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.

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.

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.

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.

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.

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.

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.

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.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List.

BACKGROUND: The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved. OBJECTIVE: To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list. METHOD: Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished. RESULTS: Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire. CONCLUSIONS: Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

Presence of Pig IgG and IgM in Sera Samples From Baboons After an Orthotopic Liver Xenotransplantation.

INTRODUCTION: The immunorejection in xenotransplantation has mostly been studied from the host's immune system activation point of view and there is very little information about the graft-vs-host reaction. OBJECTIVES: To validate an enzyme-linked immunosorbent assay (ELISA) test for porcine IgM and IgG quantitation, the assessment of porcine IgG and IgM in sera samples from baboons after liver orthotopic xenotransplantation or in human plasma after xenotransfusion through pig organs, and to assess the presence of porcine immunoglobulin in a baboon after plasmapheresis to a complete change of plasma after 4 passages through pig liver. MATERIALS AND METHODS: Two commercial ELISA kits for pig IgG and IgM quantitation were evaluated for cross reactivity with samples from baboons, Rhesus monkeys, squirrel monkeys, and humans. Then, samples from 18 baboons after orthotopic liver xenotransplantation were studied for porcine IgG and IgM. To understand the phenomenon, human plasma samples after xenotransfusion 1, 2, 3, or 4 times through liver or kidney were assessed for porcine IgG presence and finally, the porcine IgG were quantified in sera samples obtained during more than 4 years from a baboon after plasmapheresis with baboon plasma after xenotransfusion 4 times through a pig liver. RESULTS: Porcine IgG and IgM were found in samples from xenotransplanted baboon during all survival. The quantity of porcine IgG in plasma after xenotransfusion correlated with the number of passages through the pig liver, and the IgG were completely cleared from the baboon 16 days after plasmapheresis and complete substitution of plasma after 4 xenotransfusions through a pig liver.

Multivariate Analysis of the Factors Affecting Attitude Toward Organ Donation Among the Ecuadorian Population Residing in Spain.

INTRODUCTION: Immigrants from Ecuador represent the largest group of Latin Americans in Spain and are, therefore, a subgroup of interest to understand their attitudes and influences in respect to organ donation and transplantation. OBJECTIVE: To analyze the attitude of nationals of Ecuador residing in Spain regarding deceased organ donation. METHODS: The study population included the Ecuadorian population residing in Spain. A sample of population older than 15 years was obtained randomly and stratified by age and sex (n=461). Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation (PCID-DTO-Ríos). Assistance from immigration support associations in Spain was needed to advice on the location of potential respondents. RESULTS: Attitude toward cadaveric donation was favorable in 59% (n=271) of respondents, 12% (n=57) were against cadaveric donation, and 29% (n=133) were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables were independently associated with a more positive attitude toward organ donation: 1. level of formal education (odds ratio [OR]=6.849 [25.641-1.818]; P = .004); 2. being in favor of donating a family member's organs (OR=8.849 [20.833-3.717]; P < .001); 3. having commented at a family level about transplant (OR=3.717 [6.578-2.109]; P < .001); 4. not being concerned about the possible mutilation of the body after donation (OR=4.608 [8.547-2.487]; P < .001) and 5. knowing the attitude of one's religion toward donation (OR=7.462 [34.482-1.623]; P = .010). CONCLUSIONS: The attitude toward cadaveric organ donation among the Ecuadorian population residing in Spain is less favorable than that of the Spanish population and is determined by many different psychosocial variables.

Knowledge of the Concept of Brain Death: Is This an Obstacle in the Acceptance of Donation and Transplantation of Organs Among the Bolivian Population Residing in Spain?

INTRODUCTION: The Bolivian population is growing in Spain. The knowledge and acceptance of the concept of brain death are fundamental. OBJECTIVE: To analyze the level of understanding of the brain death concept among the population of Bolivians residing in Spain. METHODS: The study population was Bolivians living in Spain. The inclusion criteria were being older than 15 years, being born in Bolivia, and residing in Spain; participants were selected randomly from this group and stratified by age and sex. Knowledge of the concept of brain death was assessed using a validated questionnaire on psychosocial aspects toward organ donation. A group of people to be surveyed was randomly selected. Assistance from immigration support associations in Spain was needed to advise on the location of potential respondents. The survey was self-administered and completed anonymously. RESULTS: Of the 206 respondents, 27% understood brain death (BD) and believed that this was the death of an individual. Of the rest, 18% did not understand it and the remaining 55% believed it did not mean the death of a patient. Those who understood the concept of BD were more in favor of deceased donation than those who did not (52% vs 47%; P = .886). None of the sociopersonal variables analyzed is associated with knowledge of the concept of BD. A high percentage of respondents indicated fear of apparent death during organ donation. CONCLUSIONS: The majority of the Bolivian population residing in Spain does not understand the concept of BD. Contrary to most psychosocial studies, it is not associated with attitudes toward organ donation or other sociopersonal factors.

