INTRODUCTION

Brain death occurs in patients who suffer from severe brain injuries, leading to coma, loss of brainstem reflexes, and apnea. Research indicates that misdiagnosis of brain death often arises from insufficient adherence to established guidelines. This study aims to evaluate and identify any significant variations in physicians' knowledge, attitudes, and practices regarding brain death and organ donation.

This cross-sectional study was conducted among physicians using random sampling. The questionnaire was validated prior to distribution. After obtaining informed consent, participants completed the questionnaire. Data analysis involved the use of frequency and distribution tables, as well as analysis of variance and multivariate analysis of variance.

A total of 113 participants were involved in the study. While years of experience and position influenced knowledge, field of specialization did not show a significant effect. Overall, attitudes remained consistent across different levels of experience and positions. The data revealed a notable lack of training and institutional resources. Although there were some differences in practices, they were not statistically significant.

Significant differences in knowledge were observed based on years of practice. However, no significant differences were found in attitudes and practices, despite variations in responses. Regular seminars and workshops are crucial for staying updated with the latest guidelines. Additionally, it is important to ensure that local guidelines are readily accessible to the broader medical community.

The success of solid organ transplantation in the treatment of end-stage organ failure has fuelled a growing demand for transplantable organs worldwide that has far outstripped the supply from brain dead heart-beating donors. In Singapore, this has resulted in long waiting lists of patients for transplantable organs, especially kidneys. The Human Organ Transplant Act, introduced in 1987, is an opt-out scheme that presumes consent to removal of certain organs for transplantation upon death. Despite this legislation, the number of deceased organ donors in Singapore, at 7 to 9 per million population per year, remains low compared to many other developed countries. In this paper, we reviewed the clinical challenges and ethical dilemmas encountered in managing and identifying potential donors in the neurological intensive care unit (ICU) of a major general hospital in Singapore. The large variance in donor actualisation rates among local restructured hospitals, at 0% to 56.6% (median 8.8%), suggests that considerable room still exists for improvement. To address this, local hospitals need to review their processes and adopt changes and best practices that will ensure earlier identification of potential donors, avoid undue delays in diagnosing brain death, and provide optimal care of multi-organ donors to reduce donor loss from medical failures.
Brain Death ; Donor Selection ; Humans ; Intensive Care Units ; Presumed Consent ; ethics ; Referral and Consultation ; Singapore ; Terminally Ill ; Tissue and Organ Procurement ; organization & administration ; Waiting Lists

We analyzed the predonation tests and the characteristics of plateletpheresis of the candidates and donors during 18 month at Korea University Guro Hospital from 1993 to 1995. Among the 810 candidates tested for predonation tests, 115(14.2%) candidates were deferred due to incompatible factors. The most common incompatible factor is elevated alanine aminotransferase(4.6%, ALT > 64 Iu) followed by incompatible ABO discrepancy (4.1%), positive HBsAg(3.3%), low platelet count(2.2%). 43.1 percent of the platelet donation candidates were processed plateletpheresis. 43(18%) of prospectively reviewed 240 plateletpheresis donors were relatives of the recipients. The percent of redonation was only 14% and its mean interval was 11.4 days. The result showed the plateletpheresis candidates have the relatively safety compared to that of the directed donation, social support of plateletpheresis donation program is strongly needed because of low redonation rate and characteristics of plateletpheresis donation.
Alanine ; Blood Platelets ; Directed Tissue Donation ; Fibrinogen ; Humans ; Korea ; Plateletpheresis* ; Prospective Studies ; Tissue Donors*

Tissue and Organ Procurement

Background: Most countries around the world have experienced a shortage in organs needed for transplantation. Organ donation performance is widely attributed to two important factors: the legislation and the role of the family. Thus, this literature review aims to examine the willingness of people for organ donation while highlighting the importance of having a presumed consent system. Methodology: In this study, we explored many papers of which 10 articles were studied to gain conclusive understanding of the two factors and their interactions. Results: Our analysis of literature regarding the legislation and family response showed that the presumed consent system for organ donation accounted for 21 – 30% higher organ donation rates than the informed consent system. We also found a gap between the willingness of people to donate their own and their relatives’ organs. The ratio of people willing to donate their organs after death was estimated to be 10 – 12% higher than the ratio of those willing to donate their relatives’ organs. Furthermore, the study revealed the importance of a presumed consent system in raising the willingness of the people and their relatives for donation, but that did not eliminate the gap. Conclusion: Countries seeking to overcome organ shortage and increase organ donation rates by moving towards the presumed consent system should consider the importance of providing families with proper information about this system. The fact that a gap between the willingness of the people to donate their own as well as their deceased relatives’ organs exists, has to be conveyed to the governments, which will be helpful in optimising organ donation rates.
Tissue and Organ Procurement

