Attitude of Personnel in Hospital Cadaveric Organ Transplant-Related Units Faced with Living Kidney Donation in a Hospital with a Living Kidney Donor Transplantation Program

Background: Compared to dialysis, living kidney donation has a greater chance of restoring health and is associated with better outcomes than deceased kidney donation. Although physicians advocate for this treatment, it is uncertain how they would act as potential living kidney donors or recipients. Methods: We surveyed 104 physicians, pediatric, and internal medicine nephrologists, to ascertain their attitudes toward living donation. Results: Among surveyed nephrologists, there was nearly universal support for living kidney donation as a viable medical option, and nearly all of them would support a healthy and medically cleared patient who wishes to participate. Although support was still strong, nephrologists were significantly less likely to support their friends and relatives participating in living kidney donation, and their support declined further for friends and relatives donating to nonrelatives. Conclusion: Our findings suggest the need to more deeply examine physician-perceived risks involved in serving as a living kidney donor. Based on differences in surveyed nephrologist attitudes regarding donation to and from loved ones versus nonrelatives, we suggest that physicians should give careful consideration to how they describe the risks of living donation to potential donors.

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Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358119857718 ◽

2019 ◽

Vol 6 ◽

pp. 205435811985771

Author(s):

Carlos Garcia-Ochoa ◽

Liane S. Feldman ◽

Christopher Nguan ◽

Mauricio Monroy-Cuadros ◽

Jennifer Arnold ◽

...

Keyword(s):

Online Survey ◽

Perioperative Complications ◽

Kidney Donation ◽

Complication Rates ◽

Living Kidney Donation ◽

Kidney Donor ◽

Living Kidney Donor ◽

Multicenter Cohort Study ◽

Kidney Donors ◽

Living Kidney Donors

Background: While living kidney donation is considered safe in healthy individuals, perioperative complications can occur due to several factors. Objective: We explored associations between the incidence of perioperative complications and donor characteristics, surgical technique, and surgeon’s experience in a large contemporary cohort of living kidney donors. Design: Living kidney donors enrolled prospectively in a multicenter cohort study with some data collected retrospectively after enrollment was complete (eg, surgeon characteristics). Setting: Living kidney donor centers in Canada (n = 12) and Australia (n = 5). Patients: Living kidney donors who donated between 2004 and 2014 and the surgeons who performed the living kidney donor nephrectomies. Measurements: Operative and hospital discharge medical notes were collected prospectively, with data on perioperative (intraoperative and postoperative) information abstracted from notes after enrollment was complete. Complications were graded using the Clavien-Dindo system and further classified into minor and major. In 2016, surgeons who performed the nephrectomies were invited to fill an online survey on their training and experience. Methods: Multivariable logistic regression models with generalized estimating equations were used to compare perioperative complication rates between different groups of donors. The effect of surgeon characteristics on the complication rate was explored using a similar approach. Poisson regression was used to test rates of overall perioperative complications between high- and low-volume centers. Results: Of the 1421 living kidney donor candidates, 1042 individuals proceeded with donation, where 134 (13% [95% confidence interval (CI): 11%-15%]) experienced 142 perioperative complications (55 intraoperative; 87 postoperative). The most common intraoperative complication was organ injury and the most common postoperative complication was ileus. No donors died in the perioperative period. Most complications were minor (90% of 142 complications [95% CI: 86%-96%]); however, 12 donors (1% of 1042 [95% CI: 1%-2%]) experienced a major complication. No statistically significant differences were observed between donor groups and the rate of complications. A total of 43 of 48 eligible surgeons (90%) completed the online survey. Perioperative complication rates did not vary significantly by surgeon characteristics or by high- versus low-volume centers. Limitations: Operative and discharge reporting is not standardized and varies among surgeons. It is possible that some complications were missed. The online survey for surgeons was completed retrospectively, was based on self-report, and has not been validated. We had adequate statistical power only to detect large effects for factors associated with a higher risk of perioperative complications. Conclusions: This study confirms the safety of living kidney donation as evidenced by the low rate of major perioperative complications. We did not identify any donor or surgeon characteristics associated with a higher risk of perioperative complications. Trial registration(s): NCT00319579: A Prospective Study of Living Kidney Donation ( https://clinicaltrials.gov/ct2/show/NCT00319579 ) NCT00936078: Living Kidney Donor Study ( https://clinicaltrials.gov/ct2/show/NCT00936078 )

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The Irish living kidney donor program - why potential donors do not proceed to live kidney donation?

