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Background: Understanding the perception of the risks associated with xenotransplant, especially among professionals who will contribute to the care of the animals, is important for xenotransplant to become a clinical reality. The objective of this study was to analyze opinions regarding the risks of organ xenotransplant among veterinary university students in Spain., Methods: The study population was 2683 veterinary students from different courses and universities in Spain. Instrument valuation: Validated self-administered questionnaire completed anonymously (PCID-XENOTx-Ríos). Consent to collaborate in the study was requested. Variables for the study: attitude toward xenotransplant and risks (infectious, immunologic, ethical/moral, philosophical, religious, other unspecified risks)., Statistics: descriptive analysis, Student t test, χ 2 test, and Fisher exact test., Results: Of the total number of respondents, 2646 students answered this question, with a completion rate of 98.6%. They considered immunologic risk 78.4% (n = 2074), infectious risk 48.6% (n = 1286), ethical/moral risk 10.7% (n = 284), philosophical risk 5.2% (n = 137), religious risk 1.5% (n = 40), and other risks 3.9% (n = 104). Significant relationships were observed between immunologic risks (P < .001), ethical/moral risks (P < .001), and other risks (P = .002)., Conclusions: Despite the consideration of different types of risks, the favorable attitude toward xenotransplant among veterinary students at Spanish universities is highly prevalent, and evidence-based information campaigns on the different risks associated with xenotransplant are important., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Xenotransplantation could be a source of organs for transplantation given the global organ shortage. It is important to know the opinion and variables that influence the acceptance of xenotransplantation of the professionals who will work in the genetic manipulation, production, and care of animals to be used for this purpose., Objective: Analyze the influence of religious beliefs on the attitude toward xenotransplantation in veterinary students., Methods: The study population included 2683 veterinary students from different courses and Spanish Universities. Instrument evaluation included a validated self-administered and anonymously completed questionnaire (PCID-XENOTx-Ríos). The survey was self-administered and completed anonymously. Consent to collaborate in the study was requested. Variables for the study included attitude toward xenotransplantation and toward religion, considering the following options: practicing Catholic, nonpracticing Catholic, non-Catholic, and atheist/agnostic. Statistics were performed using descriptive analysis, Student t test, -X 2 , and Fisher's exact test., Results: Of the total number of participants, 7 did not answer this question. Those in favor of xenotransplantation were 92.9% (n = 247) of practicing Catholics, 92.8% (n = 812) of nonpracticing Catholics, and 87.3% (n = 69) of those professing another non-Catholic religion compared with 93.5% (n = 1361) of those considering themselves agnostic/atheist (P = .037)., Conclusions: Religion is an influential factor in attitudes toward organ xenotransplantation. Those who practice Catholicism and those who consider themselves agnostic/atheist are more accepting of organ procurement for transplantation than those who practice other religious doctrines., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Health professionals are asked to promote health, especially organ transplantation; however, they do not always have specific training., Objective: To analyze information about donation and organ transplantation among Spanish medical students., Method: The population under study is medical students in Spanish universities using the database of the International Donor Collaborative Project, stratified by geographic area and academic year (n = 9275). The instrument used is the attitude questionnaire for organ donation for "PCID-DTO-Ríos" transplantation, validated with an explained variance of 63.203% and α = 0.834. The Student t test was applied together with the χ 2 test, complemented by an analysis of the remainders, and Fisher's exact test was applied., Results: Of the students, 74% indicate that they have received information from university professors about organ transplant. Concerning specific issues with the donation, it is notable that only 66.7% (n = 6190) know and accept the concept of brain death as the death of a person. However, only 22% consider themselves as having good information, and 35.3% indicate that their information is scarce or void. Students indicate having received information about transplant from other extra-university sources, such as television and Internet (80.9%), books and magazines (73.2%), and the press (66.9%). From the information obtained in the sociofamilial field, 60.7% have obtained information from the family and 58.1% from friends. Of this information, 9% has been negative from friends, 7.5% from family, 6% from the Internet and television, and 4% from university professors., Conclusion: Spanish medical students believe they have little information about organ transplantation and have received negative information., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: Despite sensitization of medical students toward the donation of organs, a non-negligible percentage of students are not in favor of donation., Objective: To analyze the reasons of Spanish medical students who do not have a favorable attitude toward the donation of their own organs after death., Method: The population under study is medical students in Spanish universities, using the database of the International Donor Collaborative Project, stratified by geographic area and academic year. The questionnaire completion was anonymous and self-administered. The study group is medical students with an unfavorable attitude toward organ donation. The assessment instrument used is a validated questionnaire of attitude toward the donation of organs for transplant, "PCID-DTO-Ríos." The reasons against the donation are valued in the questionnaire through a question., Results: Of the participants included in the PCID, students who are not in favor of organ donation were selected (n = 1899). Of them, 8.1% (n = 154) are against and 91.1% (n = 1745) are doubtful. The main reasons indicated are the fear of apparent death in 11.4% of respondents, fear of possible mutilation after donation in 11.1%, and religious reasons in 2.6%. Of those, 6.9% indicate other reasons but do not clearly specify the reasons, using words such as "fear" (2.5%) or "doubts about the process" (4.1%); 66.2% (n = 1257) indicated an "assertive refusal" ("I don't want to express my reasons")., Conclusion: Twenty percent of Spanish medical students are not in favor of donating their organs and are not in favor of showing their reasons., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: Awareness of organ donation among Spanish doctors and medical students is very positive. However, the emerging group of professionals of non-Spanish nationality studying in Spain has not been analyzed., Objective: To analyze the differences in the attitudes toward the different types of donation among medical students, according to their nationality., Methods: The population under study is medical students in Spanish universities using the database of the International Collaborative Donor Project, stratified by geographic area and academic year. Groups under study include students of non-Spanish nationality as group 1 (n = 1570) and students of Spanish nationality as Group 2 (n = 7705). Instruments are validated questionnaires of attitude toward donation "PCID-DTO-Ríos," "PCID-DVR-Ríos," "PCID-DVH-Ríos," and "PCID-XenoTx-Ríos.", Results: The attitude toward the donation of own organs after death is similar in both groups (P = .703). Non-Spaniards are 79.2% in favor compared to 79.6% of Spaniards. Living kidney donation, both unrelated (33.3% vs 29.3% in favor; P = .001) and related (91.2% vs 89, 6% in favor; P = .047), is more favorable among non-Spanish students. There are no differences regarding non-related living liver donation (29.7% vs 29.3% in favor; P = .063), but there are differences in the results for related living liver donation (94.1% vs 88%; P < .001). The attitude toward xenotransplantation of organs is similar (80.8% vs 80.8%; P = .999)., Conclusions: Awareness of the donation of organs among Spanish medical students is similar to non-Spanish students studying in Spain, except the attitude toward living donation., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Health care professionals and the information that they provide to the public on organ donation and transplantation (ODT) influence attitudes toward this option., Objective: The objective was to analyze the knowledge of university nursing students at Spanish universities toward ODT and the factors affecting it., Methods and Design: The methods and design included a multicenter, sociologic, and observational study including university nursing diploma students in a complete academic year., Participants: A sample of 10,566 students was selected stratified by geographic area and year., Instrument: A validated questionnaire of knowledge toward ODT (PCID-DTO RIOS), self-administered and completed anonymously., Results: Questionnaire completion rate: 85% (n = 9001). Only 18% (n = 1580) believed that their knowledge about ODT was good, 40% (n = 3578) believed that the information they had was normal, and 39% believed that their knowledge was sparse. Of the students, 96% believed that organ needs are not covered and 79% that they might need a transplant in the future. Only 39% (n = 3493) had attended a talk about ODT. Furthermore, 83% (n = 7435) believed that attending a talk would be interesting. The following variables were associated with having a more adequate knowledge: gender (62% men vs 57% women; P < .001); academic year (P < .001); knowing a donor (P < .001); knowing