southeastern Spain: a study of attitude toward organ donation.

BACKGROUND: Spain is frequently a place of residence for a high percentage of the German population. Our aim is to analyze the attitude of the German population that is resident in Spain toward organ donation. METHODS: A sample of German residents in the south east of Spain was obtained randomly between November 2005 and April 2006 (n = 227). Attitude was evaluated using a validated questionnaire. This survey was self-administered and completed anonymously. CONTROL GROUP: a sample of 2000 Spanish citizens. RESULTS: There is a favorable attitude toward donation in 64% of respondents, similar to the control group (64% vs. 63%; p = 0.8545). The most important factors that affect such attitude are: (i) having dependents (odds ratio = 4.569); (ii) having talked about donation within the family (OR = 4.132); (iii) being willing to accept an autopsy if one were necessary (OR = 5.952); (iv) having had previous experience of organ donation and transplantation (OR = 5.814); (v) not being concerned about mutilation of the cadaver (OR = 8.792); and (vi) the attitude of one's partner toward donation, especially when this is negative (OR = 0.002). CONCLUSIONS: The attitude toward organ donation of Germans who usually reside in Spain is the same as that described in the native Spanish population, and is determined by many psychosocial factors.

Factors Related to the Attitude Toward Living Kidney Donation of the Population of Havana.

INTRODUCTION: Living kidney donation (LKD) is one of the most used alternatives in the field of organ transplantation. OBJECTIVE: Analyze the attitude toward LKD among the population of Havana, Cuba. METHODS: Population under study. Population resident in Havana, Cuba. INCLUSION CRITERIA: Sample of population over 15 years stratified by age and sex. INSTRUMENT: Validated questionnaire of attitude toward donation and transplant "PCID-DVR-Ríos," self-administered and anonymously filled out. STATISTICS: χ2, Student t test, and a logistic regression analysis. RESULTS: A total of 920 respondents have been included in the study. A total of 85.5% (n = 787) are in favor of the related LKD. In our study, 26.5% (n = 244) would remain in favor of unrelated LKD. Regarding the related LKD, the following variables remain independent in the multivariate analysis: 1. having studies (odds ratio [OR] = 3.649; P = .018); 2. attitude toward cadaveric organ donation (OR = 8.547; P < .001); 3. religion (OR = 4.385; P = .001); 4. opinion of the couple (OR = 4.672; P = .028); and 5. risk with living donation (OR = 10.989; P = .003). CONCLUSIONS: The population of Havana has a very favorable attitude toward related LKD. Only a quarter of respondents are in favor of unrelated LKD.

Knowledge of the Brain Death Concept Among Older People.

BACKGROUND: The concept of brain death (BD) is not well understood in the general population; this lack of knowledge is one of the main factors that generates an attitude against organ donation. Older people are a population group that has rarely been studied in relation to organ donation and transplantation (ODT), and it is important to investigate the most important aspects of ODT, such as people's concept of BD. OBJECTIVES: To analyze the level of understanding of the concept of BD in people > 65 years of age and the factors that influence their mode of thinking. METHODS: A multicenter study was carried out with a representative sample of people > 65 years of age, stratified by sex and geographic location in the southeast of Spain (n = 420). Knowledge of BD as well as the influence of other variables were analyzed through a validated questionnaire about ODT. SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software was used for statistical analysis. Descriptive analysis included Student t test and the χ2 test. RESULTS: The questionnaire had a completion rate of 84% (n = 351). In 36% (n = 127) of cases, people ˃ 65 years of age understood the concept of BD. In general, knowledge of this concept has not been associated with other variables including social-family interaction about ODT (P > .05). CONCLUSIONS: Older people do not understand the concept of BD. It is, therefore, necessary to carry out informative campaigns on ODT explaining this concept. This would improve organ donation awareness in this particular group of people.

The Influence of Mass Media on Organ Donation and Transplantation in Older People.

BACKGROUND: Worldwide population aging has resulted in changes in the approach to the organ donation and transplantation (ODT) process, forcing us to include older people on transplant waiting lists and to assess older patients as potential donors. However, this is a sector of the population that has not been studied in great detail in terms of the information they receive about ODT. OBJECTIVES: To analyze what kinds of media provide people > 65 years of age with information about ODT and which sources of information affect their attitude about this subject. METHODS: A multicentric study was undertaken using a sample of people > 65 years of age stratified by sex and geographic location in southeastern Spain (n = 420). Questions about ODT and methods of receiving information were analyzed using a questionnaire. Statistical analysis was performed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States). Descriptive analyses were performed with a Student t test and χ2 test. RESULTS: The questionnaire completion rate was 84% (n = 351). People aged > 65 years received information about ODT, mainly positive, from the television (82%), followed by films (35%), the radio (30%), the press (26%), family (26%), and friends (17%). Receiving information through one of the following sources was associated with a more favorable attitude toward organ donation: the family (76% vs 45%; P < .001), friends (77% vs 48%; P = .01), and the press (62% vs 49%; P = .034). CONCLUSIONS: Older people mainly receive information about ODT from the mass media. However, social and family circles have the greatest influence on their attitudes toward organ donation.

