[Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation]. / Estudio multicéntrico hospitalario en España, México y Cuba de actitud hacia la donación de vivo hepática.

INTRODUCTION: Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion. OBJECTIVE: To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America. MATERIAL AND METHOD: Ten hospitals were selected from the «International Donor Collaborative Project¼: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis. RESULTS: Of the 2,618 employees surveyed, 85% (n=2,231) were in favor of related LLD; of these, 31% (n=804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P<.001); being in favor of deceased donation (P<.001); believing that one might need a possible transplant (P<.001); being in favor of living kidney donation (P<.001); being willing to accept a liver from a living donor (P<.001); having discussed the matter of donation and transplantation within the family (P<.001) and with one's partner (P<.001); carrying out pro-social type activities (P<.001); being Catholic (P=.040); believing that one's religion is in favor of donation and transplantation (P<.001); and not being concerned about the possible mutilation of the body after donation (P<.001). CONCLUSIONS: Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body.

A multicenter study in Spanish, Mexican, and Cuban hospitals of attitude toward living kidney donation.

BACKGROUND: Living kidney donation (LKD) is a treatment with good results, although it is not very widely used in Spanish-speaking countries. OBJECTIVE: To analyze the attitude toward LKD among hospital personnel in healthcare centers in Spain and Latin America. MATERIAL/METHODS: Ten hospitals within the "International Collaborative Donor Project" were selected, from Spain, Mexico, and Cuba. A random sample was taken, which was stratified according to type of service and job category. RESULTS: Of the 2618 workers surveyed, 90% were in favor of related LKD, 6% were against it, and the remaining 4% were undecided. If the LKD was not related, then 32% were in favor. Other factors associated with a favorable attitude toward related LKD were: Working in Latin American hospitals (p<0.001); Working in clinical services (p=0.030); Having job stability (p=0.013); Having had personal experience of donation and transplantation (p=0.002); Being in favor of deceased donation (p<0.001); Considering the possibility of needing a transplant (p<0.001); Being in favor of living liver donation (p<0.001); Accepting a kidney from a living donor (p<0.001); Having spoken about donation and transplantation within family and partner (p<0.001); Having carried out pro-social activities (p<0.001); and Having no concern about the possible mutilation of the body after donation (p<0.001). CONCLUSIONS: Hospital personnel had a favorable attitude toward LKD donation, both in Spain and Latin America. This attitude was related with factors of knowledge about and general attitude toward organ donation and transplantation, family factors, religious factors, and fear about mutilation remaining after the donation.

Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers.

INTRODUCTION: Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation. OBJECTIVE: To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude. MATERIAL AND METHOD: Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered. STATISTICAL ANALYSIS: Student's t-test, the χ2 test and logistic regression analysis. RESULTS: Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001). CONCLUSIONS: Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors.

The attitude toward living kidney donation among personnel from units related to donation and transplantation in Spain, Mexico and Cuba.

BACKGROUND: Living kidney donation (LKD) is becoming increasingly necessary as a treatment option for reducing the deficit in transplant organs. Hospital personnel in services related to donation and transplantation play a key role in promoting this kind of donation. OBJECTIVE: To analyze the attitude toward LKD among hospital workers in services related to donation and transplantation in Spain and Latin America. METHODS: Eight hospitals in the "International Collaborative Donor Project" were selected (Spain-Mexico-Cuba). A random sample was taken which was stratified according to the type of service and job category, in transplant-related services. RESULTS: Of the 878 respondents, 90% were in favor of related LKD, and 28% were in favor if the LKD was not related. Attitude was more favorable among Latin Americans workers compared to the Spanish (p=0.014). Other factors associated to attitude included: age (p=0.004); an attitude in favor of deceased donation and living liver donation (p<0.001); and acceptance of a kidney from a donor (p<0.001). CONCLUSIONS: The attitude toward related LKD was very favorable among hospital personnel in units related to the donation and transplantation process in Spain and Latin America, which means that they could contribute to its promotion particularly at the current time when living kidney donation needs to be expanded.

[Attitudes among Spanish and Latin American non-medical health professionals to living donor liver transplantation]. / Actitud de los profesionales hospitalarios no sanitarios españoles y latinoamericanos hacia la donación de hígado de vivo.

