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Donation
Kinds of Donation Terms modified by Donation Selected AbstractsETHICAL DEBATE OVER ORGAN DONATION IN THE CONTEXT OF BRAIN DEATHBIOETHICS, Issue 2 2010MARY JIANG BRESNAHAN ABSTRACT This study investigated what information about brain death was available from Google searches for five major religions. A substantial body of supporting research examining online behaviors shows that information seekers use Google as their preferred search engine and usually limit their search to entries on the first page. For each of the five religions in this study, Google listings reveal ethical controversy about organ donation in the context of brain death. These results suggest that family members who go online to find information about organ donation in the context of brain death would find information about ethical controversy in the first page of Google listings. Organ procurement agencies claim that all major world religions approve of organ donation and do not address the ethical controversy about organ donation in the context of brain death that is readily available online. [source] THE COMBINED EFFECT OF DONATION PRICE AND ADMINISTRATIVE INEFFICIENCY ON DONATIONS TO US NONPROFIT ORGANIZATIONSFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2009Fred A. Jacobs We examine the effects that two accounting measures of nonprofit organization (NPO) inefficiency, administrative inefficiency and donation price, have on donations to US NPOs using a better-specified model and industry-specific samples. Although numerous studies examine the effect that donation price has on donations (e.g., Marudas and Jacobs, 2006; Marudas, 2004; Khanna and Sandler, 2000; and Tinkelman, 1999), only three studies examine the effect of administrative inefficiency on donations (Tinkelman and Mankaney, 2007; Frumkin and Kim, 2001; and Greenlee and Brown, 1999). However, none of these studies tests donation price and administrative inefficiency in one model and only two test industry-specific samples of NPOs. We find that misspecifying the model by including only one of these two inefficiency measures creates substantial bias and the effect of administrative inefficiency on donations varies substantially across industries. Administrative inefficiency has a significantly negative effect on donations to NPOs in the full sample and the philanthropy sample, but no significant effect on donations to NPOs in the arts, education, health, or human services samples. Furthermore, donation price has a significantly negative effect on donations to NPOs in the full sample and the education, health and human services samples, but not in the arts or philanthropy samples. Results are also reported for the other variables in the model , government support, program service revenue, fundraising and organizational age, wealth and size. [source] THE INFLUENCE OF VOLUNTEERS, DONATIONS AND PUBLIC SUBSIDIES ON THE WAGE LEVEL OF NONPROFIT WORKERS: EVIDENCE FROM AUSTRIAN MATCHED DATAANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 1 2010Astrid Haider ABSTRACT,:,In this article we add to the literature analyzing wages in the nonprofit sector by estimating a wage function based on employer-employee matched data for Austria. We concentrate on the influence of voluntary contributions on the wage level of paid workers. By using a quantile regression approach we find that the existence of volunteers reduces the wages of paid employees in nonprofit organizations. The number of volunteers does not have an influence on the wage level. Donations have a small but positive effect for higher income groups only. Public subsidies increase wages of all paid workers in a nonprofit organization. [source] Individual and Family Decisions About Organ DonationJOURNAL OF APPLIED PHILOSOPHY, Issue 1 2007T. M. WILKINSON abstract This paper examines, from a philosophical point of view, the ethics of the role of the family and the deceased in decisions about organ retrieval. The paper asks: Who, out of the individual and the family, should have the ultimate power to donate or withhold organs? On the side of respecting the wishes of the deceased individual, the paper considers and rejects arguments by analogy with bequest and from posthumous bodily integrity. It develops an argument for posthumous autonomy based on the liberal idea of self-development and argues that this establishes a right of veto over donation. It claims, however, that whether the family's power to veto would conflict with posthumous autonomy rights depends on how it comes about. On the side of respecting the family's wishes, the paper first considers an argument from family distress. This supports a contingent, non-rights-based reason for the family's power that is trumped by the deceased's rights. It then outlines and criticises an argument based on family autonomy. The conclusion is that the individual has the right to veto the family's wish to donate and that, while the family has no right to veto the individual's wishes to donate, it can legitimately acquire this power and has done so in practice. [source] College Students' Knowledge, Attitudes, and Behaviors Regarding Organ Donation: An Integrated Review of the Literature,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 2 2007Thomas Hugh Feeley The current paper provides an integrated review of research literature on college students' knowledge, attitudes, and intentions regarding organ and tissue donation (OTD). Findings across 27 studies