Clinical Transplantation ◽

10.1111/ctr.12641 ◽

2015 ◽

Vol 30 (1) ◽

pp. 17-25 ◽

Cited By ~ 11

Author(s):

Dervla M. Connaughton ◽

Grainne Harmon ◽

Anne Cooney ◽

Yvonne Williams ◽

John O'Regan ◽

...

Keyword(s):

Kidney Donation ◽

Kidney Donor ◽

Living Kidney Donor ◽

Live Kidney Donation

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Renal transplantation at the Singapore General Hospital: a miracle in the making over 50 years

Proceedings of Singapore Healthcare ◽

10.1177/2010105820952095 ◽

2020 ◽

Vol 29 (4) ◽

pp. 245-251

Author(s):

Terence Kee Yi Shern

Keyword(s):

Kidney Transplantation ◽

Renal Transplantation ◽

Renal Transplant ◽

General Hospital ◽

Organ Transplant ◽

Kidney Donation ◽

Kidney Donor ◽

Human Organ ◽

Singapore General Hospital ◽

Donor Transplant

Background: This paper documents the history of the renal transplant programme at Singapore General Hospital. Renal transplantation in Singapore was born out of a necessity to offer a cheaper alternative to the expensive and scarce dialysis treatments in the 1970s. As a result, the first deceased kidney donor transplant was performed in 1970 at what Singapore General Hospital was then called ‘the Outram General Hospital’. However, deceased donation rates were dismal and prompted the start of a living kidney donor transplant programme in 1976 at Singapore General Hospital. Unfortunately, the prevalent population of patients with end-stage renal failure rapidly grew while kidney donation rates remain poor despite active efforts to raise awareness and even importing unwanted kidneys from other countries. Discussion: As a result, an opting-out legislation called the Human Organ Transplant Act was introduced in 1987 and increased the rate of deceased kidney donor transplantation in Singapore. Over the next two decades, access to kidney transplantation was further expanded with the introduction of living unrelated kidney donor transplantation and laparoscopic donor nephrectomy. In the past 10 years, there have been further advances in kidney transplantation with the introduction of newer immunosuppressive agents and technologies to perform incompatible kidney transplantation. The Human Organ Transplant Act has also been amended to allow the use of older deceased donors and permit paired kidney donor exchanges. Conclusion: Despite these many advances, kidney donation rates remain low and are even declining. This would certainly be the major challenge for the renal transplant programme in the next 50 years to come.

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Living kidney donor with monoclonal gammopathy of undetermined significance: Is it a contraindication for kidney donation?

Indian Journal of Transplantation ◽

10.4103/ijot.ijot_67_18 ◽

2019 ◽

Vol 13 (1) ◽

pp. 54

Author(s):

Vinay Rathore ◽

Pankaj Beniwal ◽

Dhananjai Agarwal ◽

Vinay Malhotra ◽

Rajesh Jhorawat ◽

...

