Low rates of organ donation and transplantation: causes and solutions
List of Authors
  • Dimo, Peter Masibinyane , Mulqueeny, Delarise, M.

Keyword
  • Organ donation, transplantation, deceased organ donation, living donation

Abstract
  • Organ donation presents as a global public health, societal and educational challenge with a high number of patients with end-stage diseases being left in limbo due to the low rates of life-saving organ donation and transplantation. Organ transplantation is a definitive therapy for patients suffering from a wide range of end-stage diseases and organ failures which prolongs and improves their lives and wellbeing. Countries including South Africa struggle with low rates of organ donation and transplantation with the number of patients on organ donation waiting lists exceeding the number of available organs. Hence, the imbalance of organ supply and demand results in many patients dying prior to receiving life-saving organs. South Africa currently utilizes the opt-in system which assumes that all people do not want to be organ donors. This study’s aim sought to explore and assess factors responsible for low rates of organ donations with its aim being achieved through the employment of a qualitative approach aligned to an explorative research design. Additionally, the eco-systems theory was adopted as the theoretical framework for this study. Purposive sampling was used to recruit thirty research participants. In-depths interviews with traditional leaders in rural areas who were 20 years and older were used to collect data that was later analyzed using a thematic content approach. The study findings highlighted the breeding grounds for low rates of organ donation and transplantation. These include the refusal to grant consent for organ donation, lack of knowledge surrounding the process, pursuance of the opt-in system of organ donation, attitudes and socio-cultural factors contributing to the chronic shortage of life-saving organs. Moreover, recommendations emanating from the findings could improve the rate of organ donation and transplantation.