indicate that (a) students reported a lack of information and knowledge on OTD; (b) 23% reported signing an organ card or state organ donation registry; (c) positive attitudes were reported toward donation; (d) surveyed students indicated a willingness to become organ donors; and (e) 36% reported having conversations with family about OTD. Self-efficacy and normative influence theory are recommended as promising theoretical approaches to studying OTD in college student samples. [source] Similarities and Differences Between African Americans' and European Americans' Attitudes, Knowledge, and Willingness to Communicate About Organ Donation,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 4 2003Susan E. Morgan While little is known about African Americans' attitudes and knowledge about organ donation, even less is known about how African Americans' attitudes, values, and beliefs affect their behavior and behavioral intentions regarding organ donation; or how African Americans' views are similar to or different from those of European Americans. Adults working 2 sites of a national corporation were randomly selected to complete a survey about organ donation willingness, intention to sign an organ donor card, knowledge and attitudes toward organ donation, and level of altruism. Results indicate that African Americans differ significantly from Whites on several individual attitude and knowledge items. However, the basic relationship between knowledge, attitudes, values, and behaviors regarding organ donation between the 2 groups appears the same. Furthermore, these results indicate that future organ donation promotion campaigns must focus on increasing basic knowledge and countering myths about organ donation for both populations. [source] Donation of explanted pacemakers for reuse in underserved nationsJOURNAL OF HEALTHCARE RISK MANAGEMENT, Issue 3 2010CPHRM, FASHRM, Robert Stanyon MS Some charitable organizations and physicians are willing to assist in the compassionate donation of explanted pacemakers for reuse in medically underserved nations. However, healthcare organizations must recognize that the Food and Drug Administration (FDA), device manufacturers, professional societies and many physicians advocate return of explanted pacemakers to the manufacturer to ensure an accurate performance database promoting improved device reliability and safety for the patient. [source] Veins of Devotion: Blood Donation and Religious Experience in North India by Jacob CopemanAMERICAN ETHNOLOGIST, Issue 2 2010RON BARRETT No abstract is available for this article. [source] Organ Donation: Moral Imperative or Outrage?NURSING FORUM, Issue 4 2001Christina S. Melvin RN. First page of article [source] Legal Issues Relevant to Non-heart beating Organ DonationNURSING IN CRITICAL CARE, Issue 1 2010Catherine Plowright No abstract is available for this article. [source] Anonymous Living Liver Donation: Donor Profiles and OutcomesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010T. W. Reichman There are no published series of the assessment process, profiles and outcomes of anonymous, directed or nondirected live liver donation. The outcomes of 29 consecutive potential anonymous liver donors at our center were assessed. We used our standard live liver assessment process, augmented with the following additional acceptance criteria: a logical rationale for donation, a history of social altruism, strong social supports and a willingness to maintain confidentiality of patient information. Seventeen potential donors were rejected and 12 donors were ultimately accepted (six male, six female). All donors were strongly motivated by a desire and sense of responsibility to help others. Four donations were directed toward recipients who undertook media appeals. The donor operations included five left lateral segmentectomies and seven right hepatectomies. The overall donor morbidity was 40% with one patient having a transient Clavien level 3 complication (a pneumothorax). All donors are currently well. None expressed regret about their decision to donate, and all volunteered the opinion that donation had improved their lives. The standard live liver donor assessment process plus our additional requirements appears to provide a robust assessment process for the selection of anonymous live liver donors. Acceptance of anonymous donors enlarges the donor liver pool. [source] Case Report: Eculizumab, Bortezomib and Kidney Paired Donation Facilitate Transplantation of a Highly Sensitized Patient Without Vascular AccessAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010B. E. Lonze A 43-year-old patient with end-stage renal disease, a hypercoagulable condition and 100% panel reactive antibody was transferred to our institution with loss of hemodialysis access and thrombosis of the superior and inferior vena cava, bilateral iliac and femoral veins. A transhepatic catheter was placed but became infected. Access through a stented subclavian into a dilated azygos vein was established. Desensitization with two cycles of bortezomib was undertaken after anti-CD20 and IVIg were given. A flow-positive, cytotoxic-negative cross-match live-donor kidney at the end of an eight-way multi-institution domino chain became available, with a favorable genotype for this patient with impending total loss of a dialysis option. The patient received three pretransplant plasmapheresis treatments. Intraoperatively, the superior mesenteric vein was the only identifiable patent target for venous drainage. Eculizumab was administered postoperatively in the setting of antibody-mediated rejection and an inability to perform additional plasmapheresis. Creatinine remains normal at 6 months posttransplant and flow cross-match is negative. In this report, we describe the combined use of new agents (bortezomib and eculizumab) and modalities (nontraditional vascular access, splanchnic drainage of graft and domino paired donation) in a patient who would have died without transplantation. [source] Does Hematuria Contraindicate Kidney Donation?