Attitude of Older People Toward Living Donation.

BACKGROUND: Living donation is a potential source of organs that could help to reduce the organ transplant deficit. Given that we have a worldwide aging population, it is important to assess the opinion of older people toward this type of donation. OBJECTIVES: To analyze the attitude of people aged > 65 years toward living kidney donation (LKD) and living liver donation (LLD) and to investigate the variables affecting their attitudes. METHODS: A multicentric study was carried out using a representative sample of people > 65 years stratified by sex and geographic location in southeastern Spain (n = 420). The measurement instrument was a validated questionnaire about LKD and LLD. Statistics were analyzed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software. Descriptive analysis was carried out using Student t test, χ2 test, and a multivariate analysis. RESULTS: The questionnaire completion rate was 84% (n = 351) with 88% (n = 310) in favor of LKD, and 89% (n = 311) in favor of LLD. Favorable attitude decreased to 3% when the donation under consideration was unrelated. Attitudes toward LKD and LLD were associated with having received information from the television (P = .016 and P = .045) and from friends (P = .017 and P = .03); accepting an autopsy after death (P = .001 and P = .002); and not being worried about scars (P = .015 and P = .044). In the multivariate analysis, the following variables continued to be significant: having received information from the television (odds ratio [OR], 2) and from friends (OR, 10.3); and the acceptance of an autopsy (OR, 2). CONCLUSIONS: Older people are in favor of both LKD and LLD, assuming it is a related donation. In addition, the information the elderly population receives regarding organ donation and transplantation affects their attitudes.

Psoas Muscle Index Does Not Predict Post-Transplant Outcomes: A Series of 57 Liver Transplant Recipients.

BACKGROUND: Sarcopenia is defined as the loss of muscle mass and function. Our aim is to evaluate the degree of sarcopenia by measuring the patients on the waiting list for liver transplantation and its influence on the different post-liver transplant outcomes in our group. METHODS: The psoas muscle index (PMI, cm2/m2) was calculated (right psoas muscle area [cm2]/the square of the body height [m2]) in 57 patients on the waiting list for liver transplantation in our center, and the post-transplant variables relevant to our study were collected. RESULTS: The 57 recipients had a mean age of 57 years (range, 35-73) and had a mean of 7.4 months (range, 0-39) on the liver transplant waiting list. The mean psoas muscle index was 2.39 (range, 1-4), and the mean body mass index was 28.01kg/m2 (range, 22-36). After multivariate analysis we found a positive correlation between the PMI and the body mass index of the recipients (r = 0.320, P = .017), intensive care unit length of stay, and donor age (r = 0.319, P = .042), and between cold ischemia time and graft survival (r = 0.366, P = .009). We found no correlation in our sample between PMI and post-liver transplant complications either in terms of graft or patient survival. CONCLUSION: PMI is not representative of total muscle mass and sarcopenia and is not effective in adequately predicting the survival of patients on the waiting list for liver transplantation.

Impact of Hepatic Artery Thrombosis on the Success of a Liver Transplant Because of Hepatocellular Carcinoma.

BACKGROUND: Hepatic artery thrombosis is one of the most serious complications after liver transplant. Our objective is to evaluate the impact of arterial thrombosis on the postoperative evolution of a series of patients who received transplants because of hepatocellular carcinoma. METHODS: A retrospective study of 100 consecutive hepatocellular carcinoma liver transplants was performed from January 2011 to November 2017. RESULTS: Of the 100 transplant recipients, we have observed hepatic artery thrombosis in 4 of them, 3 premature and 1 delayed. All of them received retransplants after diagnosis by hepatic artery ultrasonography and arteriography. The descriptive analysis showed a significant relationship between the appearance of hepatic artery thrombosis with variables of postoperative severity, such as arrhythmias, atelectasis, pleural effusion, hemodialysis requirement, acute kidney failure, and respiratory failure. Although patients with hepatic artery thrombosis had a longer mean hospital stay, this was not statistically significant. There was decreased graft survival and overall survival of patients who experienced hepatic artery thrombosis. CONCLUSION: Although the incidence of hepatic artery thrombosis has been relatively low (4%), the early detection of risk factors, such as arterial anatomic anomalies that condition a complex anastomosis, should draw our attention, thus having at our disposal strict ultrasonography and arteriography surveillance protocols as well as prophylactic anticoagulation guidelines for receptors at risk.

Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List.

BACKGROUND: It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES: To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS: Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS: More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS: Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Do Religious Factors Influence the Attitude Toward Organ Donation Among Medical Students? A Spanish Multicenter Study.

