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L Mendonça, L Martínez-Alarcón,
A Ríos,
G Ramis,
J J Quereda,
J M Abellaneda,
A Saez-Acosta,
J M Herrero,
A Muñoz,
P Ramírez,
P Parrilla
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ABSTRACT: The shortage of organs has made it necessary to search for new alternatives such as xenotransplantation. However, the use of animal organs could be opposed by society and the personnel involved in its implementation. This study aimed to analyze the attitude of veterinary degree students in a Brazilian university towards xenotransplantation, to determine factors that affect its acceptance, and to compare the attitudes among a control group of veterinary degree students in a Spanish university.
Of the 422 students registered for a veterinary course from 2010 to 2011, 374 were surveyed with a questionnaire completion rate of 89%. Attitudes were evaluated using a validated questionnaire that was self-administered administered anonymously. The process was coordinated by an independent health care worker. We applied the student t and the chi-squared-tests for statistical analysis.
If xenotransplantation was confirmed as a clinical reality, 90% (n = 338) of Brazilian students would accept the use of a xenotransplanted organ; 94% (n = 350), tissue; and 97% (n = 360), cell xenotransplantation. Attitudes toward xenotransplantation were not determined by the academic year, any psychosocial variable, or attitudes toward deceased human organ donation (P = .167). However, the attitudes would be affected by a belief that the transplanted animal organ would not change anything (P = .001). Interaction with other people was also related to more favorable attitudes (P = .015). Subjects who expressed a more favorable attitude tended to more readily accept cell (P = .000) or tissue xenotransplantation (P = .000). In Spain (control group), the results were similar: 91% (n = 436) would accept a xenotransplantation; 95% (n = 457) tissue; and 97% (n = 467), cell xenotransplantation. Also, this attitude was not affected by the academic year, any psychosocial variable, or attitude toward organ donation (P = .779).
Both Brazilian and Spanish veterinary students had favorable attitudes toward xenotransplantation.
Transplantation Proceedings 04/2013; 45(3):1046-9. · 1.00 Impact Factor
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A Ríos,
A López-Navas,
M A Ayala-García,
M J Sebastián,
A Abdo-Cuza,
B Febrero,
E J Ramírez,
G Muñoz,
G Palacios,
J Suárez-López,
R Castellanos,
J S Rodríguez,
M A Martínez,
A Nieto, L Martínez-Alarcón,
G Ramis,
P Ramírez,
P Parrilla
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ABSTRACT: Current liver donation rates are insufficient to cover transplant needs. Therefore, it is essential to promote living liver donation (LLD) given the ever decreasing morbidity and mortality in the donor and the improving results in the recipient. LLD is becoming increasingly accepted. However, in the health care system, a percentage of the personnel are not in favor.
To analyze the attitude of personnel in surgical services in Spain and Latin-America hospitals toward LLD.
As part of the "International Collaborative Donor Project," a random sample was taken and stratified according to surgical service and job category in 10 hospitals; three in Spain, five in Mexico, and two in Cuba (n = 496). Attitude was evaluated using a validated survey that was completed anonymously and self-administered.
Eighty-six percent (n = 425) of respondents were in favor of related living liver donation, and 30% (n = 147) were in favor if it were not related. According to country, 88% of the Mexican respondents were in favor of living liver donation, 85% of the Cubans, and 82% of the Spanish (P > .05). In the multivariate analysis of the variables with most weight affecting attitude toward LLD, the following significant associations were found: (1) a favourable attitude toward living kidney donation (odds ratio [OR] = 91; P < .001); (2) acceptance of a donated living liver if one were needed (OR = 11; P < .001); and (3) family discussion about donation and transplantation (OR = 2.581; P = .037).
Attitude toward related living liver donation was very favorable among hospital personnel in Spanish and Latin American surgical services.
Transplantation Proceedings 07/2012; 44(6):1482-5. · 1.00 Impact Factor
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A Ríos,
A López-Navas,
M A Ayala-García,
M Sebastián,
B Febrero,
E J Ramírez,
G Muñoz,
G Palacios,
J S Rodríguez,
M A Martínez,
A Nieto, L Martínez-Alarcón,
G Ramis,
P Ramírez,
P Parrilla
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ABSTRACT: Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis.
As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis.
Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001).
The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public.
