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BACKGROUND: Voluntary post-mortem donation to science (PDS) is the most appropriate source for body dissection in medical education and training, and highly useful for biomedical research. In Mexico, unclaimed bodies are no longer a legal source, but PDS is legally possible, although scarcely facilitated, and mostly ignored by the general population. Therefore, we aimed to evaluate the attitude and willingness for PDS and to identify a sociodemographic profile of people with willingness toward PDS. METHODS: A validated on-line survey was distributed by the convenience method via the social networks of a Catholicism-inspired, private university in northern Mexico. Frequency analyses of all variables and coded free comments were complemented with association studies. RESULTS: Although the responder cohort (n = 143) was too small and biased to be representative of the university community (n = 13,500), willingness to post-mortem organ donation was 90.7% and to PDS 70.7%. In this cohort, PDS willingness had the strongest association with mature age (> 40 years old; P, 0.0008). Among young adults, willingness to PDS was the lowest among volunteers from technical and business schools and the highest among those from the social sciences (P, 0.009). Respondents from the social sciences were also the most consistent between attitude and behavior with respect to organ donation. A free comment option revealed respondents were interested in the unusual taboo topic. CONCLUSIONS: A small, but sufficiently large proportion expressed willingness toward PDS. In our university cohort, which was biased in higher education and altruism, mature age and social interest were associated with PDS willingness.
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Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Adulto Jovem , Humanos , Adulto , Universidades , México , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Resumo: Introdução: As recomendações internacionais reforçam o estímulo à prática da doação voluntária para a disponibilidade de corpos destinados à formação de profissionais de saúde, substituindo o sistema de corpos não reclamados nas instituições de ensino superior (IES). Relato de experiência: Este trabalho reuniu informações sobre programas de doação de corpos (PDC) brasileiros, analisou lacunas e fatores impeditivos à doação do corpo, e propôs estratégias para ampliar as informações sobre o cadastro de participantes em PDC e a efetivação da doação. Discussão: No Brasil existem 39 PDC em funcionamento - seis no Nordeste, quatro no Centro-Oeste, um no Norte, 11 no Sul e 17 no Sudeste - e duas comissões de distribuição de corpos para ensino. O cadastro como participante no PDC pode agilizar as providências documentais, mas não garante a doação na ocasião da morte. No geral, as IES recebem o corpo doado e a documentação necessária. Quando o óbito acontece no município da IES, é possível ter o translado do corpo providenciado por parcerias com funerárias e prefeitura. Conclusão: Embora a legislação tenha regulamentado desde 2002 a doação do próprio corpo em vida, é necessária a implementação de campanhas de esclarecimento à população geral sobre essa possibilidade, além de mecanismos que possam promover a celeridade nos prazos de para obtenção das documentações com a finalidade de doação de corpo para fins científicos, a isenção das taxas cartoriais e a viabilização do translado do corpo doado por carro de funerária das prefeituras, sem custo. O apoio da IES por meio do cadastro do PDC como atividade de extensão universitária colabora para assegurar aspectos éticos relacionados à participação dos doadores no programa em vida, no que se refere ao tratamento com respeito e dignidade dos doadores e de suas famílias.
Abstract: Introduction: International recommendations reinforce the practice of voluntary donation for providing bodies for the training of health professionals, replacing the system of unclaimed bodies in medical courses (MC). Experience report: This work gathered information on Brazilian body donation programs (BDP), analyzed gaps and difficulties to the effectiveness of body donation, and proposed strategies to expand the information offered on the registration of participants in BDP and the effectiveness of the donation. Discussion: In Brazil, there are 39 BDP - six in the Northeast, four in the Midwest, one in the North, 11 in the South, and 17 in the Southeast - and two committees for body donation. Documents may be easily available through registration during life as a participant in the BDP, but it does not guarantee donation. In general, Brazilian's institutions receive the donated body along with the documentation. When the death occurs in the same city of the institution, it is possible to have the transfer of the body provided by partnerships with funeral services and the city hall. There is no fee to be paid or received either for registration during life or for donation after death. Conclusion: Although the legislation has regulated the donation of body in life since 2002, it is necessary to implement campaigns to inform about the donation, in addition to mechanisms that can promote speed in the deadlines for obtaining documentation for the purpose of donating body for scientific purposes, the exemption of notary fees and the possibility of transporting the body donated with no fees by funeral home of municipal governments. The MC support through the registration of the PDC as an extension activity collaborates to ensure ethical aspects related to the participation of donors in the living program, with regard to the treatment with respect and dignity of donors and their families.