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2010B. J. Nankivell Whether to use kidneys from donors with asymptomatic microscopic hematuria necessitates a thoughtful nephrological approach. See article by Kido et al on page 1597. [source] Living Donor Kidney Donation in the United States: Quo Vadis?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010G. Danovitch Editorial comment on the ethical concerns raised by Woodle, et al regarding a policy of preferentially allocating kidneys from non-directed living donors to facilitate paired-exchange and chain transplantation. See article by Woodle et al on page 1460. [source] Encouraging Psychological Outcomes After Altruistic Donation to a StrangerAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010E. K. Massey In a growing number of transplant centers worldwide, altruistic donors are accepted to anonymously donate a kidney to a stranger. An important hesitation to expand these transplantation programs is the fear of evoking psychological distress in the altruistic donor after donation. To what extent this fear is justified has not yet been systematically investigated. In this study, 24 altruistic donors were interviewed on average 2 years after donation. Lifetime mental health history, current psychological complaints, satisfaction with and impact of the donation on well-being, motives for donation, communication with recipient and donation experience were assessed. Altruistic donors report a considerable positive impact of donation on psychological well-being, whereas negative impact was limited. Satisfaction with donation was very high. Although a history of a psychiatric diagnosis was ascertained in almost half of the donors, psychological complaints before and after donation were comparable to national average norm scores. Motives for donation were genuine and the experience of donation generally conformed to their expectations. In conclusion, living kidney donation to a stranger does not appear to exacerbate psychological complaints. Moreover, altruistic donors report considerable satisfaction and personal benefit. The exceptional gift of altruistic donors can contribute toward solving the current organ shortage issue. [source] Foreigners Traveling to the U.S. for Transplantation May Adversely Affect Organ Donation: A National SurveyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010M. L. Volk The aims of this study were (1) to determine attitudes among the American public regarding foreigners coming to the United States for the purposes of transplantation, and (2) to investigate the impact this practice might have on the public's willingness to donate organs. A probability-based national sample of adults age ,18 was asked whether people should be allowed to travel to the United States to receive a transplant, and whether this practice would discourage the respondents from becoming an organ donor. Among 1049 participants, 30% (95% CI 25,34%) felt that people should not be allowed to travel to the United States to receive a deceased donor transplant, whereas 28% felt this would be acceptable in some cases. Thirty-eight percent (95% CI 33,42%) indicated that this practice might prevent them from becoming an organ donor. In conclusion, deceased-donor transplantation of foreigners is opposed by many Americans. Media coverage of this practice has the potential to adversely affect organ donation. [source] Living Donation, are There Limits?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2010F. Mortier No abstract is available for this article. [source] The System of Health Insurance for Living Donors Is a Disincentive for Live DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010E. S. Ommen The health insurance system for living donors is derived from insurance policies designed to cover accidental death or dismemberment. The system covers only the direct consequences of organ removal, and recoups the costs of related medical services from the transplant recipient's health insurance provider. The system forces transplant programs to differentiate between health services that are, or are not directly attributable to donation and may compromise the pretransplant evaluation, postoperative care and long-term care of living donors. The system is particularly problematic in the United States, where a significant proportion of donors do not have medical insurance. The requirement to assign donor costs to a particular recipient is poorly suited to facilitate advances in living donation such as the use of nondirected donors and living-donor paired exchange programs. We argue that given the current understanding regarding the long-term risks of living donation, the provision of basic medical insurance is a necessity for living donation and that the system of attributing donor costs to the recipient's insurance is inefficient, has the potential to undermine the care of living donors and is a disincentive to the expansion of living donation. [source] Altruistic