Attitudes toward organ donation among waitlisted transplant patients: results of a cross-sectional survey

Knowledge, attitudes, and practices of organ, tissue, and cell donation in Nicaragua

Organ donation and transplantation are essential for improving the quality of life of people with organ failure due to chronic diseases (e.g., chronic kidney disease) or irreparable organ damage from accidents. In Nicaragua, chronic kidney disease of unknown etiology (CKDu) has emerged as a significant public health challenge, disproportionally affecting young agricultural workers and leading to premature deaths. Despite enactment of Law 847 in 2013, which regulates organ donations and transplantation, Nicaragua faces critical challenges, including lack of awareness, inadequate infrastructure, and limited public dissemination on the value of organ donation leading to an increasing number of patients on waiting lists. To address these gaps, we conducted an online cross-sectional survey to assess the knowledge, attitudes, and practices (KAP) regarding organ donation and transplantation in Nicaragua, a lower-middle-income country. We conducted an online cross-sectional survey among 4,407 Nicaraguan residents aged 18 and above from all 15 departments and two regions between November 2022 and February 2023. Most participants were women (60.3%), people aged 18-35 years (79.9%), and residents in urban areas (62.8%). The findings revealed that only 28.6% had good knowledge regarding organ and tissue donation and transplantation, 91.9% expressed positive attitudes toward organ and tissue donation, being willing to donate regardless of religious believes (88.5%) or personal health conditions (90.0%). About 72.6% engaged in donation-related behaviors. Men, those with higher education, and unemployed participants showed greater adherence to these practices. In summary, while Nicaraguans show positive attitudes towards organ and tissue donation and transplantation, significant knowledge and supply-demand gaps persist. Targeted educational campaigns and infrastructure development are urgently needed to address these gaps, enhance public awareness, and promote organ donation, particularly in the context of CKDu´s burden on public health.

Altruism in death: Attitudes to body and organ donation in Australian students

Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate.

Pretransplant Patient Education in Solid-organ Transplant: A Narrative Review

Education for pretransplant, solid-organ recipient candidates aims to improve knowledge and understanding about the transplant process, outcomes, and potential complications to support informed, shared decision-making to reduce fears and anxieties about transplant, inform expectations, and facilitate adjustment to posttransplant life. In this review, we summarize novel pretransplant initiatives and approaches to educate solid-organ transplant recipient candidates. First, we review approaches that may be common to all solid-organ transplants, then we summarize interventions specific to kidney, liver, lung, and heart transplant. We describe evidence that emphasizes the need for multidisciplinary approaches to transplant education. We also summarize initiatives that consider online (eHealth) and mobile (mHealth) solutions. Finally, we highlight education initiatives that support racialized or otherwise marginalized communities to improve equitable access to solid-organ transplant. A considerable amount of work has been done in solid-organ transplant since the early 2000s with promising results. However, many studies on education for pretransplant recipient candidates involve relatively small samples and nonrandomized designs and focus on short-term surrogate outcomes. Overall, many of these studies have a high risk of bias. Frequently, interventions assessed are not well characterized or they are combined with administrative and data-driven initiatives into multifaceted interventions, which makes it difficult to assess the impact of the education component on outcomes. In the future, well-designed studies rigorously assessing well-defined surrogate and clinical outcomes will be needed to evaluate the impact of many promising initiatives.