Attitudes of Future Nurses and Midwives On Organ Donation and Transplantation and Affecting Factors: A Cross-Sectional Study.

OBJECTIVES: The objective of this study was to assess the attitudes of undergraduate nursing and midwifery students toward organ donation and identify the factors that influence these attitudes. MATERIALS AND METHODS: The study was conducted at Burdur Mehmet Akif Ersoy University, Bucak School of Health, in Turkey. A total of 700 students participated in the study, representing 88.49% of the population. Online forms were used for data collection, and the Organ Donation Attitude Scale was used as a data collection tool. RESULTS: Our results showed that 47.9% of the students had not expressed a desire to donate their organs, and only 0.1% reported having donated organs. Additionally, 41.4% of the participants did not share their thoughts on organ donation with their families. Our study also found that 87.4% of the participants had not participated in any training program on organ donation. Logistic regression analysis revealed that factors such as students' sex, progress toward completion of curriculum (ie, class year), presence of a family member with organ transplant experience, organ donation status, and knowledge of organ donation influenced the participants' attitudes toward organ donation. CONCLUSIONS: This study highlights the need for health care professionals, including nursing students, to be educated and prepared to promote and support organ donation. By understanding the factors that influence attitudes, interventions and educational programs can be developed to improve organ donation rates and address misconceptions or concerns among nursing students.

The experiences of patients, caregivers and donors on transplant journeys in Canada: A convergent parallel mixed methods study.

INTRODUCTION: The organ donation and transplantation (ODT) system in Canada is complex and can be challenging for individuals to navigate. We thus aimed to illuminate the experiences of individuals on transplant journeys using a patient-oriented convergent parallel mixed-methods approach. METHODS: We captured data on adult patients, living donors, and caregivers on transplant journeys across Canada through an online survey (n = 935) and focus groups (n = 21). The survey was comprised of 48 questions about the individuals' experiences with the living donation and transplantation system, which were analyzed descriptively. Qualitative data were analyzed using an inductive conventional content analysis approach. RESULTS: Most participants were female (70.1%), English speaking (92.6%) and White (87.8%). Participants' experiences were represented across six key themes: holistic person-centred care, accountable care, collective impact, navigating uncertainty, connection and advocacy. Quantitative and qualitative data were integrated to identify five opportunities to improve the organ donation and transplantation system in Canada: enhancing mental health support, establishing formal peer support programmes, improving continuity of care, improving knowledge acquisition, and expanding resources and support. CONCLUSION: It is imperative that the ODT system commits to asking, listening, and learning from individuals on transplant journeys and to provide them opportunities to help improve it.

Taking a "Care Pathway/Whole Systems" Approach to Equality Diversity Inclusion (EDI) in Organ Donation and Transplantation in Relation to the Needs of "Ethnic/Racial/Migrant" Minority Communities: A Statement and a Call for Action.

International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.

Do the Compassion and Spirituality Levels of Turkish Nursing Students Influence their Attitudes Toward Organ Donation?

This study was a descriptive-correlational design which evaluated the relationship between compassion and spirituality levels and attitudes toward organ donation among Turkish nursing students. A sample of 296 participants studying in the nursing department of a foundation university in the spring semester of the 2021-2022 academic year was formed. A descriptive information form, Spirituality Scale, Compassion Scale, and Organ Donation Attitude Scale were used for data collection. Pearson correlation and multivariate regression analysis were used to evaluate scale scores. The compassion levels of students were high, their attitudes toward organ donation were positive and strong, and their level of spirituality ([Formula: see text]= 18.71 ± 6.10) was slightly above average. Higher levels of spirituality and compassion were positively correlated with positive attitudes toward organ donation (p < 0.05). The compassion and spirituality of nurses should be high for raising public awareness of organ donation.

The Development and Implementation of an Autopsy/ Tissue Donation for Breast Cancer Research.