a transplant patient (P < .001); believing the possibility of needing a transplant oneself in the future (P < .001); attitude toward deceased donation (P < .001); and interest in receiving an informative talk about ODT (P < .001)., Conclusion: Only 18% of nursing students in Spain believed that their knowledge about ODT was adequate. These results must be considered for possible training plans for these future professionals., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The involvement of health professionals from their training period is important for the promotion of living liver donation. There are data that indicate that the awareness of living donation is lower in areas with high rates of deceased donation., Objective: To analyze the attitude toward living liver donation among Spanish medical students, according to donation rates of their regions., Method: Population under study: Medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: group 1 (n = 1136): students in universities of regions with >50 donors per million population (pmp); group 2 (n = 2018): students in region universities with <40 donors pmp. Assessment instrument: the attitude questionnaire for living liver donation Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Hepático-Ríos (PCID-DVH Ríos)., Results: The attitude toward related liver donation is more favorable among the students of regions with <40 donors pmp than among those of >50 donors pmp. Thus, in group 1, a total of 88% (n = 1002) of students are in favor compared with 91% (n = 1831) of group 2 (P=.02). The psychosocial profile of each study group about their attitude toward living related liver donation is analyzed. There is a similar profile between the 2 groups, although there are differences in some variables such as age, a belief that one might need a transplant, family discussion about donation and transplantation, discussion with friends about donation and transplantation, and knowing about a donor., Conclusions: The awareness of living related donation among Spanish medical students is greater among the regions with lower organ donation rates., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: Organ refusal rates among Gypsies is much higher than that of any other social group in Spain. However, their attitude toward new therapies related to transplantation, such as the xenotransplantation, is not known. This is especially important in countries such as Spain, where there are research and development units for xenotransplantation., Objective: To analyze the attitude toward xenotransplantation among the Gypsy population living in Spain., Method: Type of study: Observational sociological study. Population under study: Adult Gypsy population currently residing in Spain., Sample: A random sampling of 230 adult Gypsies. Assessment instrument: A validated attitude questionnaire for xenotransplantation-PCID-XenoTx Ríos. Fieldwork: Random selection based on stratification. Anonymity and self-administered fulfillment., Statistics: Student t test, χ 2 , Fisher, and a logistic regression analysis., Results: A sample of 206 Gypsies was obtained. Forty-five percent (n = 93) would accept a solid organ xenotransplantation if they needed it, and the results were similar to those currently obtained with human organs; 24% (n = 49) have doubts, and 31% (n = 64) would not accept the xenotransplantation. If the results were worse than with human organs, only 9% would accept the xenotransplantation (n = 19). Respondents with a favorable attitude toward xenotransplantation presented a more favorable attitude toward cadaveric organ donation (55% vs 34%, P = .01)., Conclusions: Gypsies do not present a very favorable attitude toward xenotransplantation, especially compared with other Spanish population groups. A favorable sensitivity is presented by the population group in favor of it to cadaveric organ donation, which could be used to sensitize this social group and promote donation campaigns with the aim of increasing donation rates., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The awareness of organ donation among health professionals is important at the time of transplant promotion. In this sense, the training and awareness of the professionals in training is fundamental., Objective: To analyze the differences in the attitude toward organ donation and the factors that condition it among medical students of regions with donation rates >50 donors per million population (pmp) with respect to those with rates <40 donor pmp., Method: Population under study: medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: Group 1 (n = 1136): students in universities of regions with >50 donors pmp. Group 2 (n = 2018): university students in regions with <40 donors pmp. Assessment instrument: attitude questionnaire for organ donation for transplant PCID-DTO-Ríos., Results: The attitude toward organ donation for transplantation is similar among students from the autonomous communities with >50 donors pmp and with <40 donors pmp. In group 1, 79% (n = 897) of students are in favor compared with 81% (n = 1625) of group 2 (P=.29). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): sex, having discussed transplantation with family and as a couple, considering the possibility of needing a transplant, involvement in prosocial activities, attitude toward the manipulation of corpses, knowledge of the brain death concept, and religion., Conclusions: The awareness of organ donation in Spanish medical students is quite homogeneous and is not related to the local donation rates of each region., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: The sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns., Objective: To analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba., Method: Population under study: Population who reside in Cienfuegos, Cuba., Inclusion Criteria: Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant-PCID-DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study., Statistics: Student t test, χ 2 , Fisher, and a logistic regression analysis., Results: A sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation., Conclusions: The attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: The refusal to consider death and the donation and transplantation of organs make Gypsies one of the subpopulation groups with the lowest donation rates in Europe. The approach of this social group implies the support of the most favorable social groups within their own ethnic group. In this sense, the young population with a high level of education is usually the most favorable toward organ donation., Objective: To analyze the attitude toward the donation of one's own organs for transplantation among the Gypsy population under 45 years and with secondary or university studies., Method: Population under study: The Gypsy population under 45 years old with secondary or university studies who currently reside in Spain. Assessment instrument: The attitude questionnaire for organ donation for transplantation PCID-DTO Ríos. Fieldwork: A random selection based on stratification. Anonymity and self-administered fulfillment., Statistics: Student t test and χ 2 ., Results: A total of 44 Gypsy people under 45 years of age were surveyed (mean age 31 ± 8.9 years); 66% were women, and the rest were men. Of these, 20 had university studies, and 24 had secondary or vocational studies. The attitude is favorable toward organ donation in 64% of the respondents, with 80% among university students and 50% among those with secondary or vocational education (P < .005)., Conclusions: The young Gypsy population with university studies has a very favorable attitude toward organ donation. This population subgroup must be key in the promotion of organ donation in the Gypsy population, so the transplant coordinators must request their collaboration in the promotion campaigns of organ donation and transplantation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: Negative organ donation rates among the Gypsies is much higher than that of any other social group in Spain. However, living donation rates have not been raised much in this social group, despite the existence of several Gypsy patients on the waiting list for transplantation., Objective: To analyze the attitude toward related living donation among the Gypsy population who reside in Spain., Methods: This type of study is an observational sociological study. The study consisted of the adult Gypsy population residing in Spain, and a random sampling of 230 adult gypsies was conducted. Attitude questionnaires for live donation, both hepatic PCID-DVH-Ríos and renal PCID-DVR-Ríos, were used, and random selection was based on stratification. Questionnaires were self-administered and completed anonymously. Student t test, χ2, Fisher, and a logistic regression analysis were used., Results: A sample of 206 Gypsies (52% women) with a mean age of 34 years is obtained. Seventy-two percent (n = 150) would donate an organ to a relative in life, 8% (n = 16) would not donate it, and 20% (n = 41) have doubts. Respondents with a favorable attitude toward living donation presented a more favorable attitude toward cadaveric organ donation (55% vs 0%, P < .001). The attitude toward living kidney donation was more favorable (81% in favor) than toward living liver donation (P < .001)., Conclusions: The Gypsy ethnic group is sensitized to live donor transplantation. The family and cultural roots of Gypsy people could condition this favorable attitude, a fact to be taken into account to sensitize this social group and promote donation campaigns with the aim of increasing donation rates., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: The knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation., Objective: To analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it., Methods: From the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ 2 , Fisher, and logistic regression analysis were used., Results: Forty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation., Conclusion: There is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: Religious factors have conditioned the attitude toward organ donation and transplantation (ODT) since the beginning of transplantation, despite the fact that most religions are in favor of transplantation., Objective: To assess the impact of religious beliefs of medical students on their attitude toward ODT., Method: Population under study: Medical students in Spanish universities., Study Sample: Stratified by geographical area and academic course. Assessment instrument: Attitude ODT questionnaire PCID-DTO-Ríos, anonymous and self-administered., Results: Of all students, 42% (n = 3907) declare themselves atheists or agnostics. The remaining 58% (n = 5368) declare themselves to be religious, the majority being Catholic (55%, n = 5102). Of the rest, 0.2% are Muslims (n = 8), 0.1% Protestants (n = 1), and the remaining 2.7% (n = 257) indicate other religious doctrines but do not want to specify it. Regarding their attitude toward ODT, those who consider themselves atheists or agnostics have a more favorable attitude than those who consider themselves religious (84% versus 76%; P < .001). Among those who follow some kind of religion, Catholics are more in favor of ODT than non-Catholics (77% vs 64%, P < .001). Note that among the religious, only 57% (n = 3050) know which religion is in favor of transplantation, while 22% (n = 1,152) consider that it has not been pronounced on the matter, 13% (n = 723) think the religion is against donation, and the remaining 8% (n = 443) do not know., Conclusion: The religion professed by medical students conditions their attitude toward donation, with the atheists and agnostics being more in favor of donation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: It is important to determine the level of social acceptance of xenotransplantation, especially in places where there are preclinical xenotransplantation projects. In this sense, it is important to know the attitude of teenagers, given that their attitude could have an influence on this kind of donation in the future., Objectives: The aim of this study is to analyze the attitudes of teenagers toward xenotransplantation and to determine the variables affecting their attitudes., Material and Methods: A random simple was obtained of students who were between 12 and 16 years of age in secondary schools in the southeast of Spain (n = 3633). Their attitudes were assessed with the use of a validated psychosocial questionnaire about xenotransplantation (PCID-XenoTx Ríos). The questionnaire was completed anonymously and was self-administered. Descriptive statistical analysis, Student t, and χ 2 tests were used., Results: The completion rate was 97% (n = 3531). With regard to animal organ donation for humans, 44% (n = 1569) would be in favor, 22% (n = 784) against, and 34% (n = 1178) undecided. Attitude was related to knowing a transplantation patient (P = .02), believing that transplant organ needs are not covered (P = .004), having received information about organ donation and transplantation (ODT) on television and from schools (P = .001), family discussion about ODT (P < .001), attitude of the respondent's parents (P < .001), and attitude toward human donation (P < .001)., Conclusions: More than half of the teenagers had unfavorable attitudes toward xenotransplantation as this was determined by factors related to knowledge of and previous information about ODT, the attitude of one's family, and attitudes toward the different types of human organ donation., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The objective of the present study was to analyze the knowledge and acceptance of the brain death (BD) concept among nursing students., Methods: The study was undertaken in the academic year of 2011 to 2012 in nursing students from the University of the South of Poland. The sample was carried out in compulsory sessions, in the 5 years of the nursing degree study, with a completion rate of 80%. The questionnaire was validated (PCID-DTO Ríos), self-administered, and completed anonymously., Results: The completion rate was 93% (492 of 530). Of the students surveyed, 75% (n = 369) knew the concept of BD and considered it to mean a person's death. Of the rest, 19% (n = 93) did not know it, and the remaining 6% (n = 30) believed that it did not mean that a person was dead. The following variables were significantly related with the correct knowledge of the BD concept: 1) age (22 ± 2 years; P ≤ .001); 2) academic year (P ≤ .001); 3) discussion with friends about organ donation and transplantation (ODT) (P = .035); 4) partner's favorable attitude toward donation and transplantation (P = .009); and 5) being Catholic (P = .031). In the multivariate analysis, the following variables persisted as independent variables related to the BD concept: a) age [OR = 1.468 (1.247-1.697); P ≤ .001] and b) partner's opinion of ODT [OR = 2.248 (1.255-4.025); P = .006]. No association was found with attitude toward ODT., Conclusions: More than 25% of the students from the Jagiellonian University of Kraków did not know or accept the concept of brain death., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Investigating the attitude of subgroups of populations living in different countries is useful for establishing whether there are differences in opinion in terms of place of residence. The objective of the study was to analyze attitudes toward deceased organ donation in the population from the Dominican Republic who are residing in the southeast of the United States and Spain., Methods: A sample was taken of residents of the population from the Dominican Republic residing in Florida (the United States) (n = 63) and in Spain (n = 80), which was stratified by age and sex. A validated questionnaire about psychosocial aspects (PCID-DTO Rios) was self-administered and completed anonymously: the χ(2) test, Student t test, and logistic regression analysis were used., Results: The completion rate was 86% (123 respondents of the 143 selected). Of those surveyed, 54% were in favor, 23% were against, and 23% were undecided. Of the residents in Spain (n = 57) 63% (n = 36) were in favor, 12% (n = 7) were against, and 25% (n = 14) were undecided. Of the residents in the United States (n = 66) 46% (n = 30) were in favor, 33% (n = 22) were against, and 21% (n = 14) were undecided (P < .001). The following factors were found to be associated with attitude: 1) level of education [OR = 12.195 (52.631-2.808); P = .001]; 2) concern about the possible mutilation of the body after donation [OR = 11.363 (47.619-2.695; P = .001]; and 3) rejection of cremation or burial of the body after death [OR = 6.134 (21.276-1.763); P = .004]., Conclusions: Attitude toward the donation of the respondent's own deceased organs after death was more favorable among Dominican residents in Spain compared with those living in the United States., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Introduction: Due to the current deficit of organs for transplantation, living kidney related donations (LKRD) should be promoted. Veterinarians often hold decision-making positions in the public health care system, and therefore can influence public opinion about organ donation. The objective was to analyze the attitude of Spanish veterinary students toward LKRD because they may influence public opinion in the future, and to determine the factors that condition it., Materials and Methods: The study was carried out among fifth-year veterinary science students from 2 southern and southeastern Spanish universities. The students' attitude toward LKRD was assessed using a psychosocial, anonymous, self-administered questionnaire. Statistics used were χ(2) test and Student t test., Results: Data from the southern Spain university included a response rate of 87%. The survey showed that 94% of respondents would donate a kidney to a relative who needed it. This attitude toward LKRD was more favorable in women (P < .001) and in those who had discussed the subject with their families (P = .003). Nevertheless, only 58% would accept a kidney from a family member. Data from the southeastern Spain university included a response rate of 97%: 97% of the respondents would donate a kidney to a relative who needed it. This attitude was not associated with any psychosocial variables. However, only 58% would accept a kidney from a relative. There are no differences between the 2 universities (P = .879)., Conclusions: Although the attitude of veterinary students from southern and southeastern Spain toward LKRD was very favorable and there are no differences between them, only 58% of the students would accept an organ from a relative., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: The concept of brain death (BD) is not very well known in the population, making it one of the main psychosocial barriers to favorable attitudes toward donation. Adolescents are a key sector of the population for future organ donation. For this reason it is important to find out what they know about this concept., Objectives: The aim of this study was to analyze the concept of BD among adolescents in the southeast of Spain and to determine their influence on attitude toward organ donation., Methods: In the southeast of Spain a random sample was stratified according to Compulsory Secondary Education (CSE) schools. In the 10 selected schools, we performed a random sampling of each of the classes from the 1st to the 4th years of CSE. Knowledge of the concept of BD and attitude toward donation were analyzed with the use of a validated questionnaire, which was self-administered and completed anonymously. Statistical analyses used the Student t test and the χ(2) test., Results: Of 3,547 adolescents surveyed, 38% (n = 1,337) of the respondents knew the BD concept, considering it to be the death of an individual. Of the rest, 54% (n = 1,930) did not know this concept and the remaining 8% (n = 280) thought it did not mean a person's death. The respondents who were more in favor of deceased donation had a better knowledge of the concept of BD than those who had doubts (40% vs 35%, respectively; P = .007). The knowledge of the concept of BD was associated with variables directly and indirectly related with donation and transplantation (P < .05)., Conclusions: Most adolescents in the southeast of Spain do not know the concept of BD, and this adversely affects the attitude toward organ donation., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: To reduce the considerable organ deficit, living donation is being promoted. The subset of foreign population living in Spain could be potential patients for transplantation and/or donation. The objective of this study was to analyze the attitudes toward living donation (LD) of the population from the southeast of Spain who are natives of Scotland., Materials and Methods: Within the "International Collaborative Donor Project," a random representative sample was obtained of the adult population residing in the southeast of Spain and who were born in Scotland (n = 350). Attitudes were evaluated with the use of a validated questionnaire that was completed anonymously and was self-administered. The Student t test, χ(2) test, and Fisher exact test were applied., Results: The completion rate was 93% (n = 324); 90% of the respondents (n = 290) were in favor of related LD, decreasing to 26% (n = 85) if it was unrelated. In the analysis of variables affecting attitude toward LD, differences were found in: 1) attitude toward deceased donation (P < .001); 2) having had previous experience of the donation and transplantation process (P = .049); 3) a respondent's belief that his or her religion was in favor of LD (P < .001); and 4) a partner's attitude toward donation and transplantation (P = .007)., Conclusions: The attitude toward related LD among Scottish residents in the southeast of Spain is very favorable, and is very closely related to attitude toward deceased donation, family attitude, and religious attitude. Patients on the waiting list of Scottish origin will be one of the most appropriate groups for promoting LD when living donation is being promoted in Spain., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: "Anxious preoccupation" is a maladaptive coping strategy for patients with terminal chronic liver pathology causing psychopathologic emotional responses. The aim of this study was to identify "anxious preoccupation" as a coping strategy when faced with this disease and to investigate its relationship with emotional-type psychopathologic symptoms in patients awaiting a liver transplant (LT)., Methods: A total of 63 patients awaiting an LT were evaluated. The instrument used to evaluate coping style was the Mental Adjustment to Cancer questionnaire. One of the coping scales of this questionnaire is "anxious preoccupation" (9 items). An Instrument for psychopathologic assessment was used, the SA-45 questionnaire, which assessed 9 psychopathologic dimensions: somatizations, obsessions-compulsions, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism., Results: "Anxious preoccupation" was used as an inadequate coping style by 51% of patients when faced with the disease. Five psychopathologic dimensions were associated with this coping strategy: 1) obsessive-compulsivity: 75% of patients with "anxious preoccupation" had obsessive-compulsivity symptoms compared with 29% of patients with other coping strategies (P < .001); 2) interpersonal sensitivity: 25% vs 6%, respectively (P = .044); 3) depression: 59% vs 29% (P = .015); 4) anxiety: 75% vs 32% (P = .001); and 5) phobic anxiety: 19% vs 3% (P = .050)., Conclusions: More than one-half of the patients on the LT waiting list used "anxious preoccupation" as a coping style for this disease. This strategy was associated with a greater presence of emotional-type psychopathologic symptoms in these patients., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Information about organ donation and transplantation (ODT) is the basis on which attitude toward this subject is shaped. The information about ODT that teachers can provide to school children is fundamental for them to develop a favorable attitude to this matter in the future., Objectives: The aims of this study were: 1) to determine the type of information on ODT received by secondary school teachers; 2) to determine through which means teachers obtain information about donation; and 3) to determine the influence of each information source on their attitudes., Methods: A sample was selected from 10 secondary schools, which were geographically stratified in southeast Spain. A validated questionnaire was applied about attitude toward ODT among teachers (n = 327), which was completed anonymously and was self-administered. The statistical analysis used the Student t test and the chi-square test., Results: The questionnaire completion rate was 88% (n = 288); 99% (n = 286) of the responding teachers stated that they had received some information about ODT, and 40% (n = 117) indicated that they had good or very good information. The teachers received information about ODT from several sources, the most frequent being audiovisual means: television (89%), press (60%), and radio (47%). Social/family means were also important, such as conversations with other people (51%) and conversations with family members (39%). Teachers who reported having good information were more in favor of ODT than those who had limited or no information (P = .001). Only the exchange of information through conversations with family members was related to a positive attitude (P = .009)., Conclusions: Most secondary school teachers in southeast Spain receive information about ODT. However, fewer than half think that the information is good. Teachers receive information through different means, especially audiovisual means, mainly television. Nevertheless, the social/family means has the most influence on attitude., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: It is fundamental to find out the level of social acceptance of xenotransplantation (XT), especially in areas where there are preclinical projects. In the native population in the southeast of Spain this situation is well known, but in recent years there has been a considerable social change due to large migratory flows, especially concerning Ireland. The aim of this study was to analyze the attitude toward XT among the population in the southeast of Spain born in Ireland and to determine the variables affecting this attitude., Methods: Within the "International Collaborative Donor Project," a random sample was taken (n = 325) of the population from the southeast of Spain born in Ireland. Attitude was evaluated using a validated questionnaire, which was self-administered and completed anonymously., Results: The questionnaire completion rate was 82% (266 respondents of the 325 selected). Regarding animal organ donation for humans, if the results were similar to those achieved using human donors, 62% (n = 165) would be in favor, 30% (n = 79) undecided, and the remaining 8% (n = 22) against. If the results were worse than those achieved using human donors, 20% (n = 50) would be in favor, 59% (n = 150) undecided, and the remaining 21% (n = 54) against. Attitude toward XT is related to religion (P = .003), knowing the favorable attitude of one's religion toward transplantation (P = .037), having spoken about donation and transplantation within the family (P = .001), a partner's favorable attitude toward transplantation (P = .001), and a favorable attitude toward both deceased (P = .001) and living (P = .023) human donation., Conclusions: Attitude toward XT among Irish citizens who are resident in the southeast of Spain is worse than that of the native Spanish population and is mainly determined by factors related to prior attitude toward the different types of human organ donation, family attitude, and religious motives., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Journalists and the information they disseminate are essential to promote health and organ donation and transplantation (ODT). The attitude of journalism students toward ODT could influence public opinion and help promote this treatment option., Objective: The aim of this study was to determine the media through which journalism students receive information on ODT and to analyze the association between the sources of information and psychosocial variables., Methods: We surveyed journalism students (n = 129) recruited in compulsory classes. A validated psychosocial questionnaire (self-administered, anonymous) about ODT was used. Student t test and χ(2) test were applied., Results: Questionnaire completion rate was 98% (n = 126). The medium with the greatest incidence on students was television (TV), followed by press and magazines/books. In the factor analysis to determine the impact of the information by its source, the first factor was talks with friends and family; the second was shared by hoardings/publicity posters, health professionals, and college/school; and the third was TV and radio. In the factor analysis between information sources and psychosocial variables, the associations were between information about organ donation transmitted by friends and family and having spoken about ODT with them; by TV, radio, and hoardings and not having spoken in the family; and by TV/radio and the father's and mother's opinion about ODT., Conclusions: The medium with the greatest incidence on students is TV, and the medium with the greatest impact on broadcasting information was conversations with friends, family, and health professionals. This could be useful for society, because they should be provided with clear and concise information., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Introduction: Patients with toxic substance abuse syndrome, such as alcohol abuse, have elevated psychopathologic morbidity and mortality such as mood disorders., Objective: To evaluate the emotional-type psychopathologic symptoms in patients with alcohol-induced hepatic cirrhosis on the liver transplant waiting list., Materials and Methods: Patients with alcoholic liver cirrhosis who were candidates for liver transplant (n = 41) completed the SA-45 questionnaire (González y Cuevas; 88), which assesses nine dimensions: somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A control group consisted of patients with chronic nonalcoholic terminal hepatopathies (n = 22)., Results: Seventy-six percent of patients had some kind of psychopathologic symptom compared to 68% of the patients in the control group with other nonalcoholic etiologies (P > .05). The emotional-type clinical symptoms were: (1) somatizations: 37% of patients with alcoholic cirrhosis had this type of clinical symptoms compared to 32% of the control group (P > .05); (2) obsessive-compulsivity: 56% versus 46%, respectively (P > .05); (3) interpersonal sensitivity: 19% versus 9%, respectively (P > .05); (4) depression: 54% versus 27%, respectively (P = .045); (5) anxiety: 59% versus 46%, respectively (P > .05); (6) hostility: 29% versus 5%, respectively (P = .021); (7) phobic anxiety: 10% versus 14%, respectively (P > .05); (8) paranoid Ideation: 7% versus 5%, respectively (P > .05); (9) psychoticism: 5% versus 4%, respectively (P > .05)., Conclusions: The patients with alcoholic liver cirrhosis on the liver transplant waiting list had elevated psychopathologic symptoms. Depressive- and hostile-type emotional alterations were most frequent in this type of patients., (Copyright © 2012. Published by Elsevier Inc.)

