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.

METHODOLOGY

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.

RESULTS

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.

CONCLUSION AND RECOMMENDATION

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.

Human ; Brain Death ; Organ Donation ; Tissue And Organ Procurement ; Knowledge ; Attitude

INTRODUCTION: There are limited reports on the epidemiology of paediatric intensive care unit (PICU) admissions, deaths and organ donation candidacy. We aimed to describe PICU admission characteristics and outcomes, determine risk factors for mortality, and perform an independent assessment of missed organ donation opportunities. METHOD: We adopted a clinical audit design recruiting consecutive patients admitted to a single-centre multidisciplinary PICU from June 2020 to December 2023. Clinical characteristics and outcomes of survivors and non-survivors were described. Multivariable regression was performed to identify independent risk factors for mortality. Organ donation candidacy was evaluated by an independent team based on the criteria by Singapore's National Organ Transplant Unit. RESULTS: There were 1766 PICU admissions with mean age ± standard deviation of 5.9 ± 6.0 years. Surgical admissions accounted for 707/1766 (40%), while the most common medical admission category was respiratory (416/1766; 23.6%). The majority of 983/1766 (55.7%) had a chronic comorbidity and 312/1766 (17.6%) were dependent on at least 1 medical technology device. Mortality occurred in 99/1766 (5.6%). After adjusting for elective admissions and admission category; comorbidity with adjusted odds ratio (aOR) 95% confidence interval (CI) 3.03 (1.54-5.96); higher Pediatric Index of Mortality 3 (PIM 3) score with aOR 1.06 (95% CI 1.04-1.08); and functional status scale with aOR 1.07 (95% CI 1.00-1.13) were associated with mortality. Among non-survivors, organ donor candidacy was 21/99 (21.2%) but successful organ donation occurred in only 2/99 (2.0%). CONCLUSION In this single-centre audit, comorbidities, PIM 3 score and functional impairment were associated with mortality. Efforts are needed to improve paediatric organ donation rates.
Humans ; Male ; Female ; Tissue and Organ Procurement/statistics & numerical data* ; Intensive Care Units, Pediatric/statistics & numerical data* ; Child, Preschool ; Child ; Infant ; Singapore/epidemiology* ; Risk Factors ; Patient Admission/statistics & numerical data* ; Hospital Mortality ; Adolescent ; Medical Audit ; Comorbidity ; Clinical Audit

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

Organ transplantation is the most effective treatment for end stage organ failure,and voluntary donation after citizen's death is the only source of transplanted organ in China.Clinically,transplantation organ protection technology plays a critical role in improving the quality of transplantation organs and the prognosis of recipients.On the basis of domestic and worldwide basic research and clinical practice and according to the Oxford evidence classification and GRADE system,the experts organized by Organ Transplantation Doctor Branch of Chinese Medical Doctor Association,Organ Transplantation Group in Surgery Branch of Chinese Medical Association and China Liver Transplant Registry Scientific Committee had compiled and published the Chinese Expert Consensus on Organ Protection of Transplantation(2016 edition) for liver,kidney,pancreas,small intestine,heart,lung transplantation organs.With the support of China Liver Transplant Registry,National Center for Healthcare Quality Management in Liver Transplant,National Quality Control Center for Donated Organ Procurement,National Clinical Research Center for Orthopedics & Sports Medicine & Rehabilitation and National Trauma Medical Organ Protection Committee and combined with recent domestic and worldwide clinical practice and research progress for organ transplantation and organ protection,the Chinese Expert Consensus on Organ Protection of Transplantation(2022 edition)(hereinafter referred to as the consensus) has been formulated in 2022.This edition of the consensus focuses on updating the technical progress and evidence-based medicine of organ procurement,organ preservation,organ transport,and quality evaluation in clinical practice.Additionally,protection of composite tissue for transplantation,mainly including limb graft,has also been included.The organ protection strategy recommended in this consensus aims to promote scientific and standardize clinical organ transplantation work.
Asians ; Consensus ; Humans ; Organ Preservation ; Organ Transplantation ; Registries ; 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

