Donación y trasplante de órganos y tejidos: ¿altruismo o negocio?

Podeu consultar el llibre complet a: http://hdl.handle.net/2445/116007En la actualidad, el trasplante de órganos es considerado internacionalmente la terapia de elección en patologías orgánicas en estado avanzado que provocan el fallo de la función del órgano de manera permanente. El trasplante, tanto de órganos y de tejidos como de células, tiene la peculiaridad, a diferencia de las otras áreas médicas, de no depender únicamente de los avances técnicos y farmacológicos, sino que esta terapia depende principalmente de la sociedad. Los donantes de órganos, tejidos y células son ciudadanos que altruistamente ceden parte de su cuerpo para que pueda ser trasplantado a otros ciudadanos (1, 2). Este hecho hace que exista una gran variedad de factores que influyan en el proceso de la donación, desde la organización del sistema de salud hasta la educación de los profesionales pasando por la confesión religiosa de la sociedad y el marco legal de esta actividad..

'Train the Trainers' Program to Improve Knowledge, Attitudes and Perceptions About Organ Donation in the European Union and Neighbouring Countries: Pre- and Post- Data Analysis of the EUDONORGAN Project

EUDONORGAN, a European Union-funded project to improve organ and tissue donation, included a blended-based 'Train the Trainers' program, which was implemented with the support of an international consortium from Croatia, Italy, Slovenia, and Spain. The web-based training included seven modules for which medical aspects, educational tips, and practical activities were scored using a 5-point Likert scale. The overall mean scores of satisfaction were higher than 4 for each module, without significant differences between HCPs and OKPs. In the face-to-face training survey similar scores above 4 were obtained for most items. Knowledge acquisition improved significantly in both HCPs and OKPs, as well as in transplant/donor coordinators, medical doctors, registered nurses, anesthesiologists/intensivists, and intensive care nurses. Improvements in attitudes and perceptions regarding organ donation were also observed, particularly among HCPs. In the accomplishment of the learning process, a successful pass mark of 95% was obtained. The 'Train the Trainers' program was associated with an improvement in learning and attitudes of healthcare and non-healthcare professionals for the benefit of organ and tissue donation

European Living Donation and Public Health (EULID Project)

Donation from alive people has been growing strongly in the recent years, thanks to the advance in the field of organ transplantation and its success as a treatment to procure quality-adjusted life years for many patients with end–stage diseases. The choice of transplantation from a living donor (LD) offers some advantages compared to that for a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety, and there are several controversial ethical aspects to be taken into account. There is no specific pronouncement of the European Union in relation to standards to quality and safety for the living donor process, and there is a great heterogeneity among European Countries legislation, ethical concern, and protection systems and donor´s data registries on the topic. The EULID project aims to establish European common standard framework regarding living donor issues to guarantee their health and safety thorough common practices and regulation

Psychosocial risk factors for impaired health‑related quality of life in living kidney donors: results from the ELIPSY prospective study

Living kidney donors' follow-up is usually focused on the assessment of the surgical and medical outcomes. Whilst the psychosocial follow-up is advocated in literature. It is still not entirely clear which exact psychosocial factors are related to a poor psychosocial outcome of donors. The aim of our study is to prospectively assess the donors' psychosocial risks factors to impaired health-related quality of life at 1-year post-donation and link their psychosocial profile before donation with their respective outcomes. The influence of the recipient's medical outcomes on their donor's psychosocial outcome was also examined. Sixty donors completed a battery of standardized psychometric instruments (quality of life, mental health, coping strategies, personality, socio-economic status), and ad hoc items regarding the donation process (e.g., motivations for donation, decision-making, risk assessment, and donor-recipient relationship). Donors' 1-year psychosocial follow-up was favorable and comparable with the general population. So far, cluster-analysis identified a subgroup of donors (28%) with a post-donation reduction of their health-related quality of life. This subgroup expressed comparatively to the rest, the need for more pre-donation information regarding surgery risks, and elevated fear of losing the recipient and commitment to stop their suffering

