|
1
|
Shafer TJ, Ehrle RN, Davis KD, Durand RE, Holtzman SM, Van Buren CT, Crafts NJ, Decker PJ. Increasing Organ Recovery from Level I Trauma Centers: The In-House Coordinator Intervention. Prog Transplant 2016; 14:250-63. [PMID: 15495785 DOI: 10.1177/152692480401400311] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Daily presence of organ procurement organization staff in level I trauma centers combined with early family contact and interaction can increase donation rates. Methods A successful in-house coordinator program already in place at 2 level I trauma centers in Houston was replicated in 6 other level I trauma centers in New York City, Los Angeles, and Seattle. Organ procurement organization staff were placed inside the 8 trauma centers to provide early family support in potential donor situations and day-to-day donation system management. Comparison data were obtained on 83 level I trauma centers nationally. Data from 1999 to 2000 were compared with data from 2001 to 2002. Results Despite demographic differences, the 8 centers with in-house coordinators had higher consent rates (60% vs 53%) and conversion rates (55% vs 45%) than centers without them. Conversion of potential to actual donors was 22% higher in centers with in-house coordinators than in centers without them. Donation rates were affected by donor age, ethnicity, previous family discussion of donation, the family's initial reaction to the request (favorable, unfavorable, undecided), amount of time family spent with the in-house coordinator, presence of the in-house coordinator during explanation of brain death, whether the request was made at the same time as the brain-death explanation, and, in cases where donation was mentioned to the family before the formal request, who first mentioned donation to the family. Conclusions In-house coordinators improve the donation process by interacting with families and staff earlier and more often during potential organ donations and improving donation systems through closer relationships with hospital staff.
Collapse
|
|
2
|
Abstract
Brain death has specific implications for organ donation with the potential for saving several lives. Awareness on maintenance of the brain dead has increased over the last decade with the progress in the field of transplant. The diagnosis of brain death is clinical and can be confirmed by apnea testing. Ancillary tests can be considered when the apnea test cannot be completed or is inconclusive. Reflexes of spinal origin may be present and should not be confused against the diagnosis of brain death. Adequate care for the donor targeting hemodynamic indices and lung protective ventilator strategies can improve graft quality for donation. Hormone supplementation using thyroxine, antidiuretic hormone, corticosteroid and insulin has shown to improve outcomes following transplant. India still ranks low compared to the rest of the world in deceased donation. The formation of organ sharing networks supported by state governments has shown a substantial increase in the numbers of deceased donors primarily by creating awareness and ensuring protocols in caring for the donor. This review describes the steps in the establishment of brain death and the management of the organ donor. Material for the review was collected through a Medline search, and the search terms included were brain death and organ donation.
Collapse
Affiliation(s)
- Lakshmi Kumar
- Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| |
Collapse
|
|
3
|
Thomas EH, Bramhall SR, Herington J, Draper H. Live liver donation, ethics and practitioners: 'I am between the two and if I do not feel comfortable about this situation, I cannot proceed'. JOURNAL OF MEDICAL ETHICS 2014; 40:157-162. [PMID: 23533055 DOI: 10.1136/medethics-2012-101261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This paper discusses the views of 17 healthcare practitioners involved with transplantation on the ethics of live liver donations (LLDs). Donations between emotionally related donor and recipients (especially from parents to their children) increased the acceptability of an LLD compared with those between strangers. Most healthcare professionals (HCPs) disapproved of altruistic stranger donations, considering them to entail an unacceptable degree of risk taking. Participants tended to emphasise the need to balance the harms of proceeding against those of not proceeding, rather than calculating the harm-to-benefits ratio of donor versus recipient. Participants' views suggested that a complex process of negotiation is required, which respects the autonomy of donor, recipient and HCP. Although they considered that, of the three, donor autonomy is of primary importance, they also placed considerable weight on their own autonomy. Our participants suggest that their opinions about acceptable risk taking were more objective than those of the recipient or donor and were therefore given greater weight. However, it was clear that more subjective values were also influential. Processes used in live kidney donation (LKD) were thought to be a good model for LLD, but our participants stressed that there is a danger that patients may underestimate the risks involved in LLD if it is too closely associated with LKD.