Attitude of the Citizens of Havana, Cuba, Toward Organ Donation: A Multivariate Analysis of the Psychosocial Factors Affecting Attitude.

INTRODUCTION: Because personal decisions affect the availability of organs for transplants, awareness about organ donations among the general population is fundamental. OBJECTIVE: To analyze attitudes toward organ donation among the citizens of Havana, Cuba. METHODS: The sample population was the residents of the city of Havana, Cuba. The inclusion criterion was being older than 15 years; the sample was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects of organ donation and transplant (PCID-DTO-Ríos). A random selection of people to be surveyed was carried out. RESULTS: A sample of 920 respondents was included in the study. Attitude toward cadaveric donation was favorable in 68% of respondents, while 14% were against and 18% were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables continue to feature as independent variables (P < .05): 1. level of studies; 2. knowledge of the concept of brain death; 3. attitude toward organ donation of a relative; 4. having discussed the issue of organ donation and transplantation with one's family; 5. the attitude of the couple toward organ donation and transplantation; 6. the religion of the respondent; 7. knowing the opinion of one's religion toward organ transplantation; 8. fear of manipulation of the body after death; and 9. acceptance of burial as a treatment of the body after the death. CONCLUSIONS: The attitude toward cadaveric organ donation among the residents of Havana is favorable and similar to that of the citizens of Spain. Improving the organ procurement system will increase donation rates given the population's awareness of the issue.

Psychosocial Factors Affecting Attitude Toward Organ Donation in Santiago, Cuba.

INTRODUCTION: Awareness about organ donation among the general population is fundamental to organ donation programs. It is important to determine the factors that influence attitudes toward organ donation within the general population in order to carry out cost-effective campaigns. OBJECTIVE: To analyze the attitude toward organ donation among Santiago, Cuba, citizens. METHODS: The study population encompassed residents in Santiago, Cuba. A sample population of residents older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation and transplant (PCID-DTO Ríos). Available census data were used. The survey was self-administered and completed anonymously. RESULTS: Of the 455 respondents, 70% of respondents are in favour of cadaveric donation, 16% are against, and 14% were undecided. Several variables were associated with having a more favorable attitude. And in the multivariate analysis, the following variables continue to feature as independent variables: 1. knowledge of the concept of brain death [OR = 2.386 (4.761-1.194); P = .014]; 2. being in favor of donating a family member's organs [OR = 3.067 (5.952-1.584); P = .001]; 3. a partner's favorable attitude [OR = 5.795 (1.477-22.731); P = .012]; 4. being an atheist/agnostic as the religious beliefs [OR = 1.845 (3.289-1.038); P = .037]; 5. not being concerned about the possible mutilation of the body after donation [OR = 7.437 (2.918-18.955); P < .001]; 6. not accepting other treatment options after death, such as inhumation [OR = 3.048 (5.714-1.626); P = .001]. CONCLUSIONS: The attitude toward cadaveric organ donation among the Santiago, Cuba population is favorable and it is associated with several psychosocial factors.

Multicenter Stratified Study From Spain About Acceptance of Living Liver Donation Among Veterinarian Students.

Veterinarians often hold decision-making positions in the public health care system, and therefore can influence public opinion about organ donation. The objective is to analyze the attitude of Spanish veterinarian students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. METHODS: A sociological, interdisciplinary, multicenter, and observational study was carried out in the veterinarian students enrolled in Spain (n = 9000) (university academic year 2010-2011). A sample of 2854 students was stratified by geographic area and academic year. A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. The questionnaire was applied to each academic year at compulsory sessions at randomly selected veterinary schools. Statistical analysis included t test, χ2 test, and logistic regression analysis. RESULTS: Completion rate was 94% (n = 2683); 89% (n = 2345) were in favor of related LLD, and 40% (n = 1053) supported unrelated LLD. The following variables were associated with a more favorable attitude: (1) age (P < .001), (2) sex (P < .001), (3) academic year (P < .001), (4) believing in the possibility of needing a transplant oneself in the future (P < .001), (5) attitude toward deceased donation (P < .001), (6) attitude toward living kidney donation (P < .001), (7) acceptance of a donated liver segment from a family member if one were needed (P < .001), (8) having discussed the subject with one's family (P = .009) and friends (P < .001), (9) a partner's opinion about the subject (P = .002), and (10) fear of the possible mutilation of the body after donation (P < .001). CONCLUSION: Spanish veterinary students have a favorable attitude toward LLD.