Leadership, management, quality, and innovation in organ donation: 2019 Kunming recommendations for One Belt & One Road countries

The findings and recommendations of the 2019 consensus conference in organ donation, held in Kunming, China, are here reported. The main objective of the conference was to gather relevant information from experts involved in the field. The data and opinions provided allowed to propose a series of recommendations for 'One Belt & One Road Countries' on how to achieve self-sufficiency in organ donation. Leadership in organ donation should be results-oriented and goal-driven based on the principles of excellence, empowerment, and engagement, providing the means, resources, and strategies necessary to reach the goal in earnest. Management includes good governance and transparency of a national registry of patients in the waiting list, donors, transplants, transplant teams, quality, and safety programs with continuous educational training of health care professionals. Mandatory monitoring, auditing and evaluation of quality must be incorporated into donation practices as relevant points in innovation, as well as the adoption of already established and novel processes and technologies. Achievement of self-sufficiency in organ donation is a crucial step to fight against transplant tourism and to prevent organ trafficking. Based on recommendations arising from the conference, each country could review and develop individualized action plans adjusted to its own circumstances and reality

Design and implementation of the European-Mediterranean Postgraduate Programme on Organ Donation and Transplantation (EMPODaT) for Middle East/North Africa countries

This prospective study reports the design and results obtained after the EMPODaT project implementation. This project was funded by the Tempus programme of the European Commission with the objective to implement a common postgraduate programme on organ donation and transplantation (ODT) in six selected universities from Middle East/North Africa (MENA) countries (Egypt, Lebanon and Morocco). The consortium, coordinated by the University of Barcelona, included universities from Spain, Germany, Sweden and France. The first phase of the project was to perform an analysis of the current situation in the beneficiary countries, including existing training programmes on ODT, Internet connection, digital facilities and competences, training needs, and ODT activity and accreditation requirements. A total of 90 healthcare postgraduate students participated in the 1-year training programme (30 ECTS academic credits). The methodology was based on e-learning modules and face-to-face courses in English and French. Training activities were evaluated through pre- and post-tests, self-assessment activities and evaluation charts. Quality was assessed through questionnaires and semi-structured interviews. The project results on a reproducible and innovative international postgraduate programme, improvement of knowledge, satisfaction of the participants and confirms the need on professionalizing the activity as the cornerstone to ensure organ transplantation self-sufficiency in MENA countries

De la solidaridad al mercado: el cuerpo humano y el comercio biotecnológico

Coordinació: María CasadoLa aplicación de criterios que priorizan las relaciones mercantiles no solo en la economía sino también en el conjunto de la sociedad, somete a las reglas del mercado ámbitos que se reservaban a la gratuidad y la solidaridad entre las personas, como es el caso del cuerpo humano. Este libro desentraña cómo es posible que, transcurrido más de medio siglo desde la aprobación de la Declaración Universal de los Derechos Humanos, se acepte la comercialización del cuerpo humano, de sus partes y componentes. Por ello los autores, con un enfoque bioético y desde diferentes perspectivas, apuestan por una reorientación de las acciones que, cada vez en mayor medida, atentan contra los principios de justicia global y respeto a los derechos

De la solidaridad al mercado: el cuerpo humano y el comercio biotecnológico

Coordinació: María CasadoLa aplicación de criterios que priorizan las relaciones mercantiles no solo en la economía sino también en el conjunto de la sociedad, somete a las reglas del mercado ámbitos que se reservaban a la gratuidad y la solidaridad entre las personas, como es el caso del cuerpo humano. Este libro desentraña cómo es posible que, transcurrido más de medio siglo desde la aprobación de la Declaración Universal de los Derechos Humanos, se acepte la comercialización del cuerpo humano, de sus partes y componentes. Por ello los autores, con un enfoque bioético y desde diferentes perspectivas, apuestan por una reorientación de las acciones que, cada vez en mayor medida, atentan contra los principios de justicia global y respeto a los derechos