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Dissection and human specimens study remain the gold standard method for teaching anatomy. Due to the increasing health science courses in Brazil, the traditional way of obtaining bodies for scientific purposes, the unclaimed ones, became insufficient. In addition, this source is no longer ethically appropriate according to anatomists. In order to maintain the teaching quality, the Federal University of Juiz de Fora (UFJF) in Brazil, inspired by successful initiatives around the world, created a body donation program; Sempre Vivo. Besides the bureaucratic difficulty faced during its regulation, the implementation of a body donation program requires special attention regarding the religiosity, culture and uniqueness of the city's inhabitants. Informing people can demystify the process, avoid prejudice and increase the number of donors. In this way, an outreach project was designed to publicize Sempre Vivo and raise public awareness. In the first six years, Sempre Vivo reached the mark of 64 registered donors and seven bodies received. The donor's profile corresponds to female (70.3%), 57 years of age, retired (50.8%), spiritist (53.1%) and with 12 years or more of formal education (90.6%). Considering that the UFJF has not received unclaimed bodies for ten years, the program was considered satisfactory up to this level and, in the future, it may be the exclusive source of anatomical specimens. The description of the creation and the publicizing of Sempre Vivo, the overcome challenges, as well as the donors' profile, may encourage and facilitate the foundation of similar programs in Brazil and abroad.
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SUMMARY: Modern anatomy education is imbued with humanistic values which manifest primarily in the ethical acquisition of bodies for research and education, and respectful treatment of these bodies in anatomy laboratories. This humanistic approach is best embedded in the organisation of commemorative ceremonies for body donors. This paper presents experiences of preparation and implementation of a commemorative ceremony at Macquarie University, Sydney. Local cultural context and university infrastructure were considered when preparing the commemoration. It was decided that it will be introduced in stages, starting with a ceremony for anatomy students. Students were surveyed about the introduction of the ceremony and their attitudes about its format. The results of the survey influenced the format in which the commemoration was conducted. The commemoration was introduced in 2019, embedded in the first anatomy lecture. Such format was cost effective, caused little disturbance to a complex timetable and was aligned with learning outcomes and students' cultural preferences. It also enabled easy transition to the online modes of the delivery caused by the COVID-19 pandemic in Australia. In the next stage commemorative ceremony will be inclusive of donor family members as well as students.
RESUMEN: La educación en anatomía moderna está incentivada de valores humanistas que se manifiestan principalmente en la adquisición ética de cuerpos para la investigación y la educación, y en el trato respetuoso de estos cuerpos en los laboratorios de anatomía. Este enfoque humanista se integra mejor en la organización de ceremonias conmemorativas para donantes de cuerpos. Este documento presenta las experiencias de preparación e implementación de una ceremonia conmemorativa en la Universidad Macquarie, Sydney. Se tuvo en cuenta el contexto cultural local y la infraestructura universitaria al preparar la conmemoración. Se decidió que se presentará por etapas, comenzando con una ceremonia para estudiantes de anatomía. Los estudiantes fueron encuestados sobre la presentación de la ceremonia y sus actitudes sobre su formato. Los resultados de la encuesta influyeron en el formato en el que se llevó a cabo la conmemoración. La conmemoración se introdujo en 2019, como parte de la primera conferencia de anatomía. El formato era rentable, causaba pocas alteraciones en un horario complejo y estaba alineado con los resultados del aprendizaje y las preferencias culturales de los estudiantes. También permitió la transición a los modos en línea de la entrega causada por la pandemia de COVID-19 en Australia. En la siguiente etapa, la ceremonia conmemorativa incluirá a los miembros de la familia donante y a los estudiantes.