Reference
  • 1. Andreasen, A.R. (1994). Social marketing: its definition and domain. Journal of Public Policy & Marketing, 13(1):108-114.
    2. Aniza I., Naren, K.S., Suzana, L.S., Hani, N.Z., & Hasdy, H. (2017). Factors influencing families’ refusal for deceased organ and tissue donation in Malaysia. International medical journal, 24(3): 290-294.
    3. Anker, A.E., Akey, J.E & Feeley, T.H. (2013). Providing social support in a persuasive context: forms of social support reported by organ procurement coordinators. Health Communication, 28: 835–845.
    4. Arora, P. & Subramanian, R. (2019). Improving societal outcomes in the organ donation value chain. Production and Operations Management Society, 28(8): 2110-2131.
    5. Bahrami, A., Khaleghi, E., Vakilzadeh, A. K., & Afzalaghaee, M. (2017). Process and barriers to organ donation and causes of brain death in northeast of Iran. Electronic physician, 9(2), 3797–3802. https://doi.org/10.19082/3797.
    6. Bharambe, V.K., Arole, V.U., Puranam, V., Manvikar, P. & Rathod, H.K. (2016). Organ donation: from point of view of students doing medical internship in India. Bantao journal, 14 (2):67-72.
    7. Buthelezi, N, & Ross, E. (2011). Gift of life or cultural taboo: Effects of an educational pamphlet 0n young adults, knowledge and attitudes regarding organ donation. Social work care, 50:719-738.
    8. Correio, C.V.S., Pereira, J.R., Resende, L.B.C & Rezende, L.B.O. (2017). Donate to save: an analysis of the intention to donate organs under the perspective of social marketing. Revista Gestao & Technologia, Pedro Leopoldo, 17(1):10-35.
    9. Cotrau, P., Hodosan, Vladu, A., Daina, L., Negrau, M., Daina, C., Pantis, C. & Vernic, C. (2020). Consent model, opt-in/opt-out system, and organ donation rates in European Union countries. Applied medical informatics, 42(1): 36-41.
    10. Creswell, J.W., Ebersohn, L., Eloff, I., Ferreira, R., Ivankova, N.V., Jansen, J.D., Nieuwenhuis, J., Pieterson, J. & Plano Clark, V.L. (2016). First steps in research, (2nd Edition). Pretoria: Van Schaik Publishers.
    11. Dimo, P.M. (2018). Organ donation behaviour: debates amongst black South Africans. Gender & behaviour, 16(3), 2018, 12200 – 12210.
    12. Dimo, P.M. (2019). Participating in organ donation: Issues among Black South Africans. Global journal of health science, 11(1): 71-80.
    13. Dimo, P.M. (2019). Organ donation and transplantation: Implications for social work. Gender & Behaviour, 17 (4), December 2019: 14147 – 14157.
    14. Dimo, P.M. (2020). Progress in organ donation and transplantation: A critical review of literature. Global Journal of Health Science, 12(10); 2020: 133-140.
    15. dos Santos, J.R., dos Santos, A.D.B., Lira, G.G & de Moura, L.T.R. (2019). Perception of family members on the donation of organs and tissues. Journal of nursing UFPE, 13(3) :578-585.
    16. Etheredge, H., Penn, C. & Watermeyer, J. (2019). Opt-in or opt-out to increase organ donation in South Africa? Appraising proposed strategies using an empirical ethics analysis. Developing world bioethics, 2018(18): 119-125.
    17. Gray, D.E. (2018). Doing research in the real world, (4th Edition). Los Angeles: Sage.
    18. Guttman, N., Siegal, G., Appel, N. & Bar-On, G. (2016). Should altruism, solidarity, or reciprocity be used as prosocial appeals? Contrasting conceptions of members of the general public and medical professionals regarding promoting organ donation. Journal of Communication, 66(2016): 909-936.
    19. Handa, N., Vir Singh, N., Dhiman, R.K., Ghai, S. & Agnihotri, M. 2018.Knowledge of Nurses Regarding Organ Donation. Nursing and Midwifery Research Journal, 14(2): 71-78.
    20. Jawoniyi, O., Gormley, K., McGleenan, E & Noble, H.R. (2017). Organ donation and transplantation: Awareness and roles of healthcare professionals-A systematic literature review. Journal of clinical nursing, 2018(27): 726-738.
    21. Kamin, T., Berzelak, J. & Ule, M. (2017). Mind the gap: social aspects of willingness for post-mortem organ donation in Slovenia. Teorija in Praksa, Letnik, 54(5): 733-746. http://www.dlib.si.
    22. Keten, H.S., Isik, O., Ucer, H., Keten, D., Ersoy, O. & Olmez, S. (2017). Knowledge, attitudes and behaviors of physicians about organ donation. Cukurova Medical Journal, 42(4):623-629.
    23. Kiani, M., Abbasi, M., Ahmadi, M. & Salehi, B. (2018). Organ transplantation in Iran; current state and challenges with a view on ethical consideration. Journal of clinical medicine, 7 (45):2-16.
    24. Krupic, F., Sayed-Noor, A.S. & Fatahi, N. (2017). The impact of knowledge and religion on organ donation as seen by immigrants in Sweden. Sandinavian journal of caring sciences, 2016: 687-694.
    25. Krupic, F., Westin, O., Hagelberg, M., Skoldenberg, O. & Samuelsson, K. (2019). The Influence of Age, Gender and Religion on Willingness to be an Organ Donor: Experience of Religious Muslims Living in Sweden. Journal of Religion and Health, (58):847–859.
    26. Lewis, A., Lord, A., Czeisler, B.M. & Caplan, A. (2016). Public education and misinformation on brain death in mainstream media. The journal of clinical and transplantation research, 30: 1082-1083.
    27. Miller, C. & Breakwell, R. (2018). What factors influence a family’s decision to agree to organ donation? A critical literature review. London journal of primary Care, 10(4): 103-107.
    28. Mohan, G. & Aswathy, A.A. (2019). Organ donation in India-A social marketing perspective. International journal of non-profit and voluntary sector. (24): 1-12.
    29. Mostafa, M.M. (2017). Altruistic, cognitive and attitudinal determinants of organ donation intention in Egypt: A social marketing perspective. Health Marketing Quarterly, 27:97–115.
    30. Muliira, R.S. & Muliira, J.K. (2014). A review of potential Muslim organ donors‟ perspectives on solid organ donation: lessons for nurses in clinical practice, Nursing Forum. 49 (1): 59-70.
    31. Muller, E. 2013. Organ donation and transplantation in South Africa – an update. CME, 31 (6):220-222.
    32. Okere, G.O. (2017). Barriers and enablers of effective knowledge management: A case in the construction sector. The Electronic Journal of Knowledge Management, 15 (2): 85-97.
    33. Organdonor. https://www.organdonor.gov/statistics-stories/statistics.html
    34. Potter, J.E., Herkes, R.G., Perry, L., Elliott, R.M., Aneman, A., Brieva, J.L., Cavazzoni, E., Cheng, A.T.H., O’Leary, M.J., Seppelt, I.M., Gebski, V & the Comfort Investigators. (2017). Communication with families regarding organ and tissue donation after death in intensive care (comfort): Protocol for an intervention study. BMC health services research, 17(12): 2-10.
    35. Rodriguez-Arias, & Morgan, M. (2016). “Nudging” deceased donation through an opt-out system: a libertarian approach or manipulation? The American journal of bioethics, 16(11): 25-28.
    36. Shaw, D.M. (2017). The consequences of vagueness in consent to organ donation. Journal of bioethics, 31(6): 424-431.
    37. Siebelink, M.J., Verhagen, A.A.E., Roodbol, P.F, Albers, M.J.I.J. & Van de Wiel, H.B.M. (2017). Education on organ donation and transplantation in primary school; teachers' support and the first results of a teaching module. PLoS ONE, 12(5): e0178128.
    38. Simkulet, W. (2017). Reasonable default in organ donation policy. Ajob neuroscience, 8(4): 236-238.
    39. Sukalla, F., Wagner, A.J.M. & Rackow, S. (2017). Dispelling Fears and Myths of Organ Donation: How narratives that include information reduce ambivalence and reactance. International Journal of Communication, 11: 5027–5047.
    40. Suppes, M.N. & Wells, C.C. (2018). Social work experience: A case-based introduction to social work and social welfare, (7th Edition). United States of America: Pearson.
    41. Swadimath, U.C. & Joshi, P.B. (2017). Influence of Culture On Gender in India. A Peer Reviewed Research Journal, XXIII (2): 90-99.
    42. Tarus, L. & Gavrilovici, C. (2015). Attitudes, perceptions and determinant factors in organ donation. Social research reports, 27: 67-76.
    43. Uskun, E. & Ozturk, M. (2013). Attitudes of Islamic religious officials toward organ transplant and donation. Clinical transplantation, (27): 37-41.
    44. Virginio, B.C.A.E., Escudeiro, C.L., Christovam, B.P., Silvino, Z.R., Escudeiro, C.L. Guimaraes, T.C.F.G & Oroski, G. (2014). Death and organ donation from the point of view of nurses: A descriptive study. Brazilian National Cardiology Institute, 13(1): 92-101.
    45. Zwart, H. (2016). Transplantation medicine, organ-theft cinema and bodily integrity. Subjectivity, 9:151–180. https://doi.org/10.1057/sub.2016.1