Collapse
Affiliation(s)
- Elin H Thomas
- College of Medical and Dental Sciences, University of Birmingham, , Birmingham, UK
| | | | | | | |
Collapse
|
|
4
|
Sairanen T, Koivisto A, Koivusalo AM, Rantanen K, Mustanoja S, Meretoja A, Putaala J, Strbian D, Kaste M, Isoniemi H, Tatlisumak T. Lost potential of kidney and liver donors amongst deceased intracerebral hemorrhage patients. Eur J Neurol 2013; 21:153-9. [DOI: 10.1111/ene.12288] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/23/2013] [Indexed: 12/21/2022]
Affiliation(s)
- T. Sairanen
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - A. Koivisto
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
- Faculty of Medicine; University of Helsinki; Helsinki Finland
| | - A.-M. Koivusalo
- Intensive Care Unit; Helsinki University Central Hospital; Helsinki Finland
| | - K. Rantanen
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - S. Mustanoja
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - A. Meretoja
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
- Departments of Neurology, Medicine, and the Florey; Royal Melbourne Hospital; University of Melbourne; Melbourne Victoria Australia
| | - J. Putaala
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - D. Strbian
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - M. Kaste
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| | - H. Isoniemi
- Transplantation and Liver Surgery Clinic; Helsinki University Central Hospital; Helsinki Finland
| | - T. Tatlisumak
- Department of Neurology; Helsinki University Central Hospital; Helsinki Finland
| |
Collapse
|
|
5
|
Abstract
Organ transplantation represents one of the great success stories of 20th century medicine. However, its continued success is greatly limited by the shortage of donor organs. This has led to an increased focus within the critical care community on optimal identification and management of the potential organ donor. The multi-organ donor can represent one of the most complex intensive care patients, with numerous competing physiological priorities. However, appropriate management of the donor not only increases the number of organs that can be successfully donated but has long-term implications for the outcomes of multiple recipients. This review outlines current understandings of the physiological derangements seen in the organ donor and evaluates the available evidence for management strategies designed to optimize donation potential and organ recovery. Finally, emerging management strategies for the potential donor are discussed within the current ethical and legal frameworks permitting donation after both brain and circulatory death.
Collapse
Affiliation(s)
- Anna J Dare
- Department of Surgery, Auckland City Hospital, University of Auckland & New Zealand Liver Transplant Unit, Park Road, Grafton, Auckland, New Zealand
| | | | | |
Collapse
|
|
6
|
Smudla A, Mihály S, Hegedüs K, Nemes B, Fazakas J. Help, I Need to Develop Communication Skills on Donation: The “VIDEO” Model. Transplant Proc 2011; 43:1227-9. [DOI: 10.1016/j.transproceed.2011.03.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
|
7
|
Fridell JA, Rogers J, Stratta RJ. The pancreas allograft donor: current status, controversies, and challenges for the future. Clin Transplant 2011; 24:433-49. [PMID: 20384731 DOI: 10.1111/j.1399-0012.2010.01253.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The pancreas allograft is a scarce resource that is currently underutilized. The selection of appropriate deceased donors for pancreas procurement is of paramount importance for minimizing technical failure and optimizing long-term outcomes in pancreas transplantation. Despite the increasing demand for pancreas transplantation, increases in overall organ donation rates and the evolution of criteria that constitute an "acceptable" pancreas donor, the number of deceased donor pancreas transplants being performed in the United States has actually declined in recent years. Although there are many factors that must be considered during evaluation of the potential pancreas allograft donor to minimize morbidity and graft loss, it is evident that there are transplantable organs that are not used. In this review, deceased donor pancreas identification, management, selection, allocation, assessment, preservation, and the problem of pancreas underutilization will be discussed.
Collapse
Affiliation(s)
- Jonathan A Fridell
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | | | | |
Collapse
|
|
8
|
Deulofeu R, Bodí M, Twose J, López P. How to Achieve More Accurate Comparisons in Organ Donation Activity: Time to Effectiveness Indicators. Transplant Proc 2010; 42:1432-8. [DOI: 10.1016/j.transproceed.2009.12.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 12/07/2009] [Indexed: 11/25/2022]
|
|
9
|
Abstract
The systemic physiologic changes that occur during and after brain death affect all organs suitable for transplantation. Major changes occur in the cardiovascular, pulmonary, endocrine, and immunological systems, and, if untreated may soon result in cardiovascular collapse and somatic death. Understanding these complex physiologic changes is mandatory for developing effective strategies for donor resuscitation and management in such a way that the functional integrity of potentially transplantable organs is maintained. This review elucidates these physiological changes and their consequences, and based on these consequences the rationale behind current medical management of brain-dead organ donors is discussed.