Introduction: Current liver donation rates are insufficient to cover transplant needs. Therefore, it is essential to promote living liver donation (LLD) given the ever decreasing morbidity and mortality in the donor and the improving results in the recipient. LLD is becoming increasingly accepted. However, in the health care system, a percentage of the personnel are not in favor., Objective: To analyze the attitude of personnel in surgical services in Spain and Latin-America hospitals toward LLD., Materials and Methods: As part of the "International Collaborative Donor Project," a random sample was taken and stratified according to surgical service and job category in 10 hospitals; three in Spain, five in Mexico, and two in Cuba (n = 496). Attitude was evaluated using a validated survey that was completed anonymously and self-administered., Results: Eighty-six percent (n = 425) of respondents were in favor of related living liver donation, and 30% (n = 147) were in favor if it were not related. According to country, 88% of the Mexican respondents were in favor of living liver donation, 85% of the Cubans, and 82% of the Spanish (P > .05). In the multivariate analysis of the variables with most weight affecting attitude toward LLD, the following significant associations were found: (1) a favourable attitude toward living kidney donation (odds ratio [OR] = 91; P < .001); (2) acceptance of a donated living liver if one were needed (OR = 11; P < .001); and (3) family discussion about donation and transplantation (OR = 2.581; P = .037)., Conclusions: Attitude toward related living liver donation was very favorable among hospital personnel in Spanish and Latin American surgical services., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis., Material and Methods: As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis., Results: Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001)., Conclusions: The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: The infant and youth population constitutes a sector in which early awareness is important to increase favorable attitudes toward donation. Objectives were as follows: (1) to analyze the attitudes of adolescents toward living organ donation; and (2) to determine the psychosocial variables affecting them., Materials and Methods: In Southeast of Spain a random sample was stratified according to Compulsory Secondary Education (CSO) school. In the 10 selected schools we performed a random sampling of each of the classes from the first to the fourth year of CSO. Attitudes were evaluated using a validated questionnaire lowering psychosocial aspects of donation. The self-administered questionnaire was completed anonymously. Statistical analyses employed Student t test and the χ(2) test., Results: Regarding living kidney donation, 89% (n = 3146) of adolescents favored it, although only 29% (n = 1035) in unrelated cases. For living liver donation, 78% (n = 2753) were in favor of related donation, but only 19% (n = 668) were in favor if it was unrelated. The favorable attitude toward living donation was mainly associated with the following variables: (1) being a woman; (2) having previous experience with the donation-transplantation process; (3) having spoken about the matter of donation and transplantation with family and friends; (4) a favorable attitude of one's mother and father; (5) concern about possible bodily mutilation after donation; and (6) having performed pro-social type activities (P < .05)., Conclusions: Related living donation is well accepted among adolescents on the Southeast of Spain. There was a high acceptance of unrelated living donation compared with studies published in other geographic areas., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: The concept of brain death (BD) is not very well known in the population, and its unknown nature is one of the main factors that could lead to an attitude against organ donation. The teaching sector has an important influence on the education of adolescents, and for this reason the teacher's knowledge of these concepts is fundamental to spread the correct meaning of the concept to young people., Objective: To analyze the concept of BD among teachers of compulsory secondary education (CSE) in southeast Spain and to determine teachers' influence on attitude toward organ donation., Materials and Methods: Ten CSE level schools were selected and stratified according to geographical location in southeast spain. A random sample was taken of CSE teachers. The knowledge of the concept of BD and attitude toward donation were analyzed using a validated questionnaire, which was self-administered and completed anonymously., Results: Sixty-four percent (n = 180) of respondents knew the BD concept and they considered it to be the death of an individual. Of the rest, 34% (n = 95) did not know this concept, and the remaining 3% (n = 8) believed it did not mean a person's death. Those who understood the concept of BD were more in favor of deceased donation than those who held the wrong concept (82% versus 75%; P < .01). The knowledge of the concept of BD is associated with variables directly and indirectly related with donation and transplantation (P < .05)., Conclusions: A third of the CSE teaching staff did not know or understand the BD concept as the death of an individual. The knowledge of BD positively affects attitude toward organ donation. Given that teachers are a source of information, the basic training of CSE teaching staff in basic concepts such as BD would be important., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: Using a percutaneous ecoguided injection system to obtain chimeric piglets through a less invasive and traumatic technique than previously reported., Materials and Methods: The two types of human cells included umbilical cord blood mononuclear elements and mesenchymal stem cells cultured from bone marrow. Four sows at gestational day 50 were anesthetized. A needle was inserted through the skin and uterine wall to reach the peritoneal cavity of the fetuses under continuous ultrasound guidance. Fourteen piglets were injected with various cell concentrations., Results: All sows carried pregnancies to term yielding 69 piglets, among which 67 were alive and two mummified. Two piglets died during the first 48 hours of life. Chimerism was detected using flow cytometry and by quantitative polymerase chain reaction (q-PCR) to detect Alu gene in blood or tissues samples. The analysis detected blood chimerism in 13 piglets (21%) by flow cytometry and the presence of the human Alu gene in 33 (51%) by q-PCR. The results suggest cell trafficking between littermates after in utero injection., Conclusions: Transcutaneous echo-guided injection succeeded to produce chimeric piglets without disadvantages to the sow or the fetuses and avoiding abortions or fetal death., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To assess the effect of sodium heparin concentrations on antibody- and complement-mediated cytolysis by means of a real-time cell analyzer system (RTCA) investigating the complement regulation ability of heparin to reduce or prevent hyperacute in an in vitro model of pig-to-baboon xenotransplantation., Materials and Methods: Fibroblasts isolated from the skin of two transgenic pigs were cultured in microelectronic 96-well plates for 9 hours. Then, we added 20 μL of normal sera from two healthy adult olive baboons (Papio anubis) or two volunteer healthy humans. Simultaneous cultures had added heparin at 3.5, 5, 7.5, 15, and 30 IU. Moreover, rabbit complement was added for the exogenous complement group (ExC) versus the other group only with the complement present in the sera as an endogenous complement group (EnC). Cellular cultures were monitored over 150 hours after challenge. With cellular index (CI) data recorded by the xCELLigence software system, we calculate area under the curve versus concentration (AUC) and minimum CI (CImin) versus concentration., Results: All cultures showed decreased CI after challenge with human or baboon sera. There was a high correlation for AUC (r(2) > 0.90) and CImin versus concentration (r(2) > 0.970) during the first 40 hours postchallenge among the EnC group, regardless of human or baboon sera. However, there was no correlation for AUC and CImin for the ExC group. There was a reduction of CImin related to increased heparin concentrations., Conclusions: The addition of heparin did not reduce antibody- and complement-mediated cytolysis assessed in vitro by RTCA in pig-to-baboon compatibility assays., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: The concept of brain death (BD) is not well understood among the general public, rendering it one of the main psychosocial barriers to favorable attitudes toward