Organ donation and transplantation - public policy and clinical perspectives

The book provides specialist information via chapters on public policy as well as clinical developments in organ transplantation

UNDERSTANDING THE ATTITUDES AND FACTORS INFLUENCING ORGAN DONATION DECISIONS AMONG UNIVERSITY STUDENTS IN PAKISTAN: A QUALITATIVE STUDY

Purpose: The main purpose of this study was to identify factors that were important in posthumous organ donation decisions in a developing country such as Pakistan. Methodology: A qualitative study was conducted with 50 semi-structured interviews among students of one public and one private university in Lahore (Pakistan) to understand their attitudes and factors influencing their decisions on posthumous organ donations. Purposive sampling technique was used in this study. The interview questions focused on the level of knowledge, motivation and overall attitude towards the posthumous organ donation decision of the respondents. Main Findings: There was a lack of general knowledge among university students in Pakistan. Most of the students had a positive attitude for posthumous organ donation yet moral norms are very influential in the decision-making process for organ donation after death. Those who were willing were reluctant because of the influence of family and friends. Religion was also another significant norm factor for prohibiting them to be an organ donor after death. Implications/Applications: The present study provided a way in the advancement of knowledge towards an understanding of the attitude, moral norms along with social and family influence for not only intention to donate but also signing the donor card. The findings of the study are useful for the government, policymakers and the organizations in Pakistan in their efforts to increase awareness and organ donation rates in the country. Novelty/Originality: The present research was exploratory and the intention for this research was to explore the underlying behavioral and normative beliefs which may inhibit or encourage organ donation among university students. Such qualitative studies are relatively uncommon in transplant literature

Patient and allograft survival of Indo Asian and East Asian dialysis patients treated in Canada

Kidney failure is relatively common among Canadians of Asian origin. However, little is known about the health outcomes after initiation of renal replacement therapy in this population. Our study evaluates differences in the likelihood of renal transplantation and graft loss among Asian and white patients. We studied 21 523 adults of East Asian, Indo Asian or white ethnicity who had initiated dialysis in Canada from 1990–2000. Subjects were followed until death, loss to follow-up or end of study (2004). The proportion of the eligible subjects who were East Asian, Indo Asian, or white was 6, 3, and 91%, respectively. Compared to white patients, East Asian and Indo Asian patients were significantly less likely to receive a renal transplant after adjusting for potential confounding factors. This disparity is greater for transplants from living donors as compared to those from deceased donors. The adjusted death censored graft loss in transplant recipients was not significantly different between ethnic groups. The adjusted risk of death following transplantation, however, was significantly lower in Indo Asian than in white patients. Our findings show that in a Canadian population, patients of East Asian or Indo Asian origin had lower rates of renal transplantation than white patients, especially for living donor transplantation. These findings warrant further study, especially given the good graft outcomes in these individuals

Organ transplants: ethical, social, and religious issues in a multicultural society

"Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia." [author's abstracts

Factors influencing the development of transplantation in Africa

Background Access to dialysis and transplantation in Africa is very limited. The challenges vary in different countries across the continent from legislative, to political, to financial. Aim To assess factors influencing the development of organ donation and transplantation in the African context. Methods A structured interview was held with African delegates attending the 25th Southern African Transplantation Society Congress and Global Alliance for Transplantation Workshop in Durban from the 28th July to 2nd of August 2013. Data from workshop working group presentations for each African country were additionally analysed. Results 30 delegates from 10 African countries (Cameroon, Ethiopia, Ghana, Kenya, Malawi, Nigeria, Rwanda, Tunisia, Sudan and Zambia) participated in the working groups. Twenty-eight questionnaires were completed. The burden of disease and challenges were large and varied. With marked disparity between countries where kidney transplantation is paid for entirely out-of-pocket—such as Ghana, Kenya, and Nigeria (kidney transplant rates in 2012 of 0.1, 1.4 and 0.1 per million population respectively)—and countries where costs are covered by the government or by insurance schemes—such as Sudan and Tunisia (kidney transplant rates of 5.3, and11.5 per million population, respectively). For most countries, the cost of immunosuppressive drugs and the ability to perform adequate matching of donors and recipients were the main infrastructure concerns. Five countries (Cameroon, Nigeria, Ghana, Ethiopia, Zambia) did not have legislation governing organ transplantation. Conclusion There is need for major political transform which will to ensure that African populations achieve access to transplantation. This would allow international collaboration and willing local clinicians a framework within which to develop sustainable transplant systems

A Mixed Method-Approach to Exploring Human Organ Trafficking and Its Policy Implications

Human organ trafficking, which involves the exploitation, coercion, illegally purchasing or selling of organs, has become a primary international concern. According to the United Nations, legally available organs for transplants only accommodate roughly 10% of the global industry demand. The shortage in organ supply means a new patient is added to the waiting list every 10 minutes worldwide even as 20 patients die every day in the United States alone waiting for an available organ. Previous researchers have found empirical support for significant relationships between human organ trafficking and its adverse globalized effects. Using primary and secondary data, the main aim of this dissertation is to shed light on the crime of human organ trafficking and its policy implications. The multi-disciplinary approach based on social conflict, rational choice, routine activities, structural-functional, and strain theories are applicable in various contexts when understanding human organ trafficking and human rights. The implications for social change include (a) legal actions to stop the thriving global organ trade, (b) a transparent regulatory oversight system that ensures donor and recipient safety and enforces the prohibitions of unethical medical transplant procedures, (c) and recommendations for governmental agencies to focus on the prevention of organ trafficking, prosecution of organ traffickers, and protection for human organ trafficking victims

Renal transplantation among South Asians in the UK

A thesis submitted for the degree of Doctor of Philosophy of the University of LutonTIns work represents a significant contribution to the body of knowledge in the area of renal transplantation as it brings together the research related to policy analysis, empirical research, and cultural and religious issues related to organ donation and transplantation among South Asians in the UK. The candidate's work in this area is the first in the UK to systematically document and map a national picture of kidney transplant waiting lists and to identify and examine the complex reasons underlying how and why patient ethnicity impacts upon the likelihood of receiving a kidney transplant. The candidate has also developed a new evidence-base exploring the adequacies of the existing procurement arrangements and the implications of introducing any alternative policies within the context of a multi-ethnic and multifaith UK. Finally, the candidate's work has focused on developing an evidence-base of the public perceptions, attitudes, and religious viewpoints towards organ donation and transplantation among a cross-section ofthe South Asian population. The candidate's published works have been the foundation blocks for stimulating and informing the debate on the provision of renal transplant services for minority ethnic groups through the generation of an empirical evidence-base in a subject area which has traditionally relied upon anecdotal evidence. The evidence-base illuminates a very complex issue which has multi-faceted solutions that need to be addressed in different settings

Chapter 30 GENDER INEQUITIES IN ORGAN DONATION AND TRANSPLANTATION

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising forty-two chapters by emerging and established scholars, the volume is divided into six parts: I Foundations of feminist bioethics II Identity and identifications III Science, technology and research IV Health and social care V Reproduction and making families VI Widening the scope of feminist bioethics The volume is essential reading for anyone with an interest in bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers and advanced students

Organ Donation

ABSTRACT Organ donations have a lot of controversy surrounding it. There are many reasons for and against donations. There are many who research different ways to extract organs and tissues, and others who research fake cells and tissues. We hear about religious and spiritual reasons some give for giving organs, transplanting them and arguments as to why it should not be done