There is growing interest in tissue procurement for cancer research through autopsy. Establishing an autopsy/tissue donation programme for breast cancer research within an academic medical centre in the United States requires consideration, planning, multi-departmental collaboration and labour-intensive maintenance. It is the purpose of this paper to outline the necessary considerations in implementing and maintaining a tissue donation and autopsy programme within a breast cancer centre at a comprehensive cancer centre. Considerations of programme planning include: patient engagement, the recruitment of patients and families into the programme, the role and scope of work of the clinical coordinator, regulatory issues and the coordination with both pathology and the research team at time of death and autopsy/tissue donation. All aspects of the tissue donation/rapid autopsy programme development and implementation are discussed and illustrated through case study. An Autopsy/ Tissue Donation for breast cancer research can be successfully developed and implemented.

Pronounced Dead Twice: What Should an Attending Physician Do in Between?

BACKGROUND Organ donation after cardiac death (DCD) is a well-accepted practice in the medical, philosophical, and legal fields. It is important to determine the amount of time required for the loss of circulation to lead to irreversible brain loss, and ultimately brain death. CASE REPORT We report a rare case of organ donation after cardiac death. During organ procurement, it was noted that the patient's aortic and renal arteries were pumping and pulsing, and her cardiopulmonary activities were back to unexpected levels. The organ procurement surgery was stopped. At the time, the patient was given Fentanyl and Lorazepam. Subsequently, she was pronounced dead again 18 minutes after she was initially pronounced dead. After a complete autopsy, the cause of death was determined to be acute Fentanyl toxicity due to a Fentanyl injection in the hospital. The manner of death was determined to be homicide. CONCLUSIONS What should an attending physician do in the rare case that the organ procurement team notices the patient is still alive? It is our opinion that: first, the organ procurement team should leave the room immediately and withdraw from the case, and second, the attending physician should let nature run its course and refrain from excessive medical intervention.

How context affects people's willingness to register for the deceased organ donation programme.

BACKGROUND: The deceased organ donation programme is new in the United Arab Emirates (UAE), and to improve acceptability, a broad understanding of public perspectives is thought to be helpful. Therefore, this study aims to explore the extent to which context plays a role in the willingness to register for the deceased organ donation programme in Dubai, UAE. METHODS: This study used a qualitative methodology and was gauged by the tenets of a social ecological model and lay knowledge. Audio-recorded semi-structured interviews were conducted with 17 participants. The data were subsequently analysed thematically. RESULTS: Four themes emerged from the dataset: fear and body integrity, family, relational ties and the identification of the recipient, religious conviction, and knowledge and personal experiences. The participants feared the whole process, were not aware of the religious outlook, and their knowledge regarding the programme was scarce. In addition, family-related factors, such as parental authority and hierarchy in the family, were also major influencers. CONCLUSION: Using the social ecological model and lay knowledge helped to unravel the contextual factors that affected the willingness of participants to register for the deceased organ donation programme in Dubai, UAE, thereby enabling the development of a holistic understanding of deceased organ donation. The responses mainly stemmed from participants' social contexts; hence, awareness campaigns should be tailored to inform people about the technical aspects and address their contextual concerns.

A Holistic Assessment of Organ Transplantation Activities, Scientific Productivity on Brain Death in Islamic Countries, and Comparison of the Outcomes with the United Nations Development Statistics.