Collapse
Affiliation(s)
- J F Bugge
- Division of Anesthesia and Intensive Care, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
| |
Collapse
|
|
10
|
Kwek TK, Lew TWK, Tan HL, Kong S. The Transplantable Organ Shortage in Singapore – Has Implementation of Presumed Consent to Organ Donation Made a Difference. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2009. [DOI: 10.47102/annals-acadmedsg.v38n4p346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
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.
Key words: Brain death, End-of-life, Multi-organ donor, Organ procurement, Opt-out
Collapse
|
|
11
|
Snoeijs MG, van Heurn LE, van Mook WN, Christiaans MH, van Hooff JP. Controlled donation after cardiac death: a European perspective. Transplant Rev (Orlando) 2007. [DOI: 10.1016/j.trre.2007.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
|
12
|
Hevesi ZG, Lopukhin SY, Angelini G, Coursin DB. Supportive Care After Brain Death for the Donor Candidate. Int Anesthesiol Clin 2006; 44:21-34. [PMID: 16832204 DOI: 10.1097/01.aia.0000210798.53007.4b] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Zoltan G Hevesi
- Department of Anesthesiology, University of Wisconsin, Madison, WI 53792, USA
| | | | | | | |
Collapse
|
|
13
|
Abstract
AIM: To introduce the American Pittsburgh’s method of rapid liver procurement under the condition of brain death and factors influencing the quality of donor liver.
METHODS: To analyze 32 cases of allograft liver procurement retrospectively and observe the clinical outcome of orthotopic liver transplantation.
RESULTS: Average age of donors was 38.24 ± 12.78 years, with a male:female ratio of 23:9. The causes of brain death included 21 cases of trauma (65.63%) and nine cases of cerebrovascular accident (28.13%). Fourteen grafts (43.75%) had hepatic arterial anomalies, seven cases only right hepatic arterial anomalies (21.88%), five cases only left hepatic arterial anomalies (15.63%) and two cases of both right and left hepatic arterial anomalies (6.25%) among them. Eight cases (57.14%) of hepatic arterial anomalies required arterial reconstruction prior to transplantation. Of the 32 grafts evaluated for early function, 27 (84.38%) functioned well, whereas three (9.38%) functioned poorly and two (6.25%) failed to function at all. Only one recipient died after transplantation and thirty-one recipients recovered. Four recipients needed retransplantation. The variables associated with less than optimal function of the graft consisted of donor age (35.6 ± 12.9 years vs 54.1 ± 4.3 years, P < 0.05), duration of donor’s stay in the intensive care unit (ICU) (3.5 ± 2.4 d vs 7.4 ± 2.1 d, P < 0.005), abnormal graft appearance (19.0% vs 100%, P < 0.05), and such recipient problems as vascular thromboses during or immediately following transplantation (89.3% vs 50.0%, P < 0.005).
CONCLUSION: During liver procurement, complete heparization, perfusion in situ with localized low temperature and standard technique procedures are the basis ensuring the quality of the graft. The hepatic arterial anomalies should be taken care of to avoid injury. The donor age, duration of donor’s staying in ICU, abnormal graft appearance and recipient problem are important factors influencing the quality of the liver graft.