Donor Triggered Domino-Paired Kidney Donation for Unsuccessful Couples from the Kidney-Exchange ProgramAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010J. I. Roodnat Between January 2000 and July 2009, 132 individuals inquired about altruistic kidney donation to strangers. These donors were willing to donate to genetically and emotionally unrelated patients. Some altruistic donors wished to donate to a specific person, but most wished to donate anonymously. In domino-paired donation, the altruistic donor donates to the recipient of an incompatible couple; the donor of that couple (domino-donor) donates to another couple or to the waiting list. In contrast to kidney-exchange donation where bilateral matching of couples is required, recipient and donor matching are unlinked in domino-paired donation. This facilitates matching for unsuccessful couples from the kidney-exchange program where blood type O prevails in recipients and is under-represented in donors. Fifty-one altruistic donors (39%) donated their kidney and 35 domino-donors were involved. There were 29 domino procedures, 24 with 1 altruistic donor and 1 domino-donor, 5 with more domino-donors. Eighty-six transplantations were performed. Donor and recipient blood type distribution in the couples limited allocation to blood type non-O waiting list patients. The success rate of domino-paired donation is dependent on the composition of the pool of incompatible pairs, but it offers opportunities for difficult to match pairs that were unsuccessful in the kidney-exchange program. [source] Trends in Organ Donation and Transplantation in the United States, 1999,2008AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2010R. A. Wolfe Posttransplant patient and graft survival outcomes have improved over the past decade for almost every organ. [source] Organ Donation and Utilization in the United States, 1999,2008AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2010A. S. Klein Despite the Organ Donation Breakthrough Collaborative's work to engage the transplant community and the suggested positive impact from these efforts, availability of transplanted organs over the past 5 years has declined. Living kidney, liver and lung donations declined from 2004 to 2008. Living liver donors in 2008 dropped to less than 50% of the peak (524) in 2001. There were more living donors that were older and who were unrelated to the recipient. Percentages of living donors from racial minorities remained unchanged over the past 5 years, but percentages of Hispanic/Latino and Asian donors increased, and African American donors decreased. The OPTN/UNOS Living Donor Transplant Committee restructured to enfranchise organ donors and recipients, and to seek their perspectives on living donor transplantation. In 2008, for the first time in OPTN history, deceased donor organs decreased compared to the prior year. Except for lung donors, deceased organ donation fell from 2007 to 2008. Donation after cardiac death (DCD) has accounted for a nearly 10-fold increase in kidney donors from 1999 to 2008. Use of livers from DCD donors declined in 2008 to 2005 levels. Understanding health risks associated with the transplantation of organs from ,high-risk' donors has received increased scrutiny. [source] Kidney and Pancreas Transplantation in the United States, 1999,2008: The Changing Face of Living DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2010D. A. Axelrod The waiting list for kidney transplantation continued to grow between 1999 and 2008, from 41 177 to 76 089 candidates. However, active candidates represented the minority of this increase (36 951,50 624, a 37% change), while inactive candidates increased over 500% (4226,25 465). There were 5966 living donor (LD) and 10 551 deceased donor (DD) kidney transplants performed in 2008. The total number of pancreas transplants peaked at 1484 in 2004 and has declined to 1273. Although the number of LD transplants increased by 26% from 1999 to 2008, the total number peaked in 2004 at 6647 before declining 10% by 2008. The rate of LD transplantation continues to vary significantly as a function of demographic and geographic factors, including waiting time for DD transplant. Posttransplant survival remains excellent, and there appears to be greater use of induction agents and reduced use of corticosteroids in LD recipients. Significant changes occurred in the pediatric population, with a dramatic reduction in the use of LD organs after passage of the Share 35 rule. Many strategies have been adopted to reverse the decline in LD transplant rates for all age groups, including expansion of kidney paired donation, adoption of laparoscopic donor nephrectomy and use of incompatible LD. [source] Renal Transplantation Across HLA and ABO Antibody Barriers: Integrating Paired Donation into Desensitization ProtocolsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010Robert A. Montgomery The field of desensitization and incompatible transplantation has made great gains over the past decade. There are now several options and effective therapies for many patients who face antibody barriers. Kidney paired donation (KPD) and desensitization have traditionally been considered competing strategies and patients have been offered one or the other without regard for the probability of a successful outcome. It is now possible to predict which donor/recipient phenotypes will benefit from each of these modalities. KPD should be favored among patients with immunologic phenotypes