Assuntos
Humanos , Estudantes de Medicina , Doadores de Tecidos , Corpo Humano , Anatomia , Austrália , Universidades , Cadáver , Atitude , Inquéritos e QuestionáriosRESUMO
The aim of this study was to evaluate the awareness, knowledge level and attitudes of the community in I˙zmir/ Turkey about cadaver donation in medical education. A cross-sectional study was carried out. Randomly chosen 245 participants answered twenty items in the questionnaire providing information about their demographics (5 items), awareness and knowledge (10 items), and attitudes (5 items) about body donation. The questionnaire was applied face-to-face. Descriptive statistics presented. Student T test and One-Way ANOVA test were used for statistical analysis. 123 (50.2 %) participants were male and 159 (64.9 %) were between 30 to 59 years old. 185 (75.5 %) respondents knew what the word "cadaver" means. When asked where they would apply if they decided to donate their body, 104 (42.4 %) of the participants gave the answer "state hospital". The mean score of awareness and knowledge about importance of cadaver and body donation (AWKL-Score) was 0.41±0.24 (min:0.00, max:0.90). AWKL-Score was statistically higher in the youngest (18-29 y) and oldest (>60 y) compared to the other age groups (F:4.115; p:0.007). AWKL-Score increased as the level of education increased. The highest AWKL-Score was at post-graduate level (Level 7,8) (F:22.997; p<0.001). The AWKL-Score was higher in public employees and students compared to other occupational groups (F:5.930; p<0,001). The answers to the questionnaire were important indicators of how much society needs to be informed regarding body donation.
El objetivo de este estudio fue evaluar el nivel de conciencia, conocimiento y las actitudes de la comunidad en Izmir / Turquía sobre la donación de cadáveres en la educación médica. Se realizó un estudio transversal de 245 participantes elegidos al azar, que respondieron veinte ítems en el cuestionario proporcionando información sobre su demografía (5 ítems), conciencia y conocimiento (10 ítems) y actitudes (5 ítems) sobre la donación de cuerpos. El cuestionario fue administrado directamente en persona; la prueba T de Student y la prueba ANOVA de una vía se utilizaron para el análisis estadístico. De los participantes 123 (50,2 %) eran hombres y 159 (64,9 %) tenían entre 30 y 59 años. 185 (75,5 %) encuestados sabían lo que significa la palabra "cadáver". Cuando se les preguntó dónde se registrarían, en caso de decidir donar su cuerpo, 104 (42,4 %) de los participantes respondieron "hospital estatal". La puntuación media de conciencia y conocimiento sobre la importancia del cadáver y la donación de cuerpos (puntuación AWKL) fue de 0,41 ± 0,24 (mínimo: 0,00, máximo: 0,90). Estadísticamente el puntaje AWKL fue más alto en los más jóvenes (18-29 años) y mayores (> 60 años) en comparación con los otros grupos etarios (F: 4,115; p: 0.007). AWKL-Score aumentó a medida que aumentó el nivel de educación. El puntaje AWKL más alto fue en el nivel de posgrado (Nivel 7,8) (F: 22,997; p <0,001). El puntaje AWKL fue mayor en empleados públicos y estudiantes en comparación con otros grupos ocupacionales (F: 5,930; p <0,001). Las respuestas al cuestionario fueron indicadores importantes de cuánto necesita la sociedad estar informada sobre la donación de cuerpos.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Doadores de Tecidos/psicologia , Cadáver , Conhecimentos, Atitudes e Prática em Saúde , Anatomia/educação , Turquia , Estudos Transversais , Inquéritos e Questionários , Análise de Variância , Consciência , Educação MédicaRESUMO
Activities related to body donation programs, such as donor memorial ceremonies, provide the opportunity to complement student training, especially with regard to the ethical and humanistic elements involved in medical training. This study sought to assess the impact of a ceremony in honor of the body donors has on ethical and humanistic attitudes in medical students. Medical students were surveyed about their perceptions of changes in themselves, respect for donors and donor families, and their relationship with patients. The effect of the students' contact with the family of the donor was analyzed in students who had contact with the cadaver in the dissection room and had either participated or not participated in the donor memorial ceremony. A total of 370 questionnaires were answered by first-, second-, and third-year medical students at the Federal University of Health Sciences of Porto Alegre in 2017. The students who participated in the ceremony presented more positive responses in relation to commitment to their studies, reflection on death, and positive development of empathy when compared to those who did not attend the ceremony. Most of the students that attended the ceremony suggested the event led to an improvement in the doctor-patient relationship. These results suggest that cadaver dissection with accompanied memorial ceremony involving contact with donor families is an effective means of fostering ethical and humanistic attitudes among medical students from the beginning of the course.