donation. Individuals from the British Isles are among the most important migratory groups in southeastern Spain. We sought to analyze the level of understanding of the concept of brain death among the British and Irish populations living in southeastern Spain, and to determine factors affecting their attitudes., Material and Method: A random sample of the British and Irish population resident in Murcia was stratified according to nationality as part of the "International Collaborative Donor Program" (n = 1611). The self-administered survey in English was completed anonymously. For the statistical analysis, we used the χ(2) test and a logistical regression analysis., Results: Approximately half of the respondents (45%; n = 692) understood the concept of BD; they considered it to mean the death of an individual. Among of the other respondents, 39% (n = 605) did not understand this concept, and the remaining 16% (n = 240) erroneously believed that it did not imply a person's death. Respondents coming from Great Britain showed a greater knowledge of the BD concept than did the Irish (46% vs 34%; P < .001). Those who understood the concept of BD were more in favor of deceased donation than those who had an erroneous understanding (49% vs 36%; P < .001). Significant associations were also noted among variables directly or indirectly related to donation and transplantation (P < .05)., Conclusion: The level of understanding of the concept of BD among the population from the British Isles resident in southeastern Spain was limited. Taking into account that the BD concept is a psychosocial factor that affects attitudes toward organ donation, information campaigns should be applied to this emerging population group in southeastern Spain., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: In patients awaiting a transplant, the help received from friends and/or family members is considered to be an important factor in the transplantation process. Our objective was to determine the level of social/family support for patients on the liver transplant waiting list and to determine the relationship between clinical psychopathology and the level of social/family support., Materials and Methods: The study population consisted of 70 patients on the liver transplant waiting list. We used the following instruments: (1) Medical Outcomes Study-Social Support Survey (MOS) Questionnaire. For size of the social network, four support dimensions and a global support index for emotional support, material/instrumental support, leisure/free time activities, and love/care; (2) Family Apgar Questionnaire for personal perception of family function; (3) SA-45 questionnaire of psychopathologic symptoms for somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism., Results: The MOS showed that the mean size of the social network of these patients was 12 people. In these patients, social/family support was nonfunctional in 20% of the cases. By dimensions, the patients had the following percentage of nonfunctional support: 24% in emotional support; 10% material/instrumental support; 23% social relations of leisure/free-time activities; and 11% compassionate love/care support. The patients with nonfunctional support had the following associated psychopathologic symptoms (SA-45): depression (79% vs 39%; P = .008), anxiety (86% vs 46%; P = .008), hostility (43% vs 12%; P = .009), and psychoticism (14% vs 2%; P = .039) compared to functional patients. The Family Apgar showed that 27% of patients perceived a family dysfunction. These patients had greater interpersonal sensitivity-type emotional symptoms (32% vs 8%; P = .012), depression (79% vs 35%; P = .001), anxiety (79% vs 45%; P = .011), and hostility (42% vs 10%; P = .002) compared to normally functioning patients., Conclusions: Nearly a quarter of patients on the liver transplant waiting list have social/family support that is nonfunctional, which leads to greater emotional psychopathologic symptoms that would need to be treated., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: It is essential to provide information about organ donation and transplantation (ODT) to encourage school pupils to have favorable attitudes toward this matter in the future. The role of the teacher is crucial in this respect. The objective of this study was to determine acceptance by secondary school teachers of an educational program about ODT., Materials and Methods: A random sample of secondary school teachers was taken from 10 secondary schools in the southeast of Spain. A total of 288 teachers were surveyed using a questionnaire that assessed the following; (1) acceptance of the educational program; (2) who should carry it out; and (3) some psychosocial variables related to ODT., Results: Of the 288 secondary teachers surveyed, 283 of them responded to the acceptance of an educational program on ODT. Approximately half (54%) of the respondents believed that it would be appropriate to introduce an educational program about ODT in secondary schools, 22% believed that there were currently other more important educational considerations, 20% had doubts, and 4% believed that it would not be useful. The vast majority (71%) believed that a collaborator from the Regional Transplant Team would be the best person to carry out the program followed by any teacher (11%) or a teacher of ethics (9%). The remaining 9% were not sure. There was greater acceptance of an educational program about ODT among teachers who had a favorable attitude toward the matter (P = .003)., Conclusions: An educational program about ODT in secondary education was not equally accepted by all teachers. Most teachers believed that the program should be delivered by the Transplant Coordination Center rather than teachers themselves., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: The transplantation of pancreatic islets from animals as a treatment for diabetes mellitus could help with the current diabetes problem. Considerable advances have been made in recent years, with recent publications reporting improved conditions for carrying out clinical trials using porcine islets in humans with type 1 diabetes. Our objectives were (1) to analyze the acceptance of cell xenotransplantation for diabetes among Spanish adolescents and (2) to determine the psychosocial variables that might affect their attitudes and its relationship with other types of donation., Materials and Methods: Random sampling was carried out among secondary school students in Spanish Schools. All subjects completed a validated questionnaire evaluating the acceptance of pancreatic islet xenotransplantation together with psychosocial aspects. Questionnaire completion was anonymous and self-administered. Student t test and the chi-square test were used for statistics., Results: The total number of respondents surveyed was 3633, and the mean age of the respondents was 11 ± 18 years. Most of the respondents (62%; n = 2195) would accept cells of animal origin if they suffered diabetes, 28% (n = 1005) were unsure, and 10% (n = 340) were against xenotransplantation. There is no connection with sex, age/year of study, or country. A high level of acceptance of animal cells was found among those who had a favorable attitude toward deceased organ donation and the xenotransplantation of solid organs and animal tissues (P < .001)., Conclusions: Among Spanish adolescents, there was a good level of acceptance of the idea of using animal cells as a treatment for diabetes mellitus. Therefore, it would be beneficial to increase the information provided about these matters in secondary education to improve awareness further, as part of the general human organ donation and transplantation promotion campaigns., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: The information provided by future journalists is fundamental for promoting healthcare and their attitude toward organ donation and transplantation (ODT) could affect public opinion. The objective of this study was to analyze the attitude of students of journalism toward ODT and the factors affecting this attitude., Materials and Methods: The subjects of this study were students doing a degree in journalism in 2005-2006 (N = 129). A self-administered questionnaire about ODT was completed anonymously. For statistical analysis we used Student t test and the χ(2) test., Results: The questionnaire completion rate was 98% (n = 126). Most students (78%; n = 98) would be willing to donate their organs, although 22% (n = 28) would not. Attitude was more favourable among those respondents who knew a transplant recipient (100% vs 71%; P = .002), had a favourable attitude toward donating a family member's organs (P = .000), and had discussed ODT within the family (P = .000). Those who had a positive attitude toward living donation had a more favourable attitude toward deceased ODT (P = .000 for kidney and P = .003 for liver). Most respondents (56%; n = 70) believed that the general information they received about ODT was limited and 9% (n = 11) believed that it was good. Most (83%; n = 104) had never received a talk about the subject, although 90% (n = 113) believed that receiving one would be very interesting., Conclusion: Attitude toward ODT is favorable in a high percentage of students of journalism. This is positive if we want these professionals to inform society about the subject. They should be provided with clear and concise information., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: Various strategies have been designed to assess in vitro donor-graft compatibility in pig-to-primate xenotransplantation models. Most of them are based on a cytolysis assessment by exposing donor tissue to host serum with investigations by flow cytometry, and photocolorimetric levels. The aim of this study was to analyze the difference in cytolysis produced by sera and plasma obtained using various anticoagulants, or containing high versus low levels of platelets., Methods: The cytolysis trials were performed using an xCELLigence real-time cell analyzer (RTCA) in a cell model involving transgenic pig fibroblasts exposed to sera (S) or plasma obtained using EDTA, Li-heparin, or Na-heparin in combination with plasma containing high versus low content of platelets. Samples were obtained from two baboons and five volunteer human donors. Evolution of fibroblast cell growth was assessed by RTCA as the cell index (CI). After 9 hours of growth, cells were exposed to 20 μL of each sample. The minimum CI (CImin), time to CImin (TCImin), and time to reach the CI observed before compound addition (Trec) were recorded for each microwell., Results: The lowest CImin, highest TCImin, and Trec observed for EDTA plasma showed significant differences from other samples (P < .001)., Discussion: On the basis of this study, using the RTCA assay, heparinized plasma produced complement inhibition and with undervaluation of the cytolysis reaction. EDTA plasma produced total death of most of cultures. The most accurate sample matrix seems to be serum., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: Untreated psychiatric morbidity can worsen the quality of life in the posttransplantation stage. Therefore, it is important to detect and treat alterations associated with depression in transplantation patients from the beginning of the process. The objective of this study was to determine the psychological characteristics of patients on the liver transplantation waiting list with emotionally depressed symptoms., Material and Methods: We evaluated 70 patients on the liver transplantation waiting list for psychopathological symptoms of depression using the Symptom Assessment-45 Questionnaire (González and Cuevas) using chi-squared tests, Student t tests, and logistic regression analysis., Results: Forty-seven percent of the patients on the liver transplantation waiting list showed relevant depressive-type psychopathological symptoms. The presence of the following factors were associated with the emotionally depressed characteristics of these patients: psychiatric mental disorders (P = .015); no partner (P = .009); and alcohol abuse (P = .050). Other related factors included the following: obsessive-compulsive-type emotional alterations (P = .001); interpersonal sensitivity (P < .001); anxiety (P < .001); hostility (P = .017); phobic anxiety (P = .017); and paranoid ideation (P = .029). With regard to coping strategies, these patients used defenselessness (P < .001) and anxious preoccupation (P = .016). With regard to the social-family setting, emotionally depressed patients had nonfunctional family and/or social support, according to the global MOS (Medical Outcomes Study-Social Support Survey) index (P = .008) and the total Apgar Family Score (P < .001)., Conclusions: Almost half of the patients on the liver transplantation waiting list showed emotionally depressed-type symptoms. Other emotional-type alterations were related to this psychological profile: coping strategies of defenselessness and anxious preoccupation as well as nonfunctional social and/or family support., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico., Materials and Methods: A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey., Results: Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation., Conclusions: Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Introduction: The information provided about organ donation and transplantation (ODT) affects whether it is viewed favorably or unfavorably., Objectives: The objective of this study was to determine the means by which each source of information about ODT influenced attitudes of children., Material and Methods: Ten secondary schools from the south-east of Spain were stratified geographically. We performed a random selection of pupils from the first 4 years of compulsory secondary range, education (age 11-15 years). A validated self-administered questionnaire about attitudes toward ODT was completed anonymously., Results: The adolescents had received information about ODT through several sources. The most frequent sources were television (86%), films (59%), and magazines (56%). Positive information from information sources was associated with more favorable attitudes toward ODT (P<.05); those who received negative information had more unfavorable attitudes (P<.05)., Conclusions: Most information about ODT that reaches our children is through audiovisual means. Attitudes were more favorable among adolescents who have received positive information through the mass media, with more negative attitudes among those who received negative information., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Introduction: Patients on the liver transplant waiting list have increased emotional and clinical symptoms. The presence of psychopathologic symptoms associated with obsession-compulsion as a reflection of alterations due to anxiety disorders is common in these patients., Objective: To evaluate obsessive-compulsive psychopathological symptoms in patients on the liver transplant waiting list., Materials and Methods: The study included 50 patients on the liver transplant waiting list. The instrument was the SA-45 questionnaire (Derogatis, 75), whose Spanish version was adapted by González Rivera and De las Cuevas (1988). This dimension was evaluated using five statements., Results: Among of the patients on the liver transplant waiting list, 46% had no relevant obsessive-compulsive symptoms. Of these, 28% had no symptoms and 18% had some symptoms, but the overall evaluation in these patients was no greater than the cutoff point. The remaining 54% had relevant obsessive-compulsive clinical symptoms, most commonly (1) "Having difficulty making decisions" (P<3.45·10(-9)); (2) "Having difficulty concentrating" (P<1.70·10(-8)); (3) "One's mind goes blank" (P<3.04·10(-4)); (4) "Having to repeatedly check everything being done" (P<1.37·10(-1)); and (5) "Having to do things slowly to make sure they are done properly" (P<5.02·10(-1))., Conclusions: Many patients on the liver transplant waiting list have obsessive-compulsive psychopathologic symptoms. Their detection and application of adequate psychological treatment are important to minimize the effects of emotional changes onward from the pretransplant phase., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Background: There is a considerable transplant organ deficit. To offset the organ shortage, living donation is being encouraged. Young persons form a sector of the population in whom early awareness is important to encourage favorable attitudes toward donation. Teachers play important roles in education and in generating attitudes., Purpose: We analyzed the attitudes of secondary school teachers toward living organ donation and sought to determine the psychosocial variables that affect these attitudes., Materials and Methods: We randomly selected Teachers from 10 secondary schools in southeastern Spain. Their attitudes toward living donation were evaluated using a validated questionnaire, which was self-administered anonymously. The statistical tests were Student t test and the χ2 test., Results: Regarding living kidney donation, 92% of teachers were in favor of related donation, decreasing to 16% when it was not from a related individual. In contrast, regarding related donations, 7% were not in favor, and 1% undecided. Teachers who had discussed the matter with their family and friends had more favorable attitudes (P<.05). In the case of living liver donations, 91% were in favor of related donation (falling to 20% if not related), 7% were not in favor, and 2% had doubts. Attitudes were more favorable among women, teachers with children, and those who had discussed the matter with their family and friends (P<.05)., Conclusions: Teachers had favorable attitudes toward living related kidney or liver donation. Their students would receive positive information when they request relevant information., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Introduction: Information provided by journalists is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), wherein the participation of the general public is essential to obtain organs., Objective: The objective of this study was to determine the knowledge of students taking a degree in journalism about the concept of brain death and the law of presumed consent., Materials and Methods: The study involved 129 journalism degree students in the 2005-2006 academic year from a university in the south-east of Spain. Attitudes on the psychosocial aspects of ODT were evaluated using a validated questionnaire. The self-administered survey was completed anonymously in classes and compulsory practical sessions., Results: The questionnaire completion rate was 98% (n=126). Of the students surveyed, 43% (n=54) understood the concept of brain death, 44% (n=56) stated that they had doubts, whereas 13% (n=16) believed that a person with brain death can recover and lead a normal life. Their knowledge was more accurate in the final than in the first year (54% vs 47%; P=.016). Most students 66% (n=83) believed that it would be interesting to receive an informative talk about ODT. Concerning legislation, 75% of students were against the law of presumed consent, whereas 25% were in favor., Conclusion: More than 50% of journalism students do not understand the concept of brain death. Furthermore, up to 75% do not accept the law of presumed consent that donation must be made., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Introduction: Administrative personnel from healthcare centers are an important opinion group given their direct relationship to patients and the general public., Objective: The objective of this study was to analyze the attitudes of administrative personnel in Spanish and Mexican healthcare centers toward various kinds of donation., Material and Methods: A random selection of 418 administrative staff from 32 primary care centers and 9 hospitals in Spain and Mexico ("Proyecto Donante, Murcia") used a validated questionnaire to explore attitudes., Results: Most (76%) respondents favored deceased donation. Mexican workers had the most favorable attitude (P<.001). Factors influencing this attitude (P<.05) were as