Keyword(s):

Monoclonal Gammopathy ◽

Kidney Donation ◽

Kidney Donor ◽

Living Kidney Donor ◽

Undetermined Significance

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REWARDING A LIVING KIDNEY DONOR: A COMPARISON BETWEEN SOUTH AFRICA, SINGAPORE AND IRAN

Obiter ◽

10.17159/obiter.v34i2.12031 ◽

2021 ◽

Vol 34 (2) ◽

Author(s):

B Venter ◽

M Slabbert

Keyword(s):

South Africa ◽

South African ◽

Kidney Transplant ◽

Organ Donor ◽

Kidney Donation ◽

Kidney Donor ◽

Living Kidney Donor ◽

Donation Rate

There are thousands of desperate people globally who need a kidney for transplantation. The number of people who require a kidney transplant continues to escalate faster than the number of kidneys available for a transplant. If South Africa wants to improve its current kidney-donation rate it should seek guidance from abroad. This article will compare South African transplant legislation with currentlegislation in Singapore and Iran. These two countries are of significance to the transplant debate as Singapore has recently legalized the reimbursement of costs of the organ donor while Iran goes a step further and pays the kidney donor. In conclusion it is argued that South Africa could learn from these two countries in order to try and address the shortage of transplantable organs locally.

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Knowledge and Attitude of Bangladeshi Physicians towards Organ Donation and Transplantation

Bangladesh Critical Care Journal ◽

10.3329/bccj.v4i1.27975 ◽

2016 ◽

Vol 4 (1) ◽

pp. 23-27 ◽

Cited By ~ 2

Author(s):

Md Mostarshid Billah ◽

Hafiza Farzana ◽

Abdul Latif ◽

Palash Mitra ◽

Tufayel Ahmed Chowdhury ◽

...

Keyword(s):

Graduate Students ◽

Organ Donation ◽

Theoretical Basis ◽

Significant Positive Correlation ◽

Organ Transplant ◽

Tissue Donation ◽

Kidney Donation ◽

Living Kidney Donation ◽

Post Graduate ◽

Knowledge And Attitude

Background: Organ transplantation saves thousands of lives worldwide. There is discrepancy between organ demand and supply which demands cadaveric donation. Knowledge and attitudes of physicians towards organ donation and transplantation can increase the rate of organ and tissue donation by motivating general population.Methodology: This cross-sectional survey was done on 150 Bangladeshi physicians including specialist and post-graduate students on four teaching hospitals in Dhaka, Bangladesh over a period of six months. After taking informed consent, the participants were given a self-administered questionnaire which includes socio-demographic data, knowledge and attitude about organ donation and transplantation.Results: Male and female were almost equal (Total 102, Male 54, female 48) with mean age was 34.6±5.0 years and 54.9% were specialists and 45.1% were post graduate students. More than 32% respondents were from Medicine, followed by Nephrology (26.5%), Critical Care Medicine (CCM) (25.5%) and Urology (15.6%). Fifty-six (54.9%) physicians agreed with organ donation after death. The most important reason of agreement was to help others (78.4%) and disagreement was religious fear (54.3%). More than 40% respondents agreed and 59.8% completely disagreed with living kidney donation. The most common reason for agreement of living kidney donation was to donate to help family member (82.93%) and disagreement was probable damage to donors (52.46%). More than three-fourth (76.4%) respondents had knowledge about theoretical basis of transplantation, 50% know about cost and 43% about organ transplant Act, Bangladesh. Significant positive correlation was found between physicians attitudes towards organ and tissue donation after death and knowledge about theoretical basis of transplantation (p =0.02, r= 0.43) and cost of transplantation in Bangladesh (p= 0.02, r= 0.22) but no statistically significant correlation with knowledge about organ transplant Act, Bangladesh (p value= 0. 19, r= 0.13) whereas significant positive correlation between physicians knowledge about transplant Act (p= 0.008, r= 0.28), cost (p = 0.04, r= 0.23) and theoretical basis of transplantation (p= 0.04, r= 0.20) was found in living kidney donation.Conclusion: Physicians had a good attitude towards organ donation and transplantation although less than half of them had knowledge of transplantation rules and financial issues; therefore, additional awareness and education of physicians is needed in all areas of the organ transplant process in Bangladesh to make organ donation and transplantation successful.Bangladesh Crit Care J March 2016; 4 (1): 23-27

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