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Anatomia/educação , Educação de Graduação em Medicina/métodos , Humanismo , Relações Médico-Paciente/ética , Estudantes de Medicina/psicologia , Adolescente , Atitude , Brasil , Cadáver , Comportamento Ritualístico , Currículo , Dissecação/ética , Dissecação/psicologia , Ética Médica , Feminino , Humanos , Masculino , Desenvolvimento Moral , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Doadores de Tecidos/ética , Obtenção de Tecidos e Órgãos/ética , Adulto JovemRESUMO
SUMMARY: A better understanding of students' attitudes towards body donation, their role as potential donors and their preparedness to support body donation activities may help in the preparation of body donor programme strategies. The aim of the study was to determine the willingness to self-donate, and the religious and cultural beliefs on body donation in a sample of South African undergraduate students. A cross-sectional study was conducted on Black African undergraduate students of two schools in their first to third years of study in a South African University between 2014 and 2015. Four hundred and twenty questionnaires were administered. A total of three hundred and seventy-two students completed the questionnaire. A low proportion of the respondents (14.7 %) were willing to self-donate with the prevalent reason being to aid anatomical teaching. Religious beliefs were the predominant reason for unwillingness to self-donate. In addition, a low percentage of the students reflected that their religious (8.7 %) and cultural (4.1 %) beliefs permitted whole body donation. In conclusion, this study shares insights into the attitudes of undergraduate students towards body donation. For future body donation programmes, this group might not be a possible pool for such programmes. However, this group of students can assist in spreading the message to the public as they had very good knowledge about issues surrounding body donation.
RESUMEN: El propósito fue obtener un mayor conocimiento de las actitudes de estudiantes hacia la donación de cuerpo, su papel como potenciales donantes y su preparación para apoyar las actividades en la preparación de estrategias del programa de la donación. El objetivo del estudio fue determinar la voluntad de auto donar el cuerpo, además de las creencias religiosas y culturales sobre la donación de cuerpos en una muestra de estudiantes sudafricanos de pregrado. Se realizó un estudio transversal en estudiantes negros africanos de pregrado de dos escuelas, en su primer a tercer año de estudio en una universidad sudafricana entre los años 2014 y 2015. Se administraron 420 cuestionarios. Un total de 372 estudiantes completaron el cuestionario. Una baja proporción de los encuestados (14,7 %) estaban dispuestos a donar su cuerpo citando como razón predominante el apoyo a la enseñanza anatómica. Las creencias religiosas predominaron durante la encuesta ante la falta de voluntad de la auto-donación. Además, un porcentaje menor de los estudiantes reflejó que sus creencias religiosas (8,7 %) y culturales (4,1 %) permitían la donación de todo el cuerpo. En conclusión, este estudio entrega una mejor percepción de las actitudes de alumnos de pregrado hacia la donación de cuerpos. En el futuro, este grupo posiblemente podría no ser un buen referente para los programas de donación de órganos. Sin embargo, este grupo de estudiantes puede ayudar en la difusión de información al público, debido a que tenían muy buen conocimiento sobre los temas que se refieren a la donación del cuerpo.
