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

Procuring organs for transplantation : a European perspective

Background: The shortage of organs for transplant In Europe has been considerable for many years. A number of different policies have been implemented in an attempt to address this problem. These have had varying degrees of success from country to country. Methods: This article provides an up-to-date review of organ procurement policies throughout Europe. Alternative and In some cases controversial organ procurement programmes are also considered to establish whether the increasing demand for organs can be met elsewhere. Results: Transplant waiting lists are the greatest by far for those patients waiting for a kidney replacement. Norway has best managed to address this need through adopting a positive policy choice towards live donation whilst still maintaining an active cadaveric donation policy. Conclusion: With the lowering of both physical and social barriers In Europe, there has been a recent shift towards co-operation between some European countries in promoting transplant activity. This ensures that if an organ becomes available in one country and has no suitable recipient, then it can be used elsewhere. The future may show and increasing trend towards this level of European cooperation in order to make transplant activity more efficient

Cultural attitudes towards death practices, the body after death and life after death in deceased organ donation - a UK Polish migrant perspective

Previous studies have found the perception of the body and death practices can have an influence on perceptions of deceased organ donation. This is the first study in the UK to investigate the views of the Polish migrants, a fast growing community, toward organ donation, death practices and the deceased body. In total, there were 31 participants that took part in the study in one-to-one interviews or small focus group interviews that lasted approximately 1½ hours. The majority were conducted in English and 1 focus group and 7 interviews were in Polish. The interviews were recorded with permission from the participant, transcribed and analysed using grounded theory analysis. Participants believed the body was seen to be useful for others in need of organs after the individual had died. Families were thought to struggle with saying ‘goodbye’ if it was perceived the deceased individual was to ‘live on’ in the recipient. Participants highlighted that within Polish culture, funerals were organised quickly and opencasket burials were common, however these practices would not hinder donation. Being aware of this community's perspective may aid healthcare professionals when discussing deceased organ donation with potential donor familie

Social capital and deceased organ donation

This chapter examines the link between deceased organ donation and social capital from a theoretical standpoint.In this chapter, the theoretical links between deceased organ donation and social capital theory are examined and evaluated

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

Hard times: young people’s and young parents’ experiences of living through poverty in Luton

This research report is primarily concerned with the experiences of young people (16-24 years) and young parents bringing up children within the context of poverty in Luton. It is divided into three sections. Part One provides a general overview of poverty research in the UK. Part Two presents the findings from the study of young people and young parents’ experiences of poverty in Luton. Part Three discusses the implications of the findings presented and recommendations that arise from them. The overview of research presented in part one of this report is organised under the following headings: measures of poverty commonly adopted in UK poverty research; the extent of poverty in the UK including a short discussion of gender and ethnicity; attitudes to poverty amongst the general public; the impacts of poverty on children and families; poverty amongst young people; parenting in poverty; patterns of poverty. Part two of the report provides a brief description of the methodology adopted for this study and the sample amongst whom the research was conducted. Key findings are then summarised. Following this a thematic analysis of interview data is presented. This covers the following themes: how participants defined poverty; how participants explained poverty; the images of ‘poor people’ participants employed; whether participants considered they or their families were poor; participants’ descriptions of living through poverty; what participants thought the Local Authority should do to tackle poverty. Part three presents a discussion of the implications of the findings from this study and the recommendations that arise from them

Exploring factors contributing to low uptake of the NHS Breast Cancer Screening Programme among Black African women in the UK

Breast cancer is the most common cancer among women in the United Kingdom (UK) accounting for about 15% of cancer deaths. The National Breast Cancer Screening Programme in the UK was introduced in 1988 to assist with early detection and better management of breast cancer. Black and Minority Ethnic (BME) women however have a low uptake of the National Breast Screening programme when compared to their White counterparts. Within the BME group, Black African women have the lowest uptake of screening services and are more likely to have an advanced stage of the disease at diagnosis, leading to poorer survival rates than White women. This study aimed to explore the factors that lead to low uptake of the National Breast Cancer Screening Programme  among Black African women living in Luton and present action points to local breast cancer services. Using a qualitative research design, six focus groups were conducted with a total of twenty-five Black African women residing in Luton between May and June in 2013. Data was analysed thematically using the framework approach. Four main themes emerged across the focus group discussions: knowledge and beliefs about breast cancer and risk factors, prevention of breast cancer and awareness of the NHS breast screening service, delays in attending the NHS breast screening service and suggestions for improving information on breast cancer and the NHS breast cancer screening service. The findings from this study suggest the need for more targeted information on breast cancer and screening services for Black African women. This could help improve the uptake of the NHS breast screening service, promote early help-seeking behaviour and improve breast cancer outcomes for this ethnic group.

Altruism, gift giving and reciprocity in organ donation: a review of cultural perspectives and challenges of the concepts

Living and deceased organ donation are couched in altruism and gift discourse and this article reviews explores cultural views towards these concepts. Altruism and egoism theories and gift and reciprocity theories are outlined from a social exchange theory perspective to highlight the key differences between altruism and the gift and the wider implications of reciprocation. The notion of altruism as a selfless act without expectation or want for repayment juxtaposed with the Maussian gift where there are the obligations to give, receive and reciprocate. Lay perspectives of altruism and the gift in organ donation are outlined and illustrate that there are differences in motivations to donate in different programmes of living donation and for families who decide to donate their relative's organs. These motivations reflect cultural views of altruism and the gift and perceptions of the body and death

Organ donation as an 'altruistic gift': Incentives and reciprocity in deceased organ donation from a UK Polish migrant perspective

Background: Incentives and reciprocity have been widely debated within the literature as an alternative to altruism to motivate the public to register and consent to organ donation. This pilot study was the first to examine the views of the UK Polish migrant community toward these issues. Material and Methods: One-to-one and small group interviews were conducted in English and Polish to collect data. The interviews were recorded and transcribed and interviews in Polish were translated into English. All transcripts were coded, codes were grouped by theme and emergent themes were constantly compared to the new data until saturation. Results: Participants were motivated to donate altruistically but would accept reciprocity for organs once consent was given. Payment for organs was viewed as unfavourable but participants would accept contribution toward funeral expenses. Conclusions: Deceased organ donation was viewed as an ‘altruistic gift’. ‘Altruism’ and ‘gift’ are problematic in deceased organ donation and could explain the challenges that arise in the incentives and reciprocity debate. Mauss’s gift exchange theory could frame incentives as forming the ‘obligation to give’ and could encourage registration but could lead to coercion. Reciprocity could benefit families and be viewed as ‘fair’ and a token of gratitude