Background: Some argue that Malaysia’s extremely low organ donation rate is attributed to religion, specifically Islam. Testing this argument, this study asked Malaysian Muslims their views regarding various issues on organ donation and examined whether their decisions to donate organs are framed by religious beliefs. Materials and Methods: This study investigated the perspectives of Malaysian Muslims between October and December 2013 in Kuala Lumpur. Self-administered questionnaires were distributed to 900 people, with 829 responses collected (92% response rate). Respondents’ verbal consent was taken before proceeding with the survey. Results: The survey found that more than half of respondents felt that organ donation is permitted in Islam and that it is a communal responsibility. However, the same proportions were unsure on the issues of rewards for organs or on whether Islam permits the procuring of organs from brain dead patients. Conclusions: Malaysian Muslims are not against organ donation; however, encouraging organ donation requires the state to address public concerns on Islam’s views on this sensitive issue through effective policy tools to help address these gaps in Malaysian Muslims’ understanding of organ donation. The organ donation rate could improve by using Islamic scholars as ambassadors for an organ donation drive to convey the message of Malaysia’s urgent need for organ donation.
Tissue and Organ Procurement

PURPOSE: The aim of this study was to identify the process of experience toward decision making to donate organs. METHOD: Eleven subjects who registered at the Association for Organ Sharing in Korea were recruited. Using in-depth interviews and tape-recordings, data was collected from Jun. 2001 to Feb. 2002 and the contents of these were analyzed by Glaser's grounded theory analysis method. RESULT: Basic Social- Psychological Problem(BSPP) of subjects were 'attachment to body' and the core theme, that is Basic Socialization Progress(BSP) were discovered to 'find out what is the meaning of life'. Also it consisted of four steps: 1st 'hesitate', 2nd 'look into self', 3rd 'realize the tie up to self' and last 're-find the meaning of life'. CONCLUSION: These findings indicate the Korean's Basic Socialization Progress of decision making regarding organ donation, so possible development of promoting decision making is necessary strategies for people who is having his/her potential of organ donation in mind.
Decision Making* ; Korea ; Socialization ; Tissue and Organ Procurement

China ; Death ; Humans ; Tissue and Organ Procurement

Background: Organ donation (OD) is the major component for transplant programs. The need for the transplants is high and the gap between organs available for transplantation and the number of patients waiting for a transplant is widening globally. Nurses can play a vital role in promoting organ donation process that may influence the decision-making of donors and their families Objective: This study sought to determine the knowledge and attitudes of nurses in Southern Philippines Medical Center on organ donation. Methodology: A descriptive survey design was used in this study. Sample size computation was done in Epi Info version 7.1.4.0. A modified Organ Donor Attitude Questionnaire based on the previous study by Bishop was utilized. Results: The mean score for question pertaining to knowledge of the 268 participants was 6.34 ± 1.99 out of total of 10 points. A total of 138/268 (51.49%) participants have scores above the average score accumulated by the participants of the study. The overall mean attitude of respondents towards organ donation was 3.25 which is interpreted as undecided. Conclusion Nurses do not have adequate knowledge and attitude towards their role in OD process. There is a need to increase the nurses’ level of knowledge by exposing them to nursing courses to improve knowledge and attitudes.
Knowledge ; Attitude ; Tissue and Organ Procurement ; Nurses

In the Philippines, organ donation is regulated under the Organ Donation Act (RA7170) and promoted by the Department of Health through the Philippine Network for Organ Sharing (PHILNOS). The number of organ donors to meet the increasing demand in the country continues to lag. The emergency department (ED) was identified in several foreign studies to be a significant source of successful organ donation. This action research project investigated the attitude and perception of 125 ED healthcare workers (HCWs) from three hospitals in Metro Manila before and after an awareness event. The study reveals that ED nurses and doctors are generally supportive and hold positive perceptions and attitudes toward organ donation. Despite the positive attitude, HCWs seem to be uncomfortable or unwilling to perform tasks important to organ donation such as approaching relatives and management of the deceased organ donor. Future training on organ donation will increase the positive attitude, confidence and likelihood to participate in organ donation and transplant activities.
Tissue and Organ Procurement ; Emergency Service, Hospital