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Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention.

Publication ,  Journal Article
Boulware, LE; Ratner, LE; Sosa, JA; Cooper, LA; LaVeist, TA; Powe, NR
Published in: Transplantation
May 27, 2002

BACKGROUND: Although low rates of cadaveric organ donation have been attributed to potential cadaveric donors' concerns regarding their religious beliefs and mistrust of the health care system, it is unclear whether similar concerns are important to potential living related donors. It is also not known which factors might be most responsible for low rates of cadaveric and living related donation among the general public. METHODS: We conducted a cross-sectional study of households in Maryland, using a standardized telephone questionnaire, to assess factors associated with willingness to donate cadaveric and living related organs. We compared factors (demographic, cultural, attitudinal, and clinical) related to willingness to donate cadaveric organs with factors related to willingness to donate living related organs. In multivariate analyses, we assessed the independent relation of factors to willingness to donate cadaveric and living related organs, and we assessed the relative importance of these factors in explaining variation in the general public's willingness to donate. RESULTS: Of 385 participants (84% of randomized homes), 254 (66%) were extremely willing to donate to a sibling but only 179 (47%) had designated themselves a cadaveric donor on their drivers' licenses. In bivariate analysis, older age, comorbid conditions, mistrust in hospitals, and concerns about discrimination in hospitals were statistically significantly associated with less willingness to donate living related organs, although African-Americans, older age, lower education, lack of insurance, unemployment, comorbid conditions, and religion/spirituality were associated with less willingness to donate cadaveric organs. After adjusting for potential confounders, only mistrust in hospitals and concerns about discrimination remained strongly and independently associated with 50 to 60% less odds of willingness to donate living related organs [[relative odds [95% confidence intervals (CI)]: 0.4 (0.2-0.7) to 0.5 (0.3-1.0) and 0.4 (0.2-0.9), respectively]] although presence of dependents was associated with 70% higher odds of willingness to donate living related organs [relative odds (95% CI): 1.7 (1.0-3.0)]. In contrast, older age, employment status, religion/spirituality, and mistrust in hospitals were associated with 50 to 90% less odds of willingness to donate living related organs cadaveric organs [relative odds (95% CI): 0.3 (0.1-0.8), 0.4(0.2-0.8), 0.1 (0.1- 0.5) to 0.5 (0.2-0.9), and 0.3 (0.2-0.6), respectively]. Mistrust in hospitals and concerns about the surgical donation procedure contributed most to the variation in willingness to be a living related donor, although race contributed most to the variation in willingness to be a cadaveric donor. CONCLUSIONS: Many factors affect the general public's willingness to donate organs, but their relative contribution is different for living related versus cadaveric donation. Efforts to improve organ donation rates should be directed toward factors that are most important in explaining the existing variation in willingness to donate.

Duke Scholars

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Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 27, 2002

Volume

73

Issue

10

Start / End Page

1683 / 1691

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Racial Groups
  • Middle Aged
  • Maryland
  • Male
  • Living Donors
  • Insurance, Health
  • Income
 

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Boulware, L. E., Ratner, L. E., Sosa, J. A., Cooper, L. A., LaVeist, T. A., & Powe, N. R. (2002). Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention. Transplantation, 73(10), 1683–1691. https://doi.org/10.1097/00007890-200205270-00029
Boulware, L Ebony, Lloyd E. Ratner, Julie Ann Sosa, Lisa A. Cooper, Thomas A. LaVeist, and Neil R. Powe. “Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention.Transplantation 73, no. 10 (May 27, 2002): 1683–91. https://doi.org/10.1097/00007890-200205270-00029.
Boulware LE, Ratner LE, Sosa JA, Cooper LA, LaVeist TA, Powe NR. Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention. Transplantation. 2002 May 27;73(10):1683–91.
Boulware, L. Ebony, et al. “Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention.Transplantation, vol. 73, no. 10, May 2002, pp. 1683–91. Pubmed, doi:10.1097/00007890-200205270-00029.
Boulware LE, Ratner LE, Sosa JA, Cooper LA, LaVeist TA, Powe NR. Determinants of willingness to donate living related and cadaveric organs: identifying opportunities for intervention. Transplantation. 2002 May 27;73(10):1683–1691.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 27, 2002

Volume

73

Issue

10

Start / End Page

1683 / 1691

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Racial Groups
  • Middle Aged
  • Maryland
  • Male
  • Living Donors
  • Insurance, Health
  • Income