About one-fourth of the world population belongs to the religion of Islam, and a significant number of people in the Muslim society, including health professionals, are dedicated themselves to the holy book Qur'an but unclear about the religious teachings on organ donation and transplantation. These people are dependent on religious rulings declared by ecclesiastical authorities (scholars and imams). In this study, we aimed to question the attitude of Islamic nations on organ donation and transplantation. Secondly, we endeavored to investigate how the Islamic perspective on these issues influences scientific productivity about the subject of brain death, which is undeviatingly related to organ transplantation. The term "brain death" was searched in Thomson Reuters, Web of Science search engine, only including Muslim countries. All of the data obtained were subjected to bibliometric analysis. We also compared the transplantation statistics of Global Observatory on Donation and Transplantation Organization with the development statistics of the United Nations (UN). The two leading Muslim countries in terms of scientific productivity about brain death are Turkey and Iran. Transplantation proceedings is the leading scientific journal on this subject. These two countries have outperformed other Islamic countries in terms of organ donation and transplantation statistics. We also revealed that the human development index and education index of the UN have a positive correlation with the number of deceased transplantation, which is directly related to the number of brain-death-diagnosed cases (r 0.696, p < 0.05 and r 0.771, p < 0.05, respectively). Additionally, we found a positive correlation between expenditure on research and development data of the UN with the number of total transplantations performed and the number of scientific articles on brain death (r 0.889, p 0.01 and r 0.634, p < 0.05, respectively). There is not a consensus about brain death and organ transplantation in Islamic nations, and the majority of these countries have various hindrances about organ donation and transplantation. The legal authorities, health professionals, religious rulers, and media should spend every effort to educate the people on organ donation and transplantation. And, policymakers of Islamic nations should allocate extra funds for education and scientific activities to break down negative views on organ donation and transplantation.

Human organ donation and spirituality: a multicentre observational study aimed at healthcare professionals who work in the Italian context.

Aim: This study aimed to assess if spirituality could be a predictor of organ donation, using a descriptive/knowledge survey aimed at healthcare professionals working in Italy. Methods: This multicentre, descriptive observational study was conducted in three Italian regions (Lombardy, Piedmont and Apulia). Two scales were used for the data collection: the Organ Donation Attitude Scale (ODAS) to explore the healthcare staff's attitudes towards organ donation and the Spiritual Health Life-Orientation Measure (SHALOM) to explore their perception of the concept of spirituality. Results: The sample included 688 healthcare professionals (460 females, 66.9%). The analysis of their attitudes, assessed as their predisposition to organ donation, evidenced the women's higher degree of agreement regarding the safety and effectiveness of the practice (40.7% versus 31.1%, p = 0.001). The sample showed a high positive attitude towards organ donation (M = 4.25, SD = 0.50), whereas the level of spirituality was slightly lower than the midpoint of the Likert scale (M = 2.76, SD = 1.31). Spirituality positively predicted the positive attitude towards organ donation among Lombard professionals with shorter (-1 SD) careers (b = 0.078, p = 0.044) and among both Piedmontese (b = 0.250, p < 0.001) and Apulian (b = 0.458, p < 0.001) professionals with longer (+1 SD) careers. Discussion: Regarding organ donation, the surveyed healthcare professionals showed higher scores in the positive attitude section and lower scores in the negative attitude section, regardless of the geographical context of reference.

Modulation of Interleukin-1 and -18 Mediated Injury in Donation after Circulatory Death Mouse Hearts.

BACKGROUND: Donation after circulatory death donors (DCD) can expand the donor pool for heart transplantation, which primarily depends on brain death donors. Ischemia and reperfusion injury are inherent to the DCD process. We hypothesize that pharmacologic inhibition of interleukin-1 (IL-1) and/or IL-18 is protective to DCD hearts. MATERIALS AND METHODS: Following clinical protocol, in-situ ischemia time in control beating-heart donor (CBD) and DCD groups was less than 5 and 40 min, respectively. Wild type (WT) C57Bl6/j, IL-1 receptor type I knockout (IL-1RI-KO), and IL-18 KO mice were used. Hearts were reanimated for 90 min on a Langendorff system with Krebs-Henseleit buffer at 37°C, to assess physiologic parameters. Recombinant IL-1 receptor antagonist (IL-1Ra) and/or IL-18 binding protein (IL-18BP) were added to the Krebs-Henseleit buffer to inhibit IL-1 and/or the IL-18 signaling, respectively. RESULTS: Developed pressure and ± dP/dt were significantly impaired in the DCD-WT group compared to CBD-WT (P ≤ 0.05). Troponin release was higher in DCD-WT groups. Functional parameters were preserved, and troponin release was significantly less in the DCD knockout groups. Heart function was improved in DCD groups treated with IL-1Ra or IL-18BP compared to the DCD-WT group. CONCLUSIONS: Heart function was significantly impaired in the DCD-WT group compared to CBD-WT. Genetic deletion or pharmacologic blockade of IL-1 or IL-18 was protective to DCD hearts.