Transplantation Proceedings 07/2012; 44(6):1479-81. · 1.00 Impact Factor
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ABSTRACT: The infant and youth population constitutes a sector in which early awareness is important to increase favorable attitudes toward donation. Objectives were as follows: (1) to analyze the attitudes of adolescents toward living organ donation; and (2) to determine the psychosocial variables affecting them.
In Southeast of Spain a random sample was stratified according to Compulsory Secondary Education (CSO) school. In the 10 selected schools we performed a random sampling of each of the classes from the first to the fourth year of CSO. Attitudes were evaluated using a validated questionnaire lowering psychosocial aspects of donation. The self-administered questionnaire was completed anonymously. Statistical analyses employed Student t test and the χ(2) test.
Regarding living kidney donation, 89% (n = 3146) of adolescents favored it, although only 29% (n = 1035) in unrelated cases. For living liver donation, 78% (n = 2753) were in favor of related donation, but only 19% (n = 668) were in favor if it was unrelated. The favorable attitude toward living donation was mainly associated with the following variables: (1) being a woman; (2) having previous experience with the donation-transplantation process; (3) having spoken about the matter of donation and transplantation with family and friends; (4) a favorable attitude of one's mother and father; (5) concern about possible bodily mutilation after donation; and (6) having performed pro-social type activities (P < .05).
Related living donation is well accepted among adolescents on the Southeast of Spain. There was a high acceptance of unrelated living donation compared with studies published in other geographic areas.
Transplantation Proceedings 07/2012; 44(6):1489-92. · 1.00 Impact Factor
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ABSTRACT: The concept of brain death (BD) is not very well known in the population, and its unknown nature is one of the main factors that could lead to an attitude against organ donation. The teaching sector has an important influence on the education of adolescents, and for this reason the teacher's knowledge of these concepts is fundamental to spread the correct meaning of the concept to young people.
To analyze the concept of BD among teachers of compulsory secondary education (CSE) in southeast Spain and to determine teachers' influence on attitude toward organ donation.
Ten CSE level schools were selected and stratified according to geographical location in southeast spain. A random sample was taken of CSE teachers. The knowledge of the concept of BD and attitude toward donation were analyzed using a validated questionnaire, which was self-administered and completed anonymously.
Sixty-four percent (n = 180) of respondents knew the BD concept and they considered it to be the death of an individual. Of the rest, 34% (n = 95) did not know this concept, and the remaining 3% (n = 8) believed it did not mean a person's death. Those who understood the concept of BD were more in favor of deceased donation than those who held the wrong concept (82% versus 75%; P < .01). The knowledge of the concept of BD is associated with variables directly and indirectly related with donation and transplantation (P < .05).
A third of the CSE teaching staff did not know or understand the BD concept as the death of an individual. The knowledge of BD positively affects attitude toward organ donation. Given that teachers are a source of information, the basic training of CSE teaching staff in basic concepts such as BD would be important.
Transplantation Proceedings 07/2012; 44(6):1486-8. · 1.00 Impact Factor
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A López-Navas,
A Ríos,
F J Moya-Faz,
B Febrero,
M I Jiménez-Morales,
F J Orteso,
A Ros-Martínez, L Martínez-Alarcón,
J A Pons,
M Miras,
P Ramírez,
P Parrilla
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ABSTRACT: Patients with toxic substance abuse syndrome, such as alcohol abuse, have elevated psychopathologic morbidity and mortality such as mood disorders.
To evaluate the emotional-type psychopathologic symptoms in patients with alcohol-induced hepatic cirrhosis on the liver transplant waiting list.
Patients with alcoholic liver cirrhosis who were candidates for liver transplant (n = 41) completed the SA-45 questionnaire (González y Cuevas; 88), which assesses nine dimensions: somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A control group consisted of patients with chronic nonalcoholic terminal hepatopathies (n = 22).
Seventy-six percent of patients had some kind of psychopathologic symptom compared to 68% of the patients in the control group with other nonalcoholic etiologies (P > .05). The emotional-type clinical symptoms were: (1) somatizations: 37% of patients with alcoholic cirrhosis had this type of clinical symptoms compared to 32% of the control group (P > .05); (2) obsessive-compulsivity: 56% versus 46%, respectively (P > .05); (3) interpersonal sensitivity: 19% versus 9%, respectively (P > .05); (4) depression: 54% versus 27%, respectively (P = .045); (5) anxiety: 59% versus 46%, respectively (P > .05); (6) hostility: 29% versus 5%, respectively (P = .021); (7) phobic anxiety: 10% versus 14%, respectively (P > .05); (8) paranoid Ideation: 7% versus 5%, respectively (P > .05); (9) psychoticism: 5% versus 4%, respectively (P > .05).