that are likely to match without prolonged waiting times. However, as many as 50% of patients with incompatible donors will fail to find a match in a KPD pool and many of these patients could be desensitized to their donor. Positive crossmatch and ABO incompatible transplantation has been accomplished in selective cases without the need for heavy immunosuppression or B-cell ablative therapy. Patients who are both difficult-to-match due to broad sensitization and hard-to-desensitize because of strong donor reactivity can often be successfully transplanted through a combination of desensitization and KPD. Using these various modalities it is estimated that most patients with incompatible live donors can undergo successful renal transplantation. [source] Specific Unwillingness to Donate Eyes: The Impact of Disfigurement, Knowledge and Procurement on Corneal DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010M. Lawlor Although willingness, attitudes and beliefs surrounding solid-organ donation have been extensively investigated, much less is known about corneal donation. Despite evidence that a substantial number of families who agree to multiorgan donation also specifically refuse corneal donation, it is unclear why this occurs and what can be done to increase rates of corneal donation. We conducted a survey of 371 Australian adults regarding their views on corneal donation. Although willingness to donate corneas generally reflected a person's willingness to donate all of one's organs, unwillingness to donate corneas appeared to be due to other factors. Specifically, decisions not to donate appear to be driven by a range of concerns surrounding disfigurement. The survey also provides eye banks with reassurance about the acceptability of whole globe procurement, and recognition that research into blindness is a highly valued part of corneal donation. Finally, the survey identifies that many individuals see benefit in having their family engaged in the decision-making process, suggesting that decisions about donation are more complex than a simple appeal to the autonomy of the deceased. [source] Attitudes of the American Public toward Organ Donation after Uncontrolled (Sudden) Cardiac DeathAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010M. L. Volk Concerns about public support for organ donation after cardiac death have hindered expansion of this practice, particularly rapid organ recovery in the context of uncontrolled (sudden) cardiac death (uDCD). A nationally representative Internet-based panel was provided scenarios describing donation in the context of brain death, controlled cardiac death and uncontrolled cardiac death. Participants were randomized to receive questions about trust in the medical system before or after the rapid organ recovery scenario. Among 1631 panelists, 1049 (64%) completed the survey. Participants expressed slightly more willingness to donate in the context of controlled and uncontrolled cardiac death than after brain death (70% and 69% vs. 66%, respectively, p < 0.01). Eighty percent of subjects (95% CI 77,84%) would support having a rapid organ recovery program in their community, though 83% would require family consent or a signed donor card prior to invasive procedures for organ preservation. The idea of uDCD slightly decreased trust in the medical system from 59% expressing trust to 51% (p = 0.02), but did not increase belief that a signed donor card would interfere with medical care (28% vs. 32%, p = 0.37). These findings provide support for the careful expansion of uDCD, albeit with formal consent prior to organ preservation. [source] Diabetes after Kidney DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2010H. N. Ibrahim Kidney donors, similar to the general population, are at risk for development of type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been studied. We surveyed 3777 kidney donors regarding the development of T2DM. Of the 2954 who responded, 154 developed T2DM 17.7 ± 9.0 years after donation. The multivariable risk of development of T2DM was associated with type 1 DM in the recipient, male gender and body mass index >30 kg/m2 at time of donation. Compared to age, gender, duration after donation and body mass index (BMI)-matched non-diabetic donor controls; diabetic donors were more likely to have hypertension (70.8% vs. 36.2%, p = 0.005), proteinuria (18.8% vs. 3.9%, p < 0.0001) but had a similar serum creatinine. eGFR change after T2DM development was ,0.80 ± 0.94 mL/min/year, ,0.70 ± 0.86 in nondiabetic donors with similar duration after donation and ,0.61 ± 0.76 mL/min/year in age, gender, BMI and duration after donation matched nondiabetic donor controls. These preliminary and shor-term data demonstrate that factors associated with T2DM in kidney donors are similar to those in the general population and donors screened carefully at the time of donation do not appear to have an acceleration of diabetic kidney disease. [source] Clinical Outcomes of Multicenter Domino Kidney Paired DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2009Y. J. Lee Domino kidney paired donation (KPD) is a method by which an altruistic living nondirected donor (LND) is allocated to a pool of incompatible donor,recipient pairs (DRP) and a series of KPDs is initiated. To evaluate the feasibility and clinical outcomes of multicenter domino KPD, we retrospectively analyzed a cohort of DRPs who underwent domino KPD between February 2001 and July 2007 at one of 16 transplant centers. One hundred