follows: type of healthcare center, clinical service, personal experience of organ donation and transplantation (ODT), attitude toward living donation, attitude toward the donation of a family member's organs, discussion of ODT, partner's attitude toward ODT, participation in pro-social activities, and variables related to attitudes toward the body. Most respondents (89%) favored related living kidney donation (LKD) and 87% favored living liver donation (LLD). Mexican respondents showed the most favorable attitudes (P<.05). Factors influencing this attitude (P<.05) were as follows: personal experience of ODT, belief that a transplant is needed, willingness to accept a living organ, family discussion about ODT, partner's attitude about the matter, and respondent's awareness of the view of his or her religion toward ODT., Conclusion: Attitudes toward deceased organ donation were not favorable among administrative personnel from Spanish compared with Mexican centers, although attitudes toward LKD and LLD were favorable in both countries., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Background: Transplantation hospitals have played a key role in developing deceased organ donation and transplantation (ODT). To reduce the number of deaths on the transplant waiting list, it is essential to encourage living liver donation (LLD). Involvement of personnel in these hospitals is crucial., Purpose: We analyzed the attitudes toward LLD among hospital personnel in Spain, Mexico, and Cuba., Materials and Methods: Data were obtained from 5 transplant hospitals in Spain, Mexico, and Cuba. The sample was stratified according to job category and type of service (n=2273). A validated questionnaire about living donation was used as the instrument., Results: Most respondents (82%) were in favor of related LLD. If the LLD was not related, acceptance fell to 21%. A total of 85% of physicians, 79% of nursing personnel, 74% of nursing assistants, and 83% of auxiliary staff were in favor (p<.001). A favorable attitude toward LLD was associated (P<.05) with age (37±10 y vs 39±10 y), a favorable attitude toward deceased donation, a belief that a possible transplant is needed, acceptance of LLD if necessary, a favorable attitude toward living kidney donation, family discussion about ODT, a partner's favorable attitude toward ODT, an intention to participate in prosocial activities, being a Catholic, and a belief that one's religion is in favor of ODT., Conclusions: Personnel from Spanish, Mexican, and Cuban transplantation hospitals have favorable attitudes toward LLD. This suggests that there may be an increase in LLD in the future, provided that there is the necessary sociopolitical and economic support., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Introduction: The increase in the British population, including Welsh citizens, in the south-east of Spain is generating a new social and healthcare reality that is affecting the world of transplantation., Objectives: The objectives of this study were as follows: (1) to determine the attitude of the local population originating from Wales toward the donation of their own organs, and (2) to analyze the factors that determine this attitude., Materials and Methods: A random sample (n=126) was selected from the population in Murcia originating from Wales (November 2005-March 2006). Attitudes were evaluated using a validated questionnaire. A control group comprised the autochthonous population (n=2000). The sample was stratified according to age, gender, and geographical location., Results: In this study 76% (n=96) had favorable attitudes toward donation, 6% (n=8) were against, and the remainder 18% (n=22) were not sure. Attitudes were more favorable than among the Spanish control group (76% vs 63%; P=.045). The following variables were associated with this attitude: (1) knowledge of the concept of brain death (P<.001); (2) having spoken within the family about the subject (P=.005); (3) attitude toward the donation of a family member's organs (P<.001); (4) knowing the attitude of one's religion toward donation (P=.033); and (5) attitude of one's partner toward donation (P<.001)., Conclusion: Welsh citizens who are residents in south-eastern Spain have attitudes toward organ donation that are more favorable than those of the native Spanish population. They seem to be determined by knowing the concept of brain death and positive attitudes of one's family., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Introduction: Chronic end-stage liver disease is a difficult situation for the patient., Objective: The objective of this study was to analyze the disease coping styles of patients on the liver transplant waiting list., Materials and Methods: The study included 50 patients on the liver transplant waiting list. The instrument used was the Mental Adjustment to Cancer Scale (Ferrero, 94). Coping scales were as follows: fighting spirit, hopelessness, anxious preoccupation, fatalism, and negation., Results: Only 6% of subjects adapted well, whereas 94% adapted badly: 89% poor fighting spirit, 32% hopelessness, 50% anxious preoccupation, 28% fatalism, and 30% negation. Of those who had a poor fighting spirit, 88% also used another type of maladaptive style. The associated statements were (P<.05) as follows: "I value my life more"; "I don't think about the disease"; "I think about people who are worse off." Regarding hopelessness, 100% of those who confessed hopelessness also showed maladaptive signs. The associated statements were (P<.05) as follows: "I cannot cheer myself up"; "I cannot help myself"; "I've given up." Regarding anxious preoccupation, nearly all of these patients (96%) provided dysfunctional answers. The most associated were (P<.05) as follows: "I don't have any plans"; "I feel a lot of anxiety"; "I'm very angry." Regarding fatalism, all of the patients also had maladaptive behavior. The main types were (P<.05) as follows: "Nothing will change things"; "I cannot control the situation"; "I don't need information." Regarding negation, Only 14% used this style, and in 86% negation was associated with other inadequate coping styles., Conclusions: Patients on the liver transplant waiting list were maladaptive to their disease. It is important to establish adequate psychological care for these patients, given the important repercussions in the posttransplantation phase., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Objective: To analyze the attitude of nursing personnel about organ donation and transplantation in hospitals in Spain and Latin America, and factors that affect this attitude., Methods: Data were selected from 12 hospitals and 32 primary care centers participating in an international study (Proyecto Donante, Murcia) in 4 countries including Spain (n = 650), Mexico (n = 428), Cuba (n = 89), and Costa Rica (n = 27). The sample was random and stratified by type of service among nursing personnel (n = 1194). Attitude was evaluated using a psychosocial questionnaire., Results: Of nursing personnel surveyed, 77% (n = 922) were in favor of organ donation. No differences were found according to whether they were directly involved in transplantation-related services (P < .05). Attitude in favor of organ donation varied between countries: 92% in Cuba, 85% in Costa Rica, 80% in Mexico, and 73% in Spain (P < .001) This attitude was also related to donation of a family member's organs (P < .001), having discussed organ donation and transplantation within the family (P < .001), the concept of brain death (P < .001), fear of body mutilation (P < .001), and manipulation of the body after death (P = .001)., Conclusion: Attitude toward deceased organ donation among nurses varies between countries. There is a discrepancy between those in favor vs actual donation rates in countries and work centers. These fears may become worse when donation is seen as common in daily clinical practice.

Introduction: Training and information for university nursing students about the organ donation and transplantation process is necessary because it will influence their attitudes toward the subject. We analyzed attitudes toward organ donation among nursing students in a donation and transplantation training course and any changes in opinions as a result of the course., Materials and Methods: We questioned 48 students in the third year of nursing (University of Murcia, Spain) who were attending a 32-hour training course about donation and transplantation. We used a descriptive concurrent study, through the completion of a validated opinion survey with 27 items before and after the training course., Results: Attitudes toward donation were favorable in 87% of respondents increasing to 94% after course completion. Before starting the course, 87% believed that there were not enough transplantable organs available to cover needs compared to 96% after the course. Before the course, 46% stated that they did not have complete information about the subject. Taking part in the course has encouraged family discussion about the subject (85% to 90%) and improved knowledge about family opinions (64% to 83%; P = .031). Attitudes toward living donation did not change after the course. However, there was an improvement in knowledge of the Spanish organ distribution system., Conclusions: Attitudes toward organ donation among third-year nursing students were favorable, and increased after undergoing a course about donation and transplantation. The most important part of the course was the increase in theoretical knowledge about the matter as well as the health education.

Introduction: Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba., Materials and Methods: Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis., Results: Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P < .001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P < .001), discussion about organ donation and transplantation (P < .001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P < .001), and attitude toward living liver donation (P < .001)., Conclusions: Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.