Polish attitudes towards unspecified kidney donation: a cross-sectional study
Paulina Kurleto, Lucyna Tomaszek, Irena Milaniak, Katrina A Bramstedt, Paulina Kurleto, Lucyna Tomaszek, Irena Milaniak, Katrina A Bramstedt
Abstract
Background: Chronic kidney disease effects about 4.2 million people in Poland, yet Polish organ donation research is rare. In addition, compared to other countries in the world, Poland has a relatively low living donation rate. Still, little is known about how Poles would react to the possibility of living kidney donation to strangers. A study was conducted to examine public opinion about living kidney donation, as well as their knowledge about it, willingness to donate to a stranger, and support for a possible expansion of existing Polish organ donation legislation to include living donation to strangers.
Methods: A self-report questionnaire, which included a socio-demographic datasheet (9 questions), 16 questions about attitudes towards living donation, and 1 question about knowledge concerning transplantation law was sent to the respondents from December 2020 - February 2021. Logistic regression was used to assess factors affecting the support of the legalization of unspecified kidney donation amongst the participants.
Results: More than sixty percent (62.1) of respondents supported legalization of unspecified living kidney donation. Such legalization would be accepted by people who accept a choice of a family member to donate a kidney to a stranger (OR = 3.50; Cl 95%: 1.49 to 4.85), who think bone-marrow transplant is safe (OR = 2.65; Cl 95%: 1.80 to 3.91), recognize the benefit of carrying out tests before donating a kidney (OR = 2.56; Cl 95%: 1.79 to 3.69), would agree to receive a kidney from another person (OR = 2.24; Cl 95%: 2.53 to 3.13), or would agree to donate organs after death (OR = 2.06; Cl 95%: 1.45 to 2.95). However, support for unspecified living kidney donation would not be given by respondents fearing the risk of organ trafficking (OR = 0.54; Cl 95%: 0.38 to 0.79).
Conclusions: In Poland there is strong support for legalization of unspecified living kidney donation. It is vital that future legislation define organ trafficking as a crime with serious punishment so that legal unspecified living kidney donation is not hindered.
Trial registration: The study was registered with ClinicalTrials.gov (ID: NCT04789122 ) on 08/03/2021.
Keywords: Kidney transplantation; Legislation; Organ donation; Poland; Unspecified kidney donation.
Conflict of interest statement
None.
© 2022. The Author(s).
Figures
References
- Wasser WG, Boner G, Koslowsky M, Lazar A. Emergence of an Israel faith-based community organization facilitating live donor kidney transplantation. BMC Nephrol. 2018;19(1):128. doi: 10.1186/s12882-018-0923-4.
- Nagi K, Srinivasan M, Lekamlage PB, Bramstedt KA. Exploring the success of Good Samaritan organ donation in New Zealand. Prog Transplant. 2015;25(2):160–3, 175. doi: 10.7182/pit2015182
- Li Y, Song PX, Leichtman AB, Rees MA, Kalbfleisch JD. Decision Making in Kidney Paired Donation Programs with Altruistic Donors. Sort (Barc) 2014;38(1):53–72.
- Abdallah MA, Waleed M, Bell MG, Nelson M, Wong R, Sundaram V, Singal AK. Systematic review with meta-analysis: liver transplant provides survival benefit in patients with acute on chronic liver failure. Aliment Pharmacol Ther. 2020;52(2):222–232. doi: 10.1111/apt.15793.
- Kaballo MA, Canney M, O’Kelly P, Williams Y, O’Seaghdha CM, Conlon PJ. A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clin Kidney J. 2018;11(3):389–93. 10.1093/ckj/sfx117.
- Global Observatory on Donation and Transplantation. . Accessed 25 May 2021.
- Azzi Y, Bartash R, Scalea J, Loarte-Campos P, Akalin E. COVID-19 and Solid Organ Transplantation: A Review Article. Transplantation. 2021;105(1):37–55. doi: 10.1097/TP.0000000000003523.
- Global Observatory on Donation and Transplantation. . Accessed 28 May 2021.
- Centrum Organizacyjno- Koordynacyjne do spraw transplantacji-Poltransplant. Biuletyn Informacyjny 2020. . Accessed 2 May 2021.
- Durlik, M. History of kidney transplantation in Poland. G Ital Nefrol 2018;35:84–86..
- Dz. U. 2005 Nr 169 poz. 1411. Ustawa z dnia 1 lipca 2005 r.o pobieraniu, przechowywaniu i przeszczepianiu komórek, tkanek i narządów. . Accessed 30 April 2021.
- Burnapp L, Van Assche K, Lennerling A, Slaats D, Van Dellen D, Mamode N, Citterio F, Zuidema W, Weimar W, Dor FJMF. Raising awareness of unspecified living kidney donation: an ELPAT view. Clin Kidney J. 2019;13(2):159–165. doi: 10.1093/ckj/sfz067.