PURPOSE: This study was conducted to examine the effects of an intervention program for human tissue donation with nurses, modified from the Korea Foundation for Human Tissue Donation, to promote human tissue donation via nurses' knowledge and attitudes toward human tissue donation, and self-efficacy for teaching tissue donation. METHODS: A non-equivalent control group quasi-experimental design was adopted, and data were collected from 82 nurses (41 of each group: experimental and comparison) working at a general hospital in Inchon, South Korea. RESULTS: In a multivariate analysis (MANOVA), the integrative effect on outcome variables from the intervention program was statistically significant (p<.001). Accordingly, an ANOVA was performed to determine which individual outcome variable showed a significant effect with intervention, and it was found that the effects of intervention on all the outcome variables (knowledge and attitude, and self-efficacy for teaching human tissue donation) were significant (p<.001). CONCLUSION: The results of the study showed that the intervention had positive effects on knowledge and attitudes toward tissue donation, and self-efficacy for teaching tissue donation among nurses. These outcome variables derived from the intervention might be essential for eliciting positive behavior toward human tissue donation.
Education ; Hospitals, General ; Humans ; Incheon ; Korea ; Multivariate Analysis ; Tissue and Organ Procurement

BACKGROUND: Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process. METHODS: A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs. RESULTS: The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (±15.3). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (±14 hours 50 minutes) and 22 hours 57 minutes (±16 hours 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%). CONCLUSIONS: When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.
Anoxia ; Brain Death ; Brain ; Craniocerebral Trauma ; Electroencephalography ; Facial Transplantation ; Female ; Humans ; Korea ; Male ; Organ Transplantation ; Retrospective Studies ; Surgeons ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation ; Transplants

Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intensive Care Units ; statistics & numerical data ; Male ; Middle Aged ; Organ Transplantation ; psychology ; statistics & numerical data ; Surveys and Questionnaires ; Tissue and Organ Procurement ; statistics & numerical data ; Young Adult

ObjectiveTo investigate the relationship of the characteristics of sperm donors with the results of screening and provide some reference for the screening of sperm donors.

METHODSWe statistically analyzed the screening data about 12 362 sperm donors at the Guangdong Human Sperm Bank from January 2003 to June 2017 and the relationship of the eligibility rate of screening with the donors' age, education, occupation, marriage, and fatherhood.

RESULTSOf the 12 362 sperm donors, 3 968 (32.1%) met the standards of semen quality and 3 127 (25.3%) filled all the requirements of sperm donation. The eligibility rate of screening was 27.7% in the donors aged 20－24 years, 24.3% in those aged 25－29 years, 23.8% in those aged 30－34 years, and 17.5% in those aged =≥35 years (P < 0.01); 23.5% in the senior high school students, 24% in the junior college students, 25.9% in the undergraduates, and 30.3% in the postgraduates (P < 0.01); 29.3% in the students versus 22.9% in the others (P < 0.01), 41.5% in the married versus 20.7% in the unmarried (P < 0.01), and 45.6% in the fathers versus 20.9% in the childless husbands (P < 0.01).

CONCLUSIONSA higher eligibility rate of screening was found among the sperm donors aged <35 years or with a bachelor's or higher degree, particularly among students.

Adult ; Humans ; Male ; Semen Analysis ; standards ; Spermatozoa ; Students ; statistics & numerical data ; Tissue Donors ; statistics & numerical data ; Tissue and Organ Procurement ; Young Adult

Deceased organ donation in Korea has increased steadily after legislation of transplantation law. Since last year, however, several obstacles resulting in a decrease in organ donation have been experienced. Among them, the reduced reporting of potential brain death from large size hospitals and reduced consent rate of medically available deceased donors are two main hurdles. The consent rate of organ donation was 41.9% in 2017 but has dropped to approximately 10% than 2016. Other strong family members overrode approximately 10% of donations initially consented by their next of kin. In addition to the medical points, difficulties in labor shortage are being experienced during donor management, testing and organ recovery in the hospital. Some end stage patients who are candidates as organ donor give up further management and decide to withdrawing life sustaining treatment, which deprive the chance of donation. Moreover, the national mortality rate of cerebrovascular and traffic accidents, which occupy a major part of brain death, have decreased over the recent 10 years. All of these events can cause a decrease in brain death development so it is important to find solutions to overcome all of them. Revising transplant law and donation system should be led by government. Efforts to increase the consent rate, procurement rate, and transplant rate and decrease the organ discard rate are all the responsibility of the medical team. Public awareness and a positive attitude towards organ donation are the most important basic requirements for increasing organ donation. A comprehensive task force team to overcome all of these problems is requested.
Accidents, Traffic ; Advisory Committees ; Brain Death ; Humans ; Informed Consent ; Jurisprudence ; Korea* ; Mortality ; Organ Transplantation ; Tissue and Organ Procurement* ; Tissue Donors ; Waiting Lists