The patients with alcoholic liver cirrhosis on the liver transplant waiting list had elevated psychopathologic symptoms. Depressive- and hostile-type emotional alterations were most frequent in this type of patients.
Transplantation Proceedings 07/2012; 44(6):1510-2. · 1.00 Impact Factor
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ABSTRACT: The liver is a privileged organ with a lower incidence of rejection than other organs. However, immunosuppressive regimens are still required to control the alloreactive T-lymphocyte response after transplantation. These treatments may lead to severe complications, such as infectious diseases, cancers, cardiovascular diseases, and chronic renal insufficiency. In clinical transplantation, there is increasing evidence that some liver transplant recipients who cease taking immunosuppressive drugs maintain allograft function, suggesting that tolerance is already present. This strategy is feasible in 25% to 33% of liver transplant recipients. Few of the studies performed so far have provided a detailed analysis of the impact of immunosuppression (IS) withdrawal on pre-existing complications derived from the long-term administration of immunosuppressive drugs and the side effects associated with it. In preliminary studies, IS withdrawal was safely achieved in selected liver transplant patients, and improved not only kidney function, but also other IS-associated side-effects such as hypercholesterolemia, hyperuricemia, hypertension, and diabetes control. However, longer follow-up periods are needed to confirm the benefits of IS withdrawal in liver transplant patients.
Transplantation Proceedings 07/2012; 44(6):1530-2. · 1.00 Impact Factor
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J M Abellaneda,
G Ramis, L Martínez-Alarcón,
M J Majado,
J J Quereda,
J M Herrero-Medrano,
L Mendonça,
O García-Nicolás,
M Reus,
C Insausti,
A Ríos,
A López-Navas,
M R González,
F J Pallarés,
A Munoz,
P Ramírez,
P Parrilla
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ABSTRACT: Using a percutaneous ecoguided injection system to obtain chimeric piglets through a less invasive and traumatic technique than previously reported.
The two types of human cells included umbilical cord blood mononuclear elements and mesenchymal stem cells cultured from bone marrow. Four sows at gestational day 50 were anesthetized. A needle was inserted through the skin and uterine wall to reach the peritoneal cavity of the fetuses under continuous ultrasound guidance. Fourteen piglets were injected with various cell concentrations.
All sows carried pregnancies to term yielding 69 piglets, among which 67 were alive and two mummified. Two piglets died during the first 48 hours of life. Chimerism was detected using flow cytometry and by quantitative polymerase chain reaction (q-PCR) to detect Alu gene in blood or tissues samples. The analysis detected blood chimerism in 13 piglets (21%) by flow cytometry and the presence of the human Alu gene in 33 (51%) by q-PCR. The results suggest cell trafficking between littermates after in utero injection.
Transcutaneous echo-guided injection succeeded to produce chimeric piglets without disadvantages to the sow or the fetuses and avoiding abortions or fetal death.
Transplantation Proceedings 07/2012; 44(6):1574-8. · 1.00 Impact Factor
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G Ramis, L Martínez-Alarcón,
M J Majado,
J J Quereda,
L Mendonça,
J M Herrero-Medrano,
J M Abellaneda,
A Ríos,
A López-Navas,
P Ramírez,
A Muñoz
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ABSTRACT: To assess the effect of sodium heparin concentrations on antibody- and complement-mediated cytolysis by means of a real-time cell analyzer system (RTCA) investigating the complement regulation ability of heparin to reduce or prevent hyperacute in an in vitro model of pig-to-baboon xenotransplantation.
Fibroblasts isolated from the skin of two transgenic pigs were cultured in microelectronic 96-well plates for 9 hours. Then, we added 20 μL of normal sera from two healthy adult olive baboons (Papio anubis) or two volunteer healthy humans. Simultaneous cultures had added heparin at 3.5, 5, 7.5, 15, and 30 IU. Moreover, rabbit complement was added for the exogenous complement group (ExC) versus the other group only with the complement present in the sera as an endogenous complement group (EnC). Cellular cultures were monitored over 150 hours after challenge. With cellular index (CI) data recorded by the xCELLigence software system, we calculate area under the curve versus concentration (AUC) and minimum CI (CImin) versus concentration.
