Organ xenotransplantation acceptance in veterinary students: A multicentric opinion study in Spain.

BACKGROUND: The shortage of available transplant organs has made it necessary to search for alternatives, one of which is xenotransplantation. However, the use of animal organs could face rejection from society and the personnel involved in its implementation. OBJECTIVES: (a) to analyze the attitudes of Veterinary Degree students in six Spanish Universities towards xenotransplantation; and (b) to determine the factors that affect its acceptance. METHODS: Of the 2815 students surveyed in the degree program, 2683 valid surveys were obtained. Attitudes towards organ xenotransplantation were evaluated using a validated questionnaire of organ donation. RESULTS: If xenotransplantation was confirmed as a clinical reality, 93% (n = 2493) of those surveyed would accept a xenotransplanted organ, whilst 7% would not. If the results of xenotransplantation were worse than those obtained with human donors and it entailed more risk, 12% (n = 318) would be in favor. 56% (n = 1497) of the students would accept a xenotransplantation provisionally pending the arrival of a human organ. Attitudes towards xenotransplantation were affected by the academic year in which a student was studying, with more favorable attitudes among students in the last year (88% in first year vs. 95% in fifth year; p < .001). More favorable attitudes are also observed depending on the attitude they have towards organ transplantation, with those students being more in favor of donating their organs when they die (94% vs. 88%; p < .001). CONCLUSION: Veterinary students would have a very favorable attitude toward xenotransplantation if these animal organs functioned as well as human organs. Therefore, these students could play an important role in the future promotion of this technique.

Do religious beliefs influence the acceptance of xenotransplantation? Veterinary students.

BACKGROUND: Xenotransplantation could be a source of organs for transplantation given the global organ shortage. It is important to know the opinion and variables that influence the acceptance of xenotransplantation of the professionals who will work in the genetic manipulation, production, and care of animals to be used for this purpose. OBJECTIVE: Analyze the influence of religious beliefs on the attitude toward xenotransplantation in veterinary students. METHODS: The study population included 2683 veterinary students from different courses and Spanish Universities. Instrument evaluation included a validated self-administered and anonymously completed questionnaire (PCID-XENOTx-Ríos). The survey was self-administered and completed anonymously. Consent to collaborate in the study was requested. Variables for the study included attitude toward xenotransplantation and toward religion, considering the following options: practicing Catholic, nonpracticing Catholic, non-Catholic, and atheist/agnostic. Statistics were performed using descriptive analysis, Student t test, -X2, and Fisher's exact test. RESULTS: Of the total number of participants, 7 did not answer this question. Those in favor of xenotransplantation were 92.9% (n = 247) of practicing Catholics, 92.8% (n = 812) of nonpracticing Catholics, and 87.3% (n = 69) of those professing another non-Catholic religion compared with 93.5% (n = 1361) of those considering themselves agnostic/atheist (P = .037). CONCLUSIONS: Religion is an influential factor in attitudes toward organ xenotransplantation. Those who practice Catholicism and those who consider themselves agnostic/atheist are more accepting of organ procurement for transplantation than those who practice other religious doctrines.

Predisposition Toward Living Liver Donation Is Low Among Relatives of Patients on the Waiting List for Transplantation in Spain.

INTRODUCTION: The attitude toward living liver donation (LLD) among the Spanish population is mostly positive; however, the reality is that liver transplants from live donations are currently minimal. Given this situation, studies that analyze these discrepancies should be carried out. OBJECTIVE: Analyze the attitude toward LLD among family members of patients on the waiting list for liver transplantation. METHOD: Population under study. First-degree relatives of the patients included in the waiting list for liver transplantation. INCLUSION CRITERIA: 1. Have the patient's authorization for family members to participate; 2. Accept, the relative, to participate in this investigation; and 3. Be over 18 years old. Opinion survey. The attitude toward LLD is assessed through a questionnaire on psychosocial aspects. RESULTS: Patients who accepted family members' participation in the study were 21 of 112, of which 9 placed restrictions on family access, and 12 authorized family members without restrictions. The participants were 1. children: 52.2% (n = 24); 2. brothers: 30.5% (n = 14); and 3. partners: 17.3% (n = 14). Finally, the authorized relatives and participants in the study were 45. Of these, only 44% (n = 20) would accept to be donors. CONCLUSIONS: The access to the LLD of the relatives starts from the restriction and initial rejection of the patients themselves on the waiting list. The promotion of LDD is to initially sensitize patients.

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.

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.

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.

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.

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.

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.

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.