Collapse
Affiliation(s)
- Guang-Wen Zhou
- Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
| | | | | |
Collapse
|
|
14
|
Cantarovich F. Influence of Socioeconomic and Ethical Factors on People's Behaviour Regarding the Use of Cadaveric Organs. Transplant Proc 2005; 37:539-42. [PMID: 15848449 DOI: 10.1016/j.transproceed.2004.12.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
An organ donation is based on feelings of human solidarity and altruism. This approach, however, has not improved the organ shortage problem. The following suggestions might help to dismantle the persistent barrier linked to organ donation. (1) Society should be aware that during our lifetime we might be as much potential organ recipients as organ donors. (2) Educational campaigns should integrate the notion that cadaver organs are an irreplaceable source of health for every member of society. (3) Communication campaigns should illustrate that in allowing the use of our organs after death, we are, in fact, sharing a chance to prolong health for everybody, including perhaps ourselves. Furthermore, people need to acknowledge that using body parts is acceptable, and part of a tacit agreement between all members of society. Making a live organ donation to which the donor is emotionally related is a pressure-free decision. On the contrary, the donation of cadaver organs is influenced by negative factors. Conversely, self-interest and resistance to offering the body of a loved one to a stranger may make donation much more difficult if the current message is not modified. In an international survey of 242 transplantation professionals, with a 57% response rate, 70% to 83% agreed with this proposal. An international public survey has recently been finished, showing some results about the public's knowledge about religious opinions concerning transplantation, suggesting that religious institutions should assume a leadership role to give information about their positions. On the other hand, partial results concerning public attitudes regarding economic support to organ donation indicate that final data may be of interest. The creation of a Task Force with representatives from the World Health Organization, UNESCO, churches, and leaders of the global transplantation community may be key to joint efforts as a means to modify negative attitudes, to develop a new philosophy, and to deliver a new message to society.
Collapse
Affiliation(s)
- F Cantarovich
- Hôpital Necker, Service de Transplantation, Paris, France, and Catholic University, Buenos Aires, Argentina.
| |
Collapse
|
|
15
|
Affiliation(s)
- Kenneth E Wood
- Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, USA.
| | | | | | | | | |
Collapse
|
|
16
|
Shafer T, Ehrle R, Davis K, Durand R, Holtzman S, Van Buren C, Crafts N, Decker P. Increasing organ recovery from level I trauma centers: the in-house coordinator intervention. Prog Transplant 2004. [DOI: 10.7182/prtr.14.3.m53x682544262207] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
|
17
|
Manyalich M, Cabrer C, Valero R, Paredes D, Navarro A, Trias E, Vilarrodona A, Ruiz A, Rodriguez C, Paez G. Transplant procurement management: a model for organ and tissue shortage. Transplant Proc 2004; 35:2533-8. [PMID: 14612004 DOI: 10.1016/j.transproceed.2003.09.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Manyalich
- Hospital Clínic, Transplant Services Foundation, Les Heures. Universitat de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
18
|
López-Navidad A, Caballero F. Extended criteria for organ acceptance. Strategies for achieving organ safety and for increasing organ pool. Clin Transplant 2003; 17:308-24. [PMID: 12868987 DOI: 10.1034/j.1399-0012.2003.00119.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The terms extended donor or expanded donor mean changes in donor acceptability criteria. In almost all cases, the negative connotations of these terms cannot be justified. Factors considered to affect donor or organ acceptability have changed with time, after showing that they did not negatively affect graft or patient survival per se or when the adequate measures had been adopted. There is no age limit to be an organ donor. Kidney and liver transplantation from donors older than 65 years can have excellent graft and patient actuarial survival and graft function. Using these donors can be from an epidemiological point of view the most important factor to esablish the final number of cadaveric liver and kidney transplantations. Organs with broad structural parenchyma lesion with preserved functional reserve and organs with reversible functional impairment can be safely transplanted. Bacterial and fungal donor infection with the adequate antibiotic treatment of donor and/or recipient prevents infection in the latter. The organs, including the liver, from donors with infection by the hepatitis B and C viruses can be safely transplanted to recipients with infection by the same viruses, respectively. Poisoned donors and non-heart-beating donors, grafts from transplant recipients, reuse of grafts, domino transplant and splitting of one liver for two recipients can be an important and safe source of organs for transplantation.
