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Organ Donation (organ + donation)
Terms modified by Organ 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] 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] 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] 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] 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] 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] 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] Trends in Organ Donation and Transplantation in the United States, 1998,2007AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2009R. A. Wolfe First page of article [source] Organ Donation and Utilization in the United States: 1998,2007AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2009J. E. Tuttle-Newhall Organ transplantation remains the only life-saving therapy for many patients with organ failure. Despite the work of the Organ Donation and Transplant Collaboratives, and the marked increases in deceased donors early in the effort, deceased donors only rose by 67 from 2006 and the number of living donors declined during the same time period. There continues to be increases in the use of organs from donors after cardiac death (DCD) and expanded criteria donors (ECD). This year has seen a major change in the way organs are offered with increased patient safety measures in those organ offers made by OPOs using DonorNet©. Unfortunately, the goals of 75% conversion rates, 3.75 organs transplanted per donor, 10% of all donors from DCD sources and 20% growth of transplant center volume have yet to be reached across all donation service areas (DSAs) and transplant centers; however, there are DSAs that have not only met, but exceeded, these goals. Changes in organ preservation techniques took place this year, partly due to expanding organ acceptance criteria and increasing numbers of ECDs and DCDs. Finally, the national transplant environment has changed in response to increased regulatory oversight and new requirements for donation and transplant provider organizations. [source] The Evolution and Direction of OPTN Oversight of Live Organ Donation and Transplantation in the United StatesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2009R. S. Brown For more than 20 years, the Organ Procurement and Transplantation Network (OPTN) has developed policies and bylaws relating to equitable allocation of deceased donor organs for transplantation. United Network for Organ Sharing (UNOS) operates the OPTN under contract with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). Until recent years, the OPTN had little defined authority regarding living donor organ for transplantation except for the collection of data relating to living donor transplants. Beginning with the implementation of the OPTN Final Rule in 2000, and continuing with more recent announcements, the OPTN's role in living donation has grown. Its responsibilities now include monitoring of living donor outcomes, promoting equity in nondirected living donor transplantation and ensuring that transplant programs have expertise and established protocols to promote the safety of living donors and recipients. The purpose of this article is to describe the evolving mandates for the OPTN in living donation, as well as the network's recent activities and ongoing efforts. [source] Trends in Organ Donation and Transplantation in the United States, 1997,2006AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2008F. K. Port First page of article [source] Transmission of Anaplastic Large Cell Lymphoma via Organ Donation After Cardiac DeathAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2008J. W. Harbell Recently, donation after cardiac death (DCD) has been encouraged in order to expand the donor pool. We present a case of anaplastic T-cell lymphoma transmitted to four recipients of solid organ transplants from a DCD donor suspected of having bacterial meningitis. On brain biopsy, the donor was found to have anaplastic central nervous system T-cell lymphoma, and the recipient of the donor's pancreas, liver and kidneys were found to have involvement of T-cell lymphoma. The transplanted kidneys and pancreas were excised from the respective recipients, and the kidney and pancreas recipients responded well to chemotherapy. The liver recipient underwent three cycles of chemotherapy, but later died due to complications of severe tumor burden. We recommend transplanting organs from donors with suspected bacterial meningitis only after identification of the infectious organism. In cases of lymphoma transmission, excision of the graft may be the only chance at long-term survival. [source] Emigration from the British Isles to Southeastern Spain: A Study of Attitudes Toward Organ DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2007A. Ríos Southeastern Spain is a cosmopolitan area where there is a growing British and Irish population. The objective is to analyze the attitude toward organ donation among British and Irish citizens living in southeastern Spain. A sample was taken stratified according to a respondent's country of origin (n = 1700) between November 2005 and April 2006. Attitude was evaluated using a validated questionnaire, which was self-administered and completed anonymously. A sample of 2000 Spanish citizens was used as a control group. The survey completion rate was 95% (n = 1611). Attitude toward donation is favorable in 72% (n = 1155) of respondents with 8% (n = 122) against and 20% (n = 334) undecided. Attitude is more favorable than in the control group (72% vs. 63%; p < 0.0001). The following factors influence this attitude: (1) attitude toward the donation of a family member's organs (OR = 4.891); (2) having discussed the matter of organ donation within the family (OR = 2.513); (3) a willingness to accept an autopsy if it were necessary (OR = 1.706); (4) having no concern about the mutilation of the deceased donor (OR = 3.294); (5) having a partner who is in favor of donation (OR = 2.786) and (6) a respondent's belief that he or she might need a transplant in the future (OR = 2.243). The attitude of this population is more positive than in the native Spanish population and is determined by many psychosocial factors. [source] Trends in Organ Donation and Transplantation in the United States, 1996,2005AMERICAN JOURNAL OF TRANSPLANTATION, Issue 2007F. K. Port First page of article [source] Limiting Financial Disincentives in Live Organ Donation: A Rational Solution to the Kidney ShortageAMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2006R. S. Gaston Availability of kidney transplantation is limited by an inadequate supply of organs, with no apparent remedy on the immediate horizon and increasing reliance on living donors (LDs). While some have advocated financial remuneration to stimulate donation, the National Organ Transplant Act (NOTA) of 1984 expressly forbids the offer of ,valuable consideration.' However, recent developments indicate some fluidity in the definition of valuable consideration while evolving international standards highlight deficiencies (particularly regarding long-term care and follow-up) in the current American system. Recognizing that substantial financial and physical disincentives exist for LDs, we propose a policy change that offers the potential to enhance organ availability as well as address concerns regarding long-term care. Donors assume much greater risk than is widely acknowledged, risk that can be approximated for the purpose of determining appropriate compensation. Our proposal offsets donor risk via a package of specific benefits (life insurance, health insurance and a small amount of cash) to minimize hazard and ensure donor interests are protected after as well as before nephrectomy. It will fund medical follow-up and enable data collection so that long-term risk can be accurately assessed. The proposal should be cost effective with only a small increase in the number of LDs, and the net benefit will become greater if removal of disincentives stimulates even further growth. As importantly, by directly linking compensation to risk, we believe it preserves the essence of kidney donation as a gift, consistent with NOTA and implementable in the United States without altering current legal statutes. [source] The Importance of Emergency Medicine in Organ Donation: Successful Donation Is More Likely When Potential Donors Are Referred From the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 9 2009Glen E. Michael MD Abstract Objectives:, This study sought to identify factors that are associated with successful organ retrieval among patients referred to organ procurement services for potential organ donation. Particular attention was paid to the frequency, patient characteristics, and outcomes of patients referred for donation from the emergency department (ED). Methods:, For this retrospective cohort study, data were collected on all solid-organ donor referrals made to a single organ procurement organization serving 78 hospitals over a 45-month period. Data retrieved included patient age, sex, race, referral site (ED vs. inpatient), and mechanism of injury. Outcome of referral (organs retrieved or not) was the primary outcome variable. Pearson chi-square and Student's t-tests were used for bivariate statistical analysis. Multiple logistic regression analysis was used to determine which variables remained associated with organ retrieval after controlling for potential confounders. Results:, A total of 6,886 donor referrals were made in the study population. Of these, 155 were excluded due to incomplete data, leaving 6,731 subjects for analysis. Using bivariate statistical analysis, we found that successful organ retrieval was associated with younger age (donor mean age 40.8 years, 95% confidence interval [CI] = 39.1 to 42.5 vs. nondonor mean age 59.4, 95% CI = 58.9 to 59.9), mechanism of injury (p < 0.001), and referral from the ED (ED 15.5% retrieved, inpatient 5.9%, odds ratio [OR] = 2.92, 95% CI = 2.32 to 3.67). After controlling for potential confounders with multiple logistic regression, referral from the ED remained significantly associated with successful organ retrieval (OR = 1.52, 95% CI = 1.18 to 1.97), as did age (OR = 0.96, 95% CI = 0.96 to 0.97) and mechanism of injury (p < 0.001). On regression analysis, race emerged as a significant predictor of organ retrieval (p < 0.001). Medically suitable patients referred from the ED were significantly more likely on bivariate analysis to have consent for donation granted compared to patients referred from inpatient settings (OR = 1.48, 95% CI = 1.03 to 2.12), but this association was not found to be significant on regression analysis (OR = 1.37, 95% CI = 0.93 to 2.02). Conclusions:, Referral of