All cultures showed decreased CI after challenge with human or baboon sera. There was a high correlation for AUC (r(2) > 0.90) and CImin versus concentration (r(2) > 0.970) during the first 40 hours postchallenge among the EnC group, regardless of human or baboon sera. However, there was no correlation for AUC and CImin for the ExC group. There was a reduction of CImin related to increased heparin concentrations.
The addition of heparin did not reduce antibody- and complement-mediated cytolysis assessed in vitro by RTCA in pig-to-baboon compatibility assays.
Transplantation Proceedings 07/2012; 44(6):1584-8. · 1.00 Impact Factor
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ABSTRACT: The risk of zoonoses is a major obstacle to xenotransplantation. Porcine endogenous retrovirus (PERV) poses a potential risk of zoonotic infection, and its control is a prerequisite for the development of clinical xenotransplantation. The copy number of PERV varies among different breeds, and it has been suggested that the PERV integrations number is increased by inbreeding. The purpose of this study was (i) to examine the copy number of PERV in different Spanish pig breeds, Spanish wild boar and commercial cross-bred pigs from five different farms and genetic background (CCP1-CCP5) and (ii) to investigate the correlation between PERV copy number and the genetic background of the pigs in order to improve the selection of pigs for xenotransplantation. PERV copy number was determined by quantitative, real-time polymerase chain reactions. Thirty-four microsatellite markers were genotyped to describe the genetic diversity within populations (observed and expected heterozygosities, Ho and He, respectively) and the inbreeding coefficient (F). Pearson's correlation coefficient was used to determine the relationship between PERV copy number and Ho, He and F. The copy number of PERV among different pig breeds was estimated to range between three (CCP1) and 43 copies (Iberian Pig). Statistical differences were found among the studied populations concerning PERV copy number. No correlation was found between the PERV copy number and the heterozygosity (calculated at an individual level or at a population level) or the inbreeding coefficient of each population. Our data suggest that pigs inbreeding does not increase PERV copy number and support the idea that careful selection of pigs for organ donation with reduced PERV copy number will minimize the risk of retrovirus transmission to the human receptor.
Zoonoses and Public Health 02/2012; 59(6):401-7. · 1.89 Impact Factor
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ABSTRACT: The concept of brain death (BD) is not well understood among the general public, rendering it one of the main psychosocial barriers to favorable attitudes toward donation. Individuals from the British Isles are among the most important migratory groups in southeastern Spain. We sought to analyze the level of understanding of the concept of brain death among the British and Irish populations living in southeastern Spain, and to determine factors affecting their attitudes.
A random sample of the British and Irish population resident in Murcia was stratified according to nationality as part of the "International Collaborative Donor Program" (n = 1611). The self-administered survey in English was completed anonymously. For the statistical analysis, we used the χ(2) test and a logistical regression analysis.
Approximately half of the respondents (45%; n = 692) understood the concept of BD; they considered it to mean the death of an individual. Among of the other respondents, 39% (n = 605) did not understand this concept, and the remaining 16% (n = 240) erroneously believed that it did not imply a person's death. Respondents coming from Great Britain showed a greater knowledge of the BD concept than did the Irish (46% vs 34%; P < .001). Those who understood the concept of BD were more in favor of deceased donation than those who had an erroneous understanding (49% vs 36%; P < .001). Significant associations were also noted among variables directly or indirectly related to donation and transplantation (P < .05).
The level of understanding of the concept of BD among the population from the British Isles resident in southeastern Spain was limited. Taking into account that the BD concept is a psychosocial factor that affects attitudes toward organ donation, information campaigns should be applied to this emerging population group in southeastern Spain.
Transplantation Proceedings 04/2011; 43(3):692-4. · 1.00 Impact Factor
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ABSTRACT: In patients awaiting a transplant, the help received from friends and/or family members is considered to be an important factor in the transplantation process. Our objective was to determine the level of social/family support for patients on the liver transplant waiting list and to determine the relationship between clinical psychopathology and the level of social/family support.