Collapse
Affiliation(s)
- Antonio López-Navidad
- Department of Organ & Tissue Procurement for Transplantation, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | |
Collapse
|
|
19
|
Cantarovich F. Reducing the organ shortage by education and by fostering a sense of social responsibility. Transplant Proc 2003; 35:1153-5. [PMID: 12947892 DOI: 10.1016/s0041-1345(03)00129-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- F Cantarovich
- Department of Transplantation, Necker Hospital, 14, rue Fantin Latour, 75016 Paris, France
| |
Collapse
|
|
20
|
Shafer TJ, Davis KD, Holtzman SM, Van Buren CT, Crafts NJ, Durand R. Location of in-house organ procurement organization staff in level I trauma centers increases conversion of potential donors to actual donors. Transplantation 2003; 75:1330-5. [PMID: 12717225 DOI: 10.1097/01.tp.0000060532.70301.32] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Of 5810 acute care hospitals in the United States, only 3.9% (231) are Level 1 Trauma Centers (L1TCs). L1TCs have a significant number of potential organ donors (PODs). Placement of Organ Procurement Organization (OPO) staff, In House Coordinators (IHCs), directly within the L1TC to increase the number of families who consent to donate and to provide system management for the trauma center's donation program, was evaluated. METHODS Four OPO staff, IHCs, were placed in offices inside two L1TCs in Houston, Texas. The IHCs were responsible for development of a donation system, donor surveillance, management, and most importantly, family support. RESULTS Calendar year 2000 data on conversion of PODs to actual donors were compared between the L1TCs with IHCs (IHC-L1TC) (n=2) and trauma centers without IHCs (n=4) within the OPO's service area. IHC-L1TCs converted 44% more of the PODs to actual donors. Furthermore, the IHC-L1TCs were compared with 85 L1TCs (37% of U.S. L1TCs) without IHCs. IHC-L1TCs had a 28% greater donor consent rate and a 48% greater conversion rate of PODs to actual donors than the national L1TCs. CONCLUSIONS L1TC status is the America College of Surgeons' highest level of verification for trauma care. To be certified as a L1TC, hospitals must meet strict criteria in both services and patient care. The donation process is often profoundly affected by the burden of demands made on the resources of these institutions and from divergent responsibilities between specialty services within the facility. Dedicated IHCs (OPO staff) are needed to provide early family intervention and to orchestrate the donation process to maximize organ recovery.
Collapse
|
|
21
|
Affiliation(s)
- F Cantarovich
- Department of Transplantation, Necker Hospital, Paris, France
| |
Collapse
|
|
22
|
Affiliation(s)
- F Cantarovich
- Sérvice de Transplantation et Réanimation, Hôpital Nécker, Paris, France
| |
Collapse
|
|
23
|
Frutos MA, Ruiz P, Requena MV, Daga D. Family refusal in organ donation: analysis of three patterns. Transplant Proc 2002; 34:2513-4. [PMID: 12431506 DOI: 10.1016/s0041-1345(02)03469-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M A Frutos
- Transplant Coordination Service, Malaga Sector, Malaga, Spain.
| | | | | | | |
Collapse
|
|
24
|
Tuncer M, Gürkan A, Yücetin L, Ersoy F, Demirbaş A, Akaydin M, Yakupoglu G. Evaluation of transplantation in one center: Akdeniz University model. Transplant Proc 2002; 34:2012-3. [PMID: 12270295 DOI: 10.1016/s0041-1345(02)02833-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M Tuncer
- Akdeniz University, Antalya, Turkey.
| | | | | | | | | | | | | |
Collapse
|
|
25
|
Abstract
Given the persisting shortage of organs for transplantation, it is time to consider whether the message that is sent to society to encourage donation is unsuitable. This message is mainly based on altruism and solidarity, and it has failed. Patients die because of the lack of cadaver organs that society refuses to offer; paradoxically, society is denying itself a chance of life. The reasons for this enigma are (1) lack of awareness that transplantation is a common practice; (2) the persistence of the "cult of dead body integrity;" and (3) the myths surrounding transplantation.A pathway to solving this organ shortage may be education, to make society understand their need of organs for transplantation and its role to resolve this necessity. It should focus on youth but must also reach adults, through their children receiving this education, or from the media or other sources. It should erase the concept of integrity of the cadaver and establish that using cadaver organs means sharing and guaranteeing a source of health for humanity.Similarly, a new message should stress that "using" cadaver organs means "sharing a source of health for humankind." Rather than "a gift of life" we should convey the idea of "sharing a social right and obligation" or that "My decision today assures my and my family health tomorrow."
Collapse
Affiliation(s)
- Felix Cantarovich
- Service de Transplantation et de Reanimation, Hopital Necker, 14 rue Fantin Latour, 75016 Paris, France
| |
Collapse
|