potential organ donors from the ED is associated with an increased likelihood of successful organ retrieval. The authors conclude that further attention and resources should be directed toward the role of emergency medicine (EM) in the organ procurement process, owing to the relatively high likelihood of successful organ retrieval among patients referred from the ED. [source] Organ Donation: Knowledge, Attitudes, and Practice in Lagos, NigeriaARTIFICIAL ORGANS, Issue 8 2006Olumuyiwa O. Odusanya Abstract:, A cross-sectional study was conducted to determine knowledge and attitudes toward organ donation and transplant in Lagos, Nigeria. The study sample was selected through a multistaged sampling technique. The survey instrument was a standardized self-administered questionnaire. Four hundred and twenty-eight subjects participated in the study. The mean age was 31.1 ± 2.1 years. Two hundred and fifty-six (60%) were aware of organ donation. Renal failure was the most commonly identified indication for transplant. One hundred and twenty-seven (30%) subjects were willing to donate an organ. Knowledge about organ donation was significantly higher among those with tertiary level of education (P = 0.000). Willingness to donate an organ showed a significant relationship with younger age (P = 0.002), but not with gender (P = 0.47) or educational status (P = 0.09). There is a need to increase awareness about organ donation in Lagos, Nigeria. [source] The Intersection of Conversation, Cognitions, and Campaigns: The Social Representation of Organ DonationCOMMUNICATION THEORY, Issue 1 2009Susan E. Morgan Social representations theory (SRT) has been underused in the communication field. This theory helps explain the interrelationships between interpersonal communication, cognition, and the mass media, particularly in situations where a new phenomenon emerges that requires some kind of social response. Because organ donation is still poorly understood by the public, in large part because of entertainment television, SRT is well suited to helping researchers and practitioners understand the complex interplay of factors within a population(s) that contribute to reluctance to donate organs after death. In this paper, it is argued that public communication campaigns should include strategies to provoke interpersonal communication about the topic as a means of creating social representations that promote behaviors that support public health. Résumé Au croisement des conversations, de la cognition et des campagnes de communication : La représentation sociale du don d'organes La théorie des représentations sociales (TRS) demeure sous-utilisée dans les sciences de la communication. Cette théorie aide à expliquer les relations entre la communication interpersonnelle, la cognition et les médias de masse, surtout dans les situations où l'émergence d,un nouveau phénomène requiert une certaine réaction sociale. Puisque le don d'organes demeure mal compris du public, en grande partie à cause de la télévision récréative, la TRS est utile pour aider les chercheurs et les intervenants à comprendre l,interaction complexe, dans une population, de facteurs contribuant à une réticence à donner ses organes après son décès. Dans cet article, il est soumis que les campagnes de communication publique devraient inclure des stratégies visant à provoquer la communication interpersonnelle sur le sujet, de manière à créer des représentations sociales qui promeuvent les comportements en appui à la santé publique. Abstract Die Schnittstelle zwischen persönlichem Gespräch, Kognitionen und Kampagnen: Die soziale Repräsentation von Organspende Bislang fand die Theorie der sozialen Repräsentation in der Kommunikationswissenschaft nur ungenügend Anwendung. Die Theorie erklärt die Beziehungen zwischen interpersonaler Kommunikation, Kognition und den Massenmedien, insbesondere in Situationen, in denen ein neues Phänomen zu Tage tritt, das eine bestimmte Art sozialer Reaktion erfordert. Da die Organspende vor allem aufgrund des Unterhaltungsfernsehens in der Öffentlichkeit immer noch eher schlecht verstanden ist, trägt die Theorie der sozialen Repräsentation dazu bei, dass Forscher und Praktiker das komplexe Zusammenspiel der Faktoren besser verstehen, welches die Zurückhaltung gegenüber der Spende von Organen nach dem Tod in verschiedenen Populationen beeinflusst. In diesem Artikel wird deshalb argumentiert, dass öffentliche Kommunikationskampagnen auch Strategien beinhalten sollten, die interpersonale Kommunikation zum Thema anregen, was wiederum als Mittel dient, soziale Repräsentationen herzustellen und Verhaltensweisen zu fördern, die der öffentlichen Gesundheit zuträglich sind. Resumen La Intersección entre la Conversación, las Cogniciones, y las Campañas: La Representación Social de la Donación de Órganos La teoría de las representaciones sociales (SRT) ha sido poco usada en el campo de la comunicación. Esta teoría ayuda a explicar las interrelaciones entre la comunicación interpersonal, la cognición y los medios de comunicación, particularmente en situaciones donde un nuevo fenómeno, que requiere algún tipo de respuesta social, emerge. Dado que la donación de órganos es poco comprendida por el público, en gran parte debido a la televisión de entretenimiento, la teoría de representación social (SRT) es apropiada para ayudar a los investigadores y los profesionales a entender