[Organ Donation from the Perspective of Certified Anesthesiology Nurses]. / Organspende aus Sicht der diplomierten Anästhesiepflege.

Organ Donation from the Perspective of Certified Anesthesiology Nurses Abstract. Abstract: The certified experts in anesthesia nursing are responsible for a holistic process of anesthesia care. This includes demanding, high-quality and safety-oriented service in the field of anesthesia and pain medicine for patients of all age groups and health conditions. Depending on their institution and working environment, these experts will also deliver patient care in the case of organ donation and/or transplantation. In this highly specialized field, certified anesthesiology nurses take on many coordi-native, planning, preparatory and technical tasks in addition to direct patient care. Long-term success of organ donation and transplantation requires an extraordinarily close and careful cooperation between many different disciplines and professions. Only in this way will patients benefit from optimal results, i.e. gain many additional years with high quality of life.

The haunted heart and the Holy Ghost: on retrieval, donation and death.

This enquiry examines problems which haunt the 'heart' and its donation. It begins by examining the heart's enduring significance for culturally mediated self-understanding, its vulnerability to misunderstanding and abuse and its relevance to challenging the determination of death by neurological criteria. Despite turns to brain-centred self-conceptions, the heart remains haunted by the hybrid experiences of identity accompanying organ transplant, the relational significance attached to dead hearts witnessed in the Alder Hey scandal and claims that heart transplants commonly constitute the legitimate killing of a person. To explore these phenomena, traditions are retrieved in which the heart-as-organ was construed in terms of a person's core identity. Influential Abrahamic beliefs about 'the heart' are considered in order to explore explanations for why the heart remains culturally pre-eminent, to make intelligible our haunted hearts and to examine possible violations of solidarity in organ donation practice. Jewish and Christian Scriptures are exegeted to illumine the sources of our haunting and address the desire for holistic bodily life. In these sources, the heart is the seat of affections, intelligence and agency but requires healing, conceived via the surgical metaphors of heart transplant and circumcision, if people are to join the insightful, solidary path of pilgrimage. Absent healing, the heart experiences a judgement of the whole person-organ-and-core-at the moment of death. Through such exegesis, the doctrine of the Holy Ghost emerges as a way to make intelligible, though not dispel, the heart's haunting. The doctrine's practical significance concerns the possibility of social unity among hearts, 'intercordiality', which construes people within a covenantal life of pilgrimage which encourages heart donation in certain circumstances, makes intelligible the Alder Hey parents' experience of social misunderstanding and rejects ascribing any legitimacy in medical culture to the consensual killing of patients for the sake of retrieving their organs.

Informed Clustering of Donation Service Areas for Improved Benchmarking.

The donation community continuously strives to collaborate and share effective practices to further the mission of saving and healing lives. Donation service areas in which the Organ Procurement Organizations (OPOs) work are multifaceted in their demographics, inciting the Organ Procurement and Transplantation Network to consider a more holistic and objective measure of similarity rather than the size of population alone or locational proximity alone. This would allow OPOs, as a part of their quality improvement efforts, to learn from and mentor other organizations that are dealing with similar challenges. By incorporating multiple informative characteristics together, we can distinguish those likenesses only revealed by taking into account multiple factors simultaneously. We used statistical approaches that take many characteristics of interest describing a donation service area and purposely excluded performance measures that an OPO may be able to influence by their own practices. Unsupervised learning methods combined the original characteristics into a smaller number of new variables, eliminating correlation and overlap in information from the original characteristics, and clustered donation service areas based on the general characteristics and population of the area. This analysis is a first step in providing a different perspective for OPOs to learn from other organizations that may face similar challenges, as well as to share best practices and open new lines of communication.