The study population consisted of 70 patients on the liver transplant waiting list. We used the following instruments: (1) Medical Outcomes Study-Social Support Survey (MOS) Questionnaire. For size of the social network, four support dimensions and a global support index for emotional support, material/instrumental support, leisure/free time activities, and love/care; (2) Family Apgar Questionnaire for personal perception of family function; (3) SA-45 questionnaire of psychopathologic symptoms for somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism.
The MOS showed that the mean size of the social network of these patients was 12 people. In these patients, social/family support was nonfunctional in 20% of the cases. By dimensions, the patients had the following percentage of nonfunctional support: 24% in emotional support; 10% material/instrumental support; 23% social relations of leisure/free-time activities; and 11% compassionate love/care support. The patients with nonfunctional support had the following associated psychopathologic symptoms (SA-45): depression (79% vs 39%; P = .008), anxiety (86% vs 46%; P = .008), hostility (43% vs 12%; P = .009), and psychoticism (14% vs 2%; P = .039) compared to functional patients. The Family Apgar showed that 27% of patients perceived a family dysfunction. These patients had greater interpersonal sensitivity-type emotional symptoms (32% vs 8%; P = .012), depression (79% vs 35%; P = .001), anxiety (79% vs 45%; P = .011), and hostility (42% vs 10%; P = .002) compared to normally functioning patients.
Nearly a quarter of patients on the liver transplant waiting list have social/family support that is nonfunctional, which leads to greater emotional psychopathologic symptoms that would need to be treated.
Transplantation Proceedings 04/2011; 43(3):701-4. · 1.00 Impact Factor
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ABSTRACT: To analyze attitude of patients on the liver transplant waiting list toward living donation (LD).
Patients on the transplant waiting list -2003-2005 (n = 164)- were selected. Attitude was evaluated using a validated questionnaire, completed by an independent healthcare professional.
The questionnaire completion rate was 97% (n = 159). A total of 87% (n = 138) of patients stated that they would donate an organ while alive if a family member needed one. However, only 39% (n = 61) would be prepared to receive a liver donation from a living relative and 50% would prefer to wait on the list (n = 80). 90% accepted that living liver donation involves a certain amount of risk. This assumption was not associated with a willingness to accept related LD (p = 0.170). A willingness to accept LD was related to patient's knowledge of his or her family's attitude toward donating an organ to the patient (p = 0.027).
Patients had a favorable attitude toward living liv-er donation. When there was a family base that is in favor of LD then this encouraged acceptance, and therefore, it is essential to carry out family screening of patients to detect those cases in which this type of LD can be successfully requested.
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 03/2011; 103(3):115-22. · 1.55 Impact Factor
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A Ríos,
A López-Navas,
M A Ayala-García,
M J Sebastián, L Martínez-Alarcón,
B González,
E J Ramírez,
G Muñoz,
A Camacho,
J S Rodríguez,
M A Martínez,
A Nieto,
G Ramis,
P Ramírez,
P Parrilla
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ABSTRACT: Administrative personnel from healthcare centers are an important opinion group given their direct relationship to patients and the general public.
The objective of this study was to analyze the attitudes of administrative personnel in Spanish and Mexican healthcare centers toward various kinds of donation.
A random selection of 418 administrative staff from 32 primary care centers and 9 hospitals in Spain and Mexico ("Proyecto Donante, Murcia") used a validated questionnaire to explore attitudes.
Most (76%) respondents favored deceased donation. Mexican workers had the most favorable attitude (P<.001). Factors influencing this attitude (P<.05) were as follows: type of healthcare center, clinical service, personal experience of organ donation and transplantation (ODT), attitude toward living donation, attitude toward the donation of a family member's organs, discussion of ODT, partner's attitude toward ODT, participation in pro-social activities, and variables related to attitudes toward the body. Most respondents (89%) favored related living kidney donation (LKD) and 87% favored living liver donation (LLD). Mexican respondents showed the most favorable attitudes (P<.05). Factors influencing this attitude (P<.05) were as follows: personal experience of ODT, belief that a transplant is needed, willingness to accept a living organ, family discussion about ODT, partner's attitude about the matter, and respondent's awareness of the view of his or her religion toward ODT.
Attitudes toward deceased organ donation were not favorable among administrative personnel from Spanish compared with Mexican centers, although attitudes toward LKD and LLD were favorable in both countries.