la complejidad de la interacción de los factores que dentro de una población (o poblaciones) contribuyen a la renuencia a donar órganos después de la muerte. Este artículo sostiene que la comunicación pública de las campañas debería incluir estrategias que provoquen la comunicación interpersonal acerca del tema como un medio para crear representaciones sociales que promuevan los comportamientos de apoyo a la salud pública. ZhaiYao Yo yak [source] Attitudes of intensive care nurses towards brain death and organ transplantation: instrument development and testingJOURNAL OF ADVANCED NURSING, Issue 5 2006Jung Ran Kim BN MClinN DipN RN Aims., This paper reports the development and testing of an instrument assessing attitudes of Korean intensive care unit nurses. Background., Reluctance by healthcare professionals to identify brain-dead patients as a potential donor is one reason for a shortfall in transplantable organs in all countries. Organ donation from brain-dead patients is a particularly contentious issue in Korea, following recent legal recognition of brain death within the cultural context of Confucian beliefs. Method., A 38-item instrument was developed from the literature and key informant interviews, and validated by an expert panel and a pilot study. A survey was conducted with Korean intensive care unit nurses (n = 520) from October 2003 to January 2004. Principal component analysis with varimax rotation was used to determine construct validity. Item-to-total correlations and Cronbach's coefficient alpha were used to determine the scale's internal consistency and unidimensionality. Results., The scale demonstrated high internal consistency (alpha = 0·88). Principal component analysis yielded a four-component structure: Discomfort, Enhancing quality of life, Willingness to be a donor and Rewarding experience. Overall, Korean intensive care unit nurses showed positive attitudes towards organ transplantation, despite some mixed feelings. Conclusion., The attitude scale was reliable and valid for this cohort. Areas were identified where professional development may enhance positive attitudes towards organ transplantation from brain-dead donors. Effective education for intensive care unit nurses is necessary to increase the organ donor pool in Korea. Further research could test the instrument with other populations. [source] Organ donation: we can solve the shortage,NURSING IN CRITICAL CARE, Issue 5 2010Chris J. Rudge FRCSArticle first published online: 15 AUG 2010 First page of article [source] Time to Cardiac Death After Withdrawal of Life-Sustaining Treatment in Potential Organ DonorsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009C. Suntharalingam Organ donation after cardiac death (DCD) is increasing markedly, allowing more patients to benefit from transplantation. The time to cardiac death following withdrawal of life-supporting treatment varies widely and is an important determinant of whether organ donation occurs. A prospective multicenter study of potential DCD donors was undertaken to evaluate the time to death and identify associated factors. One hundred and ninety-one potential adult DCD donors at nine UK centers were studied. Treatment withdrawal comprised stopping ventilator support and inotropes. Demographics and physiological variables at the time of death were recorded. Following treatment withdrawal, all potential donors died, with median time to death of 36 min (range 5 min to 3.3 days). Eighty-three potential donors (43.5%) remained alive 1 h after treatment withdrawal, and 69 (36.1%) and 54 (28.3%) at 2 and 4 h, respectively. Univariate analysis revealed that age, cause of death, ventilation mode, inotrope use, systolic blood pressure, FiO2 and arterial pH at treatment withdrawal were all associated with time to death. Multivariable analysis showed that younger age, higher FiO2 and mode of ventilation were independently associated with shorter time to death. This information may aid planning and resourcing of DCD organ recovery and help maximize DCD donor numbers. [source] Undulating toe movements in brain death,EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2004G. Saposnik For many years, death implied immobility. Nevertheless, there are anecdotal reports of spontaneous or reflex movements (SRMs) in patients with Brain death (BD). The presence of some movements can preclude the diagnosis of BD, and consequently, the possibility of organ donation for transplantation. McNair and Meador [(1992), Mov Dord7: 345,347] described the presence of undulating toe flexion movements (UTF) in BD patients. UTF consists in a sequential brief plantar flexion of the toes. Our aim was to determine the frequency, characteristics and predisposing factors of UTF movements in a prospective multicenter cohort study of patients with BD. Patients with confirmed diagnosis of BD were assessed to evaluate the presence of UTF using a standardized protocol. All patients had a routine laboratory evaluation, CT scan of the head, and EEG. Demographic, clinical, hemodynamic and blood gas concentration factors were analyzed. amongst 107 BD patients who fulfilled the AAN requirements, 47 patients (44%) had abnormal movements. UTF was observed in 25 (23%) being the most common movement (53%). Early evaluation (OR 4.3, CI95% 1.5,11.9) was a predictor of UTF in a multivariate regression model. The somato-sensory evoked potential (SSEPs) as well as brainstem auditory evoked potentials (BAEPs) did not elicit a cortical response in studied patients with UTF. This spinal reflex is probably integrated in the L5 and S1 segments of the spinal cord. Abnormal movements are common in BD, being present in more than 40% of individuals. UTF was the most common spinal reflex. In our sample, early evaluation was a predictor of UTF. Health care professionals, especially those involved in organ procurement for transplantation, must be aware of this sign. The presence of this motor phenomenon does not preclude the diagnosis of BD. [source] Exploring Chronically Ill Seniors' Attitudes About Discussing Death and Postmortem Medical ProceduresJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2005Henry S. Perkins MD Proxy decisions about postmortem medical procedures must consider the dead patient's likely preferences. Ethnic-and sex-based attitudes surely underlie such preferences but lack sufficient characterization to guide decisions. Therefore, this exploratory study interviewed Mexican-American, Euroamerican, and African-American seniors in San Antonio, Texas, for their attitudes about discussing death before it occurs and about organ donation, autopsy, and practice on cadavers. A rigorous content analysis identified themes. Majority attitudes of an ethnic group or sex subgroup here may characterize the group generally. Attitudes about discussing death differed only by ethnic group. Mexican Americans and Euroamericans favored such discussions, but African Americans did not. Attitudes about the postmortem procedures differed by ethnic group and sex. Overall, Mexican Americans viewed the procedures most favorably; Euroamericans, less so; and African Americans, least so. Men and women differed further within ethnic groups. Mexican-American men and women split evenly over organ donation, the men expressed no majority preference about autopsies and the women agreed to them, and the men refused and the women agreed to practice on their cadavers. Euroamerican men expressed no majority preferences, but Euroamerican women agreed to organ donation, had no majority preference about autopsies, and refused practice on their cadavers. African-American men expressed no majority preferences, and African-American women expressed none about organ donation or autopsies but refused practice on their cadavers. If confirmed, these ethnic- and sex-based attitudes can help health professionals tailor postmortem care to individual patients' preferences. [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] Student and community perceptions about organ donors, non-donors and transplant recipientsJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2009Melissa K. Hyde Abstract Despite efforts to encourage organ donation, low organ donation rates in Australia and other Western nations do not meet the demand for transplantable organs. One influence on organ donation decision-making yet to be fully explored is that of prototype perceptions about organ donors, non-donors and transplant recipients. We conducted focus groups and interviews with 54 student and community participants to explore these perceptions of donors and non-donors in a living and posthumous context, as well as transplant recipients. Using content and thematic analysis, transcripts were analysed for consistently emerging themes. Donors were generally perceived positively as altruistic and giving and as ordinary people; however, some participants questioned the motives of living anonymous donors. Non-donors were commonly viewed negatively as self-absorbed and unaware, with living-related non-donors particularly perceived as cold-hearted and weak. Transplant recipients were generally viewed sympathetically (unfortunate and unwell); however, many participants also expressed negative views about transplant recipients as responsible for their predicament, depending upon the type of organ transplant needed. To encourage people's willingness to donate their organs, it is crucial to understand the extent to which these perceptions influence organ donation decisions. Copyright © 2008 John Wiley & Sons, Ltd. [source] Social representations of organ donors and non-donorsJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2005Mary Anne Lauri Abstract This paper illustrates the empirical investigation of social representations by means of photographs as stimulus material and the technique of correspondence analysis to study the resulting data. The research was part of a campaign carried out to promote organ donation in Malta. The study tries to find out whether a public communication campaign could change perceptions. Five focus groups were held before the campaign and another five, two months after the campaign. Part of the data collected through these focus groups was analysed using correspondence analysis. The results showed that before the campaign, donors were generally perceived to be either young or important people or public personalities. After the campaign, donors were perceived more to be ordinary family people, educated, generous and religious. On the other hand, before the campaign, non-donors were seen as conservative, uncouth and uncaring, whereas after the campaign non-donors were generally perceived to be older, uninformed and uneducated people. Copyright © 2005 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||