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Humanos , Masculino , Feminino , Adulto Jovem , Estudantes de Medicina/psicologia , Doadores de Tecidos/psicologia , Estudos Transversais , Características Culturais , Conhecimentos, Atitudes e Prática em Saúde , Religião , África do Sul , Inquéritos e Questionários , VoliçãoRESUMO
Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students, medical student teaching assistants, medical students involved in research, and anatomy professors. A cross-sectional, prospective study was designed in which the questionnaire was distributed among first-year human anatomy students before undertaking cadaver dissection at the beginning of the semester, and then again after a commemoration service at the end of the course. The questionnaire items included demographic data, as well as questions designed to characterize participants' attitudes regarding body/organ donation from strangers, family members, and whether participants would consider such practices with their own bodies. Out of a total of 517 students enrolled in the Human Anatomy course in the Medical School at the Universidad Autónoma de Nuevo León, Mexico during January to June 2016, 95% responded to the first (491) and second (490) surveys. Participants' opinions on their own organ donation was similar before and after exposure to cadaver dissection, with between 87% and 81% in favor of such practices, and only 3% against it, in both surveys. Participants' willingness to donate their own bodies, as well as those of family members, increased, while reluctance regarding such practices decreased by half (P < 0.0001 and P < 0.05). Professors had the highest rates of positive opinions regarding their own body donation (74.9%), with 18.8% undecided. Low opposition toward organ and body donation remains prevalent among both anatomists and physicians in training in Mexico. Anat Sci Educ 10: 589-597. © 2017 American Association of Anatomists.
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Altruísmo , Anatomistas/psicologia , Docentes de Medicina/psicologia , Estudantes de Medicina/psicologia , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adolescente , Adulto , Anatomistas/estatística & dados numéricos , Anatomia/educação , Cadáver , Estudos Transversais , Dissecação , Educação de Graduação em Medicina/métodos , Docentes de Medicina/estatística & dados numéricos , Feminino , Humanos , Masculino , México , Estudos Prospectivos , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
The use of human material in anatomy education depends upon the generosity of body donors. However, little is known regarding the demographics of body donors in Brazil, where voluntary body donation is a relatively rare phenomenon. Hence, the aim of the present study was to elucidate the demographic profile of applicants to the Body Donation Program (BDP) at the Federal University of Health Sciences of Porto Alegre in Brazil, as well as to assess whether the observed characteristics of body donors are unique to that sample, or if they merely reflect the characteristics of the regional population. Information derived from the specific forms filled out by donors between January 2008 and June 2016 at the time of registration were collected. Data from 416 forms were analyzed. Based on this study, the typical applicant in Brazil is typically a white female (67.4%), over 60 years of age (60.3%), unmarried or single (70.6%), affiliated with a religious group (89.1%), of middle class background (40.4%), who has completed high school and/or holds a university degree (93.8%). The motivation of donors was, in most cases, an altruistic gesture, represented by the desire to help society and science. Elucidating these demographic characteristics of potential donors may help identify the target public to which information regarding body donation campaigns could be directed. Anat Sci Educ 10: 475-486. © 2017 American Association of Anatomists.
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Altruísmo , Anatomia/educação , Motivação , Doadores de Tecidos/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Cadáver , Criança , Pré-Escolar , Demografia , Dissecação/educação , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Doadores de Tecidos/estatística & dados numéricos , Universidades , Adulto JovemRESUMO
Anatomy, one of the key pre-clinical subjects in medical and allied medical disciplines, has traditionally relied on instruction based on the utilization of cadavers. Acquiring cadavers for anatomy education has presented a challenge in many countries. This challenge has been met through the organization of well informed and culturally sensitive body donation programs. Attitudes of the general population, medical professionals and students are important in devising these programs. The aim of this study was to investigate attitudes of medical and allied medical students from the University of Novi Sad toward whole body donation. A survey was carried out on the first and third year students enrolled in all degrees taught at the University and the sixth year medical students. A large number of respondents (87.38%) perceived cadavers as important in anatomy education. The majority of students (51.26%) would support the body donation of a stranger, while a much smaller proportion of respondents would become donors (19.51%) or support their family members (21.67%) to bequeath their body. There were differences in attitudes toward body donation related to respondents' year of study, ethnicity and religion. The main reasons for donation were altruistic, while the main reasons not to donate were lack of information and religious factors. Most of the respondents were in favor of introducing memorial services for the body donors. The results of the study highlight the importance of a culturally sensitive approach to students in the anatomy laboratories and the enrichment of anatomy education through the humanities. They also underscore the significance of well-organised and informative body donation programs.