- Veys CG, Bramstedt KA. Stranger donors: a key link in transplant chains. Prog Transplant. 2010;20(4):366–371. doi: 10.7182/prtr.20.4.v80gh271u37j175x.
- Lennerling A, Fehrman-Ekholm I, Nordén G. Nondirected living kidney donation: experiences in a Swedish Transplant Centre. Clin Transplant. 2008;22(3):304–308. doi: 10.1111/j.1399-0012.2007.00785.x.
- Ghods AJ, Savaj S. Iranian model of paid and regulated living-unrelated kidney donation. Clin J Am Soc Nephrol. 2006;1(6):1136–1145. doi: 10.2215/CJN.00700206.
- Nassiri N, Baskin AS, Herbert LK, Connor S, Pham T, Melcher ML, Sinacore J, Veale JL. Socioeconomic Status in Non-directed and Voucher-based Living Kidney Donation. Eur Urol Focus. 2018;4(2):185–189. doi: 10.1016/j.euf.2018.07.020.
- Bramstedt KA, Dave S. The silence of Good Samaritan kidney donation in Australia: a survey of hospital websites. Clin Transplant. 2013;27(3):E244–E248. doi: 10.1111/ctr.12087.
- García Martínez M, Valentín Muñoz MO, Ormeño Gómez M, Martínez Alpuente I, Dominguez-Gil GB. Can We Improve the Effectiveness of the Spanish Nondirected Donation Program? Transplant Proc. 2019;51(9):3030–3033. doi: 10.1016/j.transproceed.2019.08.024.
- Kowal K. Miedzy altruizmem a egoizmem. Społeczno-kulturowe uwarunkowania przeszczepów rodzinnych. Wydawnictwo Adam Marszałek. Toruń 2011;80–250.
- Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, STROBE Initiative Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12(12):1500–24. doi: 10.1016/j.ijsu.2014.07.014.
- World Medical Association World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi: 10.1001/jama.2013.281053.
- Daniel WW. Biostatistics: a foundation for analysis in the health sciences. 7. New York: John Wiley & Sons; 1999. pp. 141–142.
- Nordfalk F, Olejaz M, Jensen AM, Skovgaard LL, Hoeyer K. From motivation to acceptability: a survey of public attitudes towards organ donation in Denmark. Transplant Res. 2016;5:5. doi: 10.1186/s13737-016-0035-2.
- Meng OY, Lim C, Leng CW, van der Erf S, Joshi VD, Sin ST, Hong ST, Chye PG, Seng GT, Yi-Shern TK. Factors influencing living kidney donation in Singapore. Prog Transplant. 2012;22(1):95–101. doi: 10.7182/pit2012607.
- Spital A. Public attitudes toward kidney donation by friends and altruistic strangers in the United States. Transplantation. 2001;71(8):1061–1064. doi: 10.1097/00007890-200104270-00009.
- Akbulut S, Ozer A, Gokce A, Demyati K, Saritas H, Yilmaz S. Attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation: Study of a nationwide survey. World J Clin Cases. 2020;8(11):2235–2245. doi: 10.12998/wjcc.v8.i11.2235.
- Eurobarometer. Organ donation and transplantation . Accessed 5 June 2021.
- Stosunek Polaków do transplantacji -wpływ wiary i zaufania do systemu ochrony zdrowia. . Accessed 2 June 2021.
- Thomas R, Consolo H, Oniscu GC. Have we reached the limits in altruistic kidney donation? Transpl Int. 2021;34(7):1187–1197. doi: 10.1111/tri.13921.
- Gellert R, Durlik M, Małgorzewicz S. Raport 2019 Ogólnopolskie Badanie Pacjentów Nefrologicznych. Forum Nefrologiczne. 2020;13(3):149–163.
- Rodrigue JR, Cornell DL, Lin JK, Kaplan B, Howard RJ. Increasing live donor kidney transplantation: a randomized controlled trial of a home-based educational intervention. Am J Transplant. 2007;7(2):394–401. doi: 10.1111/j.1600-6143.2006.01623.x.
- Jarl J, Desatnik P, Peetz Hansson U, Prütz KG, Gerdtham UG. Do kidney transplantations save money? A study using a before-after design and multiple register-based data from Sweden. Clin Kidney J. 2018;11(2):283–288. doi: 10.1093/ckj/sfx088.
- Bramstedt KA, Down R. The Organ Donor Experience: Good Samaritans and the Meaning of Altruism. New York, NY: Rowman & Littlefield; 2011.
- Balliet W, Kazley AS, Johnson E, Holland-Carter L, Maurer S, Correll J, Marlow N, Chavin K, Baliga P. The non-directed living kidney donor: Why donate to strangers? J Ren Care. 2019;45(2):102–110. doi: 10.1111/jorc.12267.
- Eurostat. Demographic change in Europe — Country factsheets: Poland. Accessed 6 Dec 2021.
Source: PubMed