Transplantation Proceedings 10/2010; 42(8):3093-7. · 1.00 Impact Factor
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ABSTRACT: Research into xenotransplantation is centered on the fields of organs, tissues, and cells. However, the use of animals in this therapy is creating social rejection among the general public as well as among patients on the transplant waiting list.
The objective of this study was to analyze the attitudes of patients on the waiting list toward a possible transplantation of cells or tissues of animal origin.
The study included patients on the kidney and liver transplant waiting lists from January 2003 until December 2005 (N=373). Attitudes toward xenotransplantation were assessed using a psychosocial questionnaire about the donation of animal organs. The questionnaire was administered through a direct personal interview.
With regard to the xenotransplantation of tissues and cells, 83% of kidney patients (n=177) were in favor and 17% (n=37) were not in favor of both options. Patients who were more in favor for tissues and also for cells were young respondents (P=.016; age P=.006) and those with a formal education (P=.002; education P=.001). Among liver patients, 85% (n=134) were in favor and 15% (n=24) were not in favor. Those who were more in favor for tissues included elderly patients (P=.028) and those with descendents (P=.001); for cells, those who were more in favor were those who were married (P=.011), were older (P=.009), and had children (P<.000). No significant differences were observed between the groups.
Patients on the solid organ transplant waiting lists showed favorable attitudes toward tissue and cell xenotransplantation.
Transplantation Proceedings 10/2010; 42(8):3098-101. · 1.00 Impact Factor
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A Ríos,
A López-Navas,
M A Ayala-García,
M J Sebastián,
A Abdo-Cuza, L Martínez-Alarcón,
B González,
E J Ramírez,
G Muñoz,
A Camacho,
J Suárez-López,
R Castellanos,
J S Rodríguez,
M A Martínez,
A Nieto,
G Ramis,
P Ramírez,
P Parrilla
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ABSTRACT: Transplantation hospitals have played a key role in developing deceased organ donation and transplantation (ODT). To reduce the number of deaths on the transplant waiting list, it is essential to encourage living liver donation (LLD). Involvement of personnel in these hospitals is crucial.
We analyzed the attitudes toward LLD among hospital personnel in Spain, Mexico, and Cuba.
Data were obtained from 5 transplant hospitals in Spain, Mexico, and Cuba. The sample was stratified according to job category and type of service (n=2273). A validated questionnaire about living donation was used as the instrument.
Most respondents (82%) were in favor of related LLD. If the LLD was not related, acceptance fell to 21%. A total of 85% of physicians, 79% of nursing personnel, 74% of nursing assistants, and 83% of auxiliary staff were in favor (p<.001). A favorable attitude toward LLD was associated (P<.05) with age (37±10 y vs 39±10 y), a favorable attitude toward deceased donation, a belief that a possible transplant is needed, acceptance of LLD if necessary, a favorable attitude toward living kidney donation, family discussion about ODT, a partner's favorable attitude toward ODT, an intention to participate in prosocial activities, being a Catholic, and a belief that one's religion is in favor of ODT.
Personnel from Spanish, Mexican, and Cuban transplantation hospitals have favorable attitudes toward LLD. This suggests that there may be an increase in LLD in the future, provided that there is the necessary sociopolitical and economic support.
Transplantation Proceedings 10/2010; 42(8):3102-5. · 1.00 Impact Factor
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ABSTRACT: There is a considerable transplant organ deficit. To offset the organ shortage, living donation is being encouraged. Young persons form a sector of the population in whom early awareness is important to encourage favorable attitudes toward donation. Teachers play important roles in education and in generating attitudes.
We analyzed the attitudes of secondary school teachers toward living organ donation and sought to determine the psychosocial variables that affect these attitudes.
We randomly selected Teachers from 10 secondary schools in southeastern Spain. Their attitudes toward living donation were evaluated using a validated questionnaire, which was self-administered anonymously. The statistical tests were Student t test and the χ2 test.
Regarding living kidney donation, 92% of teachers were in favor of related donation, decreasing to 16% when it was not from a related individual. In contrast, regarding related donations, 7% were not in favor, and 1% undecided. Teachers who had discussed the matter with their family and friends had more favorable attitudes (P<.05). In the case of living liver donations, 91% were in favor of related donation (falling to 20% if not related), 7% were not in favor, and 2% had doubts. Attitudes were more favorable among women, teachers with children, and those who had discussed the matter with their family and friends (P<.05).