INTRODUCTION: Religious factors have conditioned the attitude toward organ donation and transplantation (ODT) since the beginning of transplantation, despite the fact that most religions are in favor of transplantation. OBJECTIVE: To assess the impact of religious beliefs of medical students on their attitude toward ODT. METHOD: Population under study: Medical students in Spanish universities. STUDY SAMPLE: Stratified by geographical area and academic course. Assessment instrument: Attitude ODT questionnaire PCID-DTO-Ríos, anonymous and self-administered. RESULTS: Of all students, 42% (n = 3907) declare themselves atheists or agnostics. The remaining 58% (n = 5368) declare themselves to be religious, the majority being Catholic (55%, n = 5102). Of the rest, 0.2% are Muslims (n = 8), 0.1% Protestants (n = 1), and the remaining 2.7% (n = 257) indicate other religious doctrines but do not want to specify it. Regarding their attitude toward ODT, those who consider themselves atheists or agnostics have a more favorable attitude than those who consider themselves religious (84% versus 76%; P < .001). Among those who follow some kind of religion, Catholics are more in favor of ODT than non-Catholics (77% vs 64%, P < .001). Note that among the religious, only 57% (n = 3050) know which religion is in favor of transplantation, while 22% (n = 1,152) consider that it has not been pronounced on the matter, 13% (n = 723) think the religion is against donation, and the remaining 8% (n = 443) do not know. CONCLUSION: The religion professed by medical students conditions their attitude toward donation, with the atheists and agnostics being more in favor of donation.

Are High Rates of Deceased Donation Conditioning the Attitude Toward Liver Donation Among Medical Students?

The involvement of health professionals from their training period is important for the promotion of living liver donation. There are data that indicate that the awareness of living donation is lower in areas with high rates of deceased donation. OBJECTIVE: To analyze the attitude toward living liver donation among Spanish medical students, according to donation rates of their regions. METHOD: Population under study: Medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: group 1 (n = 1136): students in universities of regions with >50 donors per million population (pmp); group 2 (n = 2018): students in region universities with <40 donors pmp. Assessment instrument: the attitude questionnaire for living liver donation Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Hepático-Ríos (PCID-DVH Ríos). RESULTS: The attitude toward related liver donation is more favorable among the students of regions with <40 donors pmp than among those of >50 donors pmp. Thus, in group 1, a total of 88% (n = 1002) of students are in favor compared with 91% (n = 1831) of group 2 (P=.02). The psychosocial profile of each study group about their attitude toward living related liver donation is analyzed. There is a similar profile between the 2 groups, although there are differences in some variables such as age, a belief that one might need a transplant, family discussion about donation and transplantation, discussion with friends about donation and transplantation, and knowing about a donor. CONCLUSIONS: The awareness of living related donation among Spanish medical students is greater among the regions with lower organ donation rates.

Sensitization Toward Organ Donation Among Medical Students in Spanish Regions With More Than 50 Donors Per Million Population.

The awareness of organ donation among health professionals is important at the time of transplant promotion. In this sense, the training and awareness of the professionals in training is fundamental. OBJECTIVE: To analyze the differences in the attitude toward organ donation and the factors that condition it among medical students of regions with donation rates >50 donors per million population (pmp) with respect to those with rates <40 donor pmp. METHOD: Population under study: medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: Group 1 (n = 1136): students in universities of regions with >50 donors pmp. Group 2 (n = 2018): university students in regions with <40 donors pmp. Assessment instrument: attitude questionnaire for organ donation for transplant PCID-DTO-Ríos. RESULTS: The attitude toward organ donation for transplantation is similar among students from the autonomous communities with >50 donors pmp and with <40 donors pmp. In group 1, 79% (n = 897) of students are in favor compared with 81% (n = 1625) of group 2 (P=.29). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): sex, having discussed transplantation with family and as a couple, considering the possibility of needing a transplant, involvement in prosocial activities, attitude toward the manipulation of corpses, knowledge of the brain death concept, and religion. CONCLUSIONS: The awareness of organ donation in Spanish medical students is quite homogeneous and is not related to the local donation rates of each region.

Primary health care personnel faced with cadaveric organ donation: a multicenter study in south-eastern Spain.

INTRODUCTION: Primary health care (PHC) is the first point of contact between the public and the health system and it is an important channel for the communication and promotion of organ donation and transplantation. The objective of this study was to analyze the attitude of PHC personnel toward donation and to determine the psychosocial variables affecting this attitude. MATERIALS AND METHODS: A random sample was stratified by job category and geographical location among PHC personnel (n = 482) from 32 health centers. Attitude was evaluated using a questionnaire validated in our local area. (It was completed anonymously and was self-administered.) RESULTS: The questionnaire completion rate was 86% (n = 414): 78% (n = 325) are in favor and the remaining 22% (n = 89) are either against or are not sure. The reason given for a negative attitude is fear of apparent death (16%; n = 14). There are many independent factors that affect attitude: (i) job category (OR = 2.4); (ii) knowledge of the concept of brain death (OR = 2.2); (iii) a preference for alternatives to burial (OR = 2.99); (iv) being in favor of cremation (OR = 01.87) and (v) knowledge of the attitude of one's partner toward organ donation (OR = 0.312). CONCLUSION: PHC personnel have a favorable attitude toward donation, especially physicians, although it would be useful to provide more information to PHC personnel. Physicians could be a key element in the direct and indirect promotion of donation and transplantation.