Attitude of Students in Shanghai University of Traditional Chinese Medicine Toward Donation After Cardiac Death.

BACKGROUND: This study aimed to investigate the attitude of students at Shanghai University of Traditional Chinese Medicine toward organ transplantation and donation after cardiac death (DCD). MATERIAL AND METHODS: A questionnaire including 16 single-choice questions about organ transplantation and donation was designed, and a survey was conducted using this questionnaire on 300 randomly selected respondents at Shanghai University of Traditional Chinese Medicine, Shanghai, China. RESULTS: The ratio of male to female was 1:2.4. Of the participants, 98.1% had heard of organ transplantation, and 68.2% had received the information through network news. Only 10.6% expressed a positive attitude toward organ transplantation in China. Further, 39.8% of the participants were willing to donate their organs after death, while 51.9% of the participants hesitated because of perceived opacity in how donated organs were used. Even among those who did not share this concern, only 46.2% considered it. However, 80.7% were in favor of organ donation between relatives. Separately, 67.4% and 60.2% of the participants were interested in participating in activities and publicity related to organ donation, respectively. CONCLUSIONS: A majority of the participants had an understanding of organ transplantation and had obtained this information through media. Most showed a positive attitude toward donation between relatives, but only some of them indicated willingness to donate their organs. Generally, acceptance and awareness of organ transplantation need to be improved. Media outreach and education might have a profound influence.

Comparison of medical and allied health students' attitudes on organ donation: Case study from a private university in Karachi - Short Report.

Organ transplantation is often the only hope for patients with end-stage organ failure. Organ transplant surgeries are increasingly becoming available in Pakistan. From May-July 2017, using convenience sampling and statistical programme R 3.4.1, we assessed and compared the organ donation attitudes among medical and allied health undergraduate students of the Hamdard University in Karachi. Compared to non-medical students, medical students were more likely to be concerned that family members of brain-dead patients would be upset if approached for organ donation, and felt that appropriate time for bringing up organ donation would be after the declaration of brain death has taken place. Medical students also considered prolonging life by using human organ transplants more appropriate, and considered organ donation desirable when a patient has been declared brain dead. As demand of human organs for transplantation far exceeds the supply, there is need to better understand the dynamics underpinning positive attitudes towards organ donation, and to improve educational activities by encouraging debate and acceptance of organ donation for saving lives.

How Did the War Affect Organ Transplantation in Syria?

Since 2011, the Syrian conflict has destroyed much of the country's infrastructure. The deteriorating humanitarian situation has involved health workers and facilities. In 2010, before the war, 385 kidney transplants were performed in Syria. This number declined to 154 in 2013 (60% less) before increasing to 251 transplants in 2018, which is still 35% less than the number of transplants performed before the war. In addition, the number of operational kidney transplant centers has decreased from 8 in 2010, distributed over 3 cities, to only 4 in 2013, all located in Damascus, which increased to 6 centers in 2019. Interestingly, with regard to type of living donor, the percentage of unrelated kidney donors has decreased by 20% for unclear reasons. Another alarming statistic is that more than 50% of kidney transplant physicians and surgeons are no longer practicing transplant medicine in their centers, either because they have left the country or because their centers had become nonoperational. Since the war, free and timely provision of immunosuppressive drugs for all patients in all provinces has been a leading challenge for health authorities and transplant patients. This difficulty has led to adverse medical consequences for patients. A project to initiate liver transplant came to a halt because of complex reasons but mainly because foreign trainers could not visit Syria. Although the autologous bone marrow transplant program had slowed until recently, it has become more active, involving both autologous and allogeneic transplants. The deceased-donor program is still not available in Syria; the war has just reinforced the many reasons that prevented the start of this program before the conflict. The commitment of transplant teams despite these large challenges continues to be extraordinary. The Syrian conflict has affected all aspects of organ transplant, paralyzing new projects and negatively affecting existing programs.