Teachers had favorable attitudes toward living related kidney or liver donation. Their students would receive positive information when they request relevant information.
Transplantation Proceedings 10/2010; 42(8):3106-8. · 1.00 Impact Factor
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ABSTRACT: The information provided about organ donation and transplantation (ODT) affects whether it is viewed favorably or unfavorably.
The objective of this study was to determine the means by which each source of information about ODT influenced attitudes of children.
Ten secondary schools from the south-east of Spain were stratified geographically. We performed a random selection of pupils from the first 4 years of compulsory secondary range, education (age 11-15 years). A validated self-administered questionnaire about attitudes toward ODT was completed anonymously.
The adolescents had received information about ODT through several sources. The most frequent sources were television (86%), films (59%), and magazines (56%). Positive information from information sources was associated with more favorable attitudes toward ODT (P<.05); those who received negative information had more unfavorable attitudes (P<.05).
Most information about ODT that reaches our children is through audiovisual means. Attitudes were more favorable among adolescents who have received positive information through the mass media, with more negative attitudes among those who received negative information.
Transplantation Proceedings 10/2010; 42(8):3113-5. · 1.00 Impact Factor
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ABSTRACT: The increase in the British population, including Welsh citizens, in the south-east of Spain is generating a new social and healthcare reality that is affecting the world of transplantation.
The objectives of this study were as follows: (1) to determine the attitude of the local population originating from Wales toward the donation of their own organs, and (2) to analyze the factors that determine this attitude.
A random sample (n=126) was selected from the population in Murcia originating from Wales (November 2005-March 2006). Attitudes were evaluated using a validated questionnaire. A control group comprised the autochthonous population (n=2000). The sample was stratified according to age, gender, and geographical location.
In this study 76% (n=96) had favorable attitudes toward donation, 6% (n=8) were against, and the remainder 18% (n=22) were not sure. Attitudes were more favorable than among the Spanish control group (76% vs 63%; P=.045). The following variables were associated with this attitude: (1) knowledge of the concept of brain death (P<.001); (2) having spoken within the family about the subject (P=.005); (3) attitude toward the donation of a family member's organs (P<.001); (4) knowing the attitude of one's religion toward donation (P=.033); and (5) attitude of one's partner toward donation (P<.001).
Welsh citizens who are residents in south-eastern Spain have attitudes toward organ donation that are more favorable than those of the native Spanish population. They seem to be determined by knowing the concept of brain death and positive attitudes of one's family.
Transplantation Proceedings 10/2010; 42(8):3116-9. · 1.00 Impact Factor
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ABSTRACT: Chronic end-stage liver disease is a difficult situation for the patient.
The objective of this study was to analyze the disease coping styles of patients on the liver transplant waiting list.
The study included 50 patients on the liver transplant waiting list. The instrument used was the Mental Adjustment to Cancer Scale (Ferrero, 94). Coping scales were as follows: fighting spirit, hopelessness, anxious preoccupation, fatalism, and negation.
Only 6% of subjects adapted well, whereas 94% adapted badly: 89% poor fighting spirit, 32% hopelessness, 50% anxious preoccupation, 28% fatalism, and 30% negation. Of those who had a poor fighting spirit, 88% also used another type of maladaptive style. The associated statements were (P<.05) as follows: "I value my life more"; "I don't think about the disease"; "I think about people who are worse off." Regarding hopelessness, 100% of those who confessed hopelessness also showed maladaptive signs. The associated statements were (P<.05) as follows: "I cannot cheer myself up"; "I cannot help myself"; "I've given up." Regarding anxious preoccupation, nearly all of these patients (96%) provided dysfunctional answers. The most associated were (P<.05) as follows: "I don't have any plans"; "I feel a lot of anxiety"; "I'm very angry." Regarding fatalism, all of the patients also had maladaptive behavior. The main types were (P<.05) as follows: "Nothing will change things"; "I cannot control the situation"; "I don't need information." Regarding negation, Only 14% used this style, and in 86% negation was associated with other inadequate coping styles.
Patients on the liver transplant waiting list were maladaptive to their disease. It is important to establish adequate psychological care for these patients, given the important repercussions in the posttransplantation phase.
Transplantation Proceedings 10/2010; 42(8):3149-52. · 1.00 Impact Factor