INTRODUCTION: Hospital professionals are an opinion group that influences the general population. OBJECTIVE: To analyze attitudes to living donor liver transplantation (LDLT) among non-medical professionals working in Spanish and Latin American hospitals and to determine the variables that influence these attitudes. MATERIAL AND METHOD: A random sample, stratified by department, was selected from non-medical staff in the "International Donor Collaborative Project": there were three hospitals in Spain, five in Mexico and two in Cuba. Attitudes were evaluated through a validated, anonymous, self-administered questionnaire. RESULTS: There were 951 non-medical professionals: 277 from Spain, 632 from Mexico and 42 from Cuba. A total of 86% (n = 818) were in favor of related living donation and 31% (n = 299) were in favor of unrelated living donation. This attitude was associated with the following: country (Mexico 88%, Cuba 83%, Spain 81%) (p =0.016), female sex (p =0.026), having experience of donation and transplantation (p =0.001), having a favorable attitude to donation (P <0.001), considering the possibility of needing a transplant (P <0.001), being in favor of living kidney donation (P <0.001), being willing to accept a transplant from a living donor if necessary (P <0.001), discussing donation and transplantation with the family and partner (P <0.001), carrying out pro-social activities (P <0.001), believing that one's religion was in favor of donation and transplantation (P<0.001), and not worrying about bodily mutilation after donation (P <0.001). CONCLUSIONS: Attitudes toward related LDLT among non-medical staff in various Spanish, Mexican and Cuban hospitals are favorable. In 86% of those surveyed, this attitude was not influenced by classical psychosocial factors.

Level of awareness of personnel in hospital services related to the donation process: A Spanish and Latin American multicenter study.

BACKGROUND: Services related to the donation and transplantation process are fundamental for developing solid organ transplantation and procuring organs from deceased donors. This study was conducted to analyze the attitude toward deceased organ donation among hospital personnel working in donation- and transplantation-related services in hospitals in Spain and Latin America. METHODS: Nine hospital centers within the "International Donor Collaborative Project" were selected (Spain, Mexico, Cuba, and Costa Rica). A random employee sample was taken and stratified according to the type of service and job category in transplant-related hospital services. RESULTS: Of the 925 employees surveyed, 78% were in favor of donation. By job category, attitude was more favorable among physicians (89%; p < 0.001). By type of service, attitude was more positive among personnel in transplant patient follow-up units (87%; p = 0.018). By country, the Cubans were most in favor (91%), followed by the Mexicans (81%), the Costa Ricans (77%), and the Spanish (70%; p < 0.001). Other factors were age (p < 0.001), sex (p = 0.005), considering the possibility of needing a transplant (p = 0.002), understanding the concept of brain death (p < 0.001), being in favor of living donation (p < 0.001), having discussed the subject of donation and transplantation within the family and the partner (p < 0.001), carrying out pro-social activities (p = 0.002), and concern about mutilation after donation (p = 0.002). CONCLUSIONS: Transplant-related personnel had a favorable attitude toward deceased donation, although it was not as positive as we would expect, especially among non-physicians. This attitude needs to be improved because of the negative effect that can result in organ donation. There were pronounced differences between countries, and the discordance between attitude and actual deceased donation rates in each country is notable.

[Usefulness of the Delphi method for reaching consensus in the allocation of deceased donor kidneys in six Mexican hospitals]. / Utilidad del método Delphi para la construcción de acuerdos en la asignación de riñones de donante fallecido en seis hospitales de México.

OBJECTIVE: To ascertain medical criteria and their priority in the allocation of deceased patient kidneys in pediatrics among members of Internal Transplant Committees of six hospitals. To assess if, by using the Delphi method, it is possible to reach consensus to reduce heterogeneity of criteria in the allocation of renal transplant organs among physicians ascribed to Nephrology and Surgery services in six hospital centers in Mexico. METHODOLOGY: A study was carried out by the Delphi method of independent experts panel, with three stages and two rounds. The method makes possible iteration and controlled feedback from experts to identify behaviors and trends with the synergy of the debate in a group. Kappa index was applied to assess results agreement. RESULTS: Results of first round show the criteria heterogeneity for the allocation of cadaveric origin organs within each hospital, and among hospitals compared to each other. With the results of the second round, consensus increased in four hospitals for the selection of both first and second recipient. Kappa coefficient shows the reliability of results. CONCLUSION: Our Country needs a point-score system to allocate deceased donor organs, ideally including HLA matching. Expecting that the Internal Transplant Committees throughout the Mexican territory may have available a useful tool as this, the Delphi method makes it possible to reach consensus in this task, in order to minimize subjectivity in the staff involved in the decision-making process.

DNA polymorphisms identified by six X-chromosome probes, linked to genetic diseases, in a Spanish population

Usando seis diferentes probes de cromossomo X, estimou-se a freqüência de polimorfismo de comprimento de fragmento de restriçäo (RFLP) com endonucleases de restriçäo em pessoas näo parentes, em uma populaçäo espanhola de Valência. As freqüências de alelos foram semelhantes às de outras populaçöes européias, em particular francesas e turcas. Um alto grau de polimorfismo foi encontrado para todos os marcadores, sendo que a freqüência do alelo raro variou de 0,484 a 0,357 e um alto nível de heterozigose dos marcadores L1.28, 754, OTC e p58.1 foi encontrado nesta populaçäo, confirmando sua utilidade para a diagnose.