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Factors limiting deceased organ donation: focus groups' perspective from culturally diverse community

Wong LP

Transplant Proc, 2010 Jun;42(5):1439-44.
PMID: 20620450 DOI: 10.1016/j.transproceed.2009.11.053

BACKGROUND: In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community.
METHODS: A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia.
RESULTS: Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups.
CONCLUSION: Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.

Matched MeSH terms: Tissue and Organ Procurement/methods
Tissue allograft coding and traceability in USM Tissue Bank, Malaysia

Sheikh Ab Hamid S, Abd Rahman MN

Cell Tissue Bank, 2010 Nov;11(4):401-5.
PMID: 20582480 DOI: 10.1007/s10561-010-9188-2

In Malaysia, tissue banking activities began in Universiti Sains Malaysia (USM) Tissue Bank in early 1990s. Since then a few other bone banks have been set up in other government hospitals and institutions. However, these banks are not governed by the national authority. In addition there is no requirement set by the national regulatory authority on coding and traceability for donated human tissues for transplantation. Hence, USM Tissue Bank has taken the initiatives to adopt a system that enables the traceability of tissues between the donor, the processed tissue and the recipient based on other international standards for tissue banks. The traceability trail has been effective and the bank is certified compliance to the international standard ISO 9001:2008.

Matched MeSH terms: Tissue and Organ Procurement/methods
Can financial rewards complement altruism to raise deceased organ donation rates?

Rasiah R, Naghavi N, Mubarik MS, Nia HS

Nurs Ethics, 2020 Sep;27(6):1436-1449.
PMID: 32410486 DOI: 10.1177/0969733020918927

BACKGROUND: Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.
METHODS: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.
ETHICAL CONSIDERATIONS: The study was approved by the University of Malaya ethics committee.
RESULTS: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.
CONCLUSION: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

Matched MeSH terms: Tissue and Organ Procurement/methods
Fulltext Are health professionals responsible for the shortage of organs from deceased donors in Malaysia?

Abidin ZL, Ming WT, Loch A, Hilmi I, Hautmann O

Transpl Int, 2013 Feb;26(2):187-94.
PMID: 23199156 DOI: 10.1111/tri.12019

The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia.

Matched MeSH terms: Tissue and Organ Procurement/methods*
Living kidney donation: the importance of public education

Tumin M, Rasiah R, Noh A, Satar NM, Chong CS, Lim SK, et al.

Clin Transplant, 2014 Apr;28(4):423-7.
PMID: 24617562 DOI: 10.1111/ctr.12334

A sample of Malaysians in the Klang Valley indicating their decision on becoming unrelated living kidney donors was surveyed regarding huge amounts of financial incentives to be rewarded to them. From the 1310 respondents, 72.1% said "no" on becoming a living donor. The reason "I don't think humans can live with only one kidney" scored the highest (35.6%), and from the 27.9% of the respondents who are willing to donate their organ with the right financial incentive, most of the respondents picked the reasons "I want to do something noble in life" (50%), and monetary reason scored the lowest (6.2%), indicating that financial incentive is not a major reason guiding individuals' decision on becoming living donors. We suggest that the government should put priority at targeting public education to raise the understanding on the risk, safety and the quality of life of donation and transplantation, and improving the public trust on the donation and the surgical methods to carry out transplantation.

Matched MeSH terms: Tissue and Organ Procurement/methods*