seventy-nine kidney transplants were performed, with 70 domino chains initiated by altruistic LND. There were 45 two-pair chains, 15 three-pair chains, 7 four-pair chains, 2 five-pair chains and 1 six-pair chain. A majority of donors were spouses (47.5%) or altruistic LNDs (39.1%). DRPs with a blood type O recipient or an AB donor comprised 45.9% of transplanted DRPs. HLA mismatch improved in transplanted donors compared to intended donors in pairs enrolled to improve HLA mismatch (3.4 ± 0.7 vs. 4.8 ± 1.0, p < 0.001). One-year and 5-year graft survival rates were 98.3% and 87.7%, respectively, with a median follow-up of 46 months. One-year and 5-year patient survival rates were 97.2% and 90.8%, respectively. In conclusion, multicenter domino KPD could multiply the benefits of donation from LNDs, with patients and graft survival rates comparable to those seen with conventional KPD. [source] ASTS Recommended Practice Guidelines for Controlled Donation after Cardiac Death Organ Procurement and TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009D. J. Reich The American Society of Transplant Surgeons (ASTS) champions efforts to increase organ donation. Controlled donation after cardiac death (DCD) offers the family and the patient with a hopeless prognosis the option to donate when brain death criteria will not be met. Although DCD is increasing, this endeavor is still in the midst of development. DCD protocols, recovery techniques and organ acceptance criteria vary among organ procurement organizations and transplant centers. Growing enthusiasm for DCD has been tempered by the decreased yield of transplantable organs and less favorable posttransplant outcomes compared with donation after brain death. Logistics and ethics relevant to DCD engender discussion and debate among lay and medical communities. Regulatory oversight of the mandate to increase DCD and a recent lawsuit involving professional behavior during an attempted DCD have fueled scrutiny of this activity. Within this setting, the ASTS Council sought best-practice guidelines for controlled DCD organ donation and transplantation. The proposed guidelines are evidence based when possible. They cover many aspects of DCD kidney, liver and pancreas transplantation, including donor characteristics, consent, withdrawal of ventilatory support, operative technique, ischemia times, machine perfusion, recipient considerations and biliary issues. DCD organ transplantation involves unique challenges that these recommendations seek to address. [source] Stimulus for Organ Donation: A Survey of the American Society of Transplant Surgeons MembershipAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009J. R. Rodrigue Federal legislation has been proposed to modify the National Organ Transplant Act in a way that would permit government-regulated strategies, including financial incentives, to be implemented and evaluated. The Council and Ethics Committee of the American Society of Transplant Surgeons conducted a brief web-based survey of its members' (n = 449, 41.6% response rate) views on acceptable or unacceptable strategies to increase organ donation. The majority of the membership supports reimbursement for funeral expenses, an income tax credit on the final return of a deceased donor and an income tax credit for registering as an organ donor as strategies for increasing deceased donation. Payment for lost wages, guaranteed health insurance and an income tax credit are strategies most strongly supported by the membership to increase living donation. For both deceased and living donation, the membership is mostly opposed to cash payments to donors, their estates or to next-of-kin. There is strong support for a government-regulated trial to evaluate the potential benefits and harms of financial incentives for both deceased and living donation. Overall, there is strong support within the ASTS membership for changes to NOTA that would permit the implementation and careful evaluation of indirect, government-regulated strategies to increase organ donation. [source] The Roles of Dominos and Nonsimultaneous Chains in Kidney Paired DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2009S. E. Gentry Efforts to expand kidney paired donation have included matching nondirected donors (NDDs) to incompatible pairs. In domino paired donation (DPD), an NDD gives to the recipient of an incompatible pair, beginning a string of simultaneous transplants that ends with a living donor giving to a recipient on the deceased donor waitlist. Recently, nonsimultaneous extended altruistic donor (NEAD) chains were introduced. In a NEAD chain, the last donor of the string of transplants initiated by an NDD is reserved to donate at a later time. Our aim was to project the impact of each of these strategies over 2 years of operation for paired donation programs that also allocate a given number of NDDs. Each NDD facilitated an average of 1.99 transplants using DPD versus 1.90 transplants using NEAD chains (p = 0.3), or 1.0 transplants donating directly to the waitlist (p < 0.001). NEAD chains did not yield more transplants compared with simultaneous DPD. Both DPD and NEAD chains relax reciprocality requirements and rebalance the blood-type distribution of donors. Because traditional paired donation will leave many incompatible pairs unmatched, novel approaches like DPD and NEAD chains must be explored if paired donation programs are to help a greater number of people. [source] | |||||||||||||||||||||||||||||||||||||||||||