Anatomia, um dos principais temas pré-clínicos em disciplinas da medicina e áreas médicas afins, tradicionalmente tem contado com a instrução baseada na utilização de cadáveres. A aquisição de cadáveres para o ensino da anatomia tem se mostrado um desafio em muitos países. Este desafio tem sido enfrentado através da organização de programas de doação de corpo bem informados e culturalmente sensíveis. Atitudes da população geral, de profissionais e estudantes de medicina são importantes na elaboração desses programas. O objetivo deste estudo foi investigar as atitudes de estudantes de medicina e áreas médicas afins da Universidade de Novi Sad em relação à doação completa do corpo. A pesquisa foi conduzida com todos os estudantes do primeiro e terceiro anos inscritos em todos os cursos oferecidos pela universidade e com os estudantes do sexto ano de medicina. Uma grande parcela dos entrevistados (87,38%) reconhece a importância dos cadáveres no ensino da anatomia. A maioria dos estudantes (51,26%) apoiaria a doação de corpo de um estranho, enquanto que uma proporção muito menor dos entrevistados se tornariam doadores (19,51%) ou apoiariam seus familiares a doarem os corpos deles (21,67%). Houve diferenças nas atitudes em relação à doação de corpo relacionadas aos anos de estudo, etnia e religião dos entrevistados. As principais razões para as doações foram altruísticas, enquanto que os principais motivos para a não doação foram a falta de informação e fatores religiosos. A maioria dos entrevistados foi a favor da introdução de serviços memoriais para os doadores de corpos. Os resultados do estudo destacam a importância de uma abordagem culturalmente sensível aos estudantes nos laboratórios de anatomia e do enriquecimento do ensino da anatomia através das humanidades. Eles também ressaltam a importância de programas de doação de corpo bem organizados e informativos.
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Obtenção de Tecidos e Órgãos , Cadáver , Educação Médica , AnatomiaRESUMO
Introdução: As universidades brasileiras enfrentam dificuldades na obtenção do número adequado de corpos para oferecer ensino de qualidade e pesquisa. Em virtude disso, elaboramos um Programa de Doação de Corpos. O objetivo é avaliar a resposta ao programa proposto após seu primeiro ano de implantação. Métodos: Observadas as exigências éticas e legais, o Programa foi elaborado e implementado. Os dados dos doadores foram armazenados em banco de dados digital e a análise realizada sobre o número de doações e perfil sociocultural dos doadores. Resultados: O número de doações em vida por ano aumentou 8,9 vezes, quando comparado ao período prévio ao Programa. Entre os doadores, 59,78% se declararam católicos; 19,56% declararam não possuir religião; 13,04% pertenciam a outras religiões cristãs e 6,6% eram evangélicos. Em relação ao grau de instrução, 53,5% concluíram o ensino superior; 40% possuíam ensino médio e 6,6% alfabetizados. Conclusão: O Programa mostrou-se inicialmente bem-sucedido, devido ao expressivo aumento no número de doações em vida. Os maiores benefícios são o acesso à informação para aqueles que demonstram interesse de doar, além do ganho em qualidade de ensino para a instituição.
Introduction: The Brazilian universities face difficulties in obtaining an adequate number of bodies to provide quality education and research. As a result, we have developed a Body Donation Program. The aim here is to evaluate the response to the proposed program after its first year of implementation. Methods: The program was developed and implemented in compliance with the ethical and legal requirements. The data of the donors were stored in a digital database and an analysis of the number of donations and social and cultural profile of the donors was performed. Results: The number of living donations per year increased 8.9 times compared to the previous period without the program. Among the donors 59.78% declared themselves Catholic, 19.56% reported having no religion, 13.04% belonged to other religions, and 6.6% were Christian evangelicals. Regarding schooling 53.5% completed tertiary education, 40% had secondary education, and 6.6% were just literate. Conclusion: The program was initially successful due to the significant increase in donations in life. The greatest benefits are access to information for those who are willing to donate and the gain in quality of education for the institution.