ORGAN DONATION AND TRANSPLANTATION – PUBLIC POLICY AND CLINICAL PERSPECTIVES Edited by Gurch Randhawa           Organ Donation and Transplantation – Public Policy and Clinical Perspectives Edited by Gurch Randhawa Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Anja Filipovic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published February, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Organ Donation and Transplantation – Public Policy and Clinical Perspectives, Edited by Gurch Randhawa p. cm. ISBN 978-953-51-0039-3   Contents  Preface IX Part 1 Public Policy Issues in Organ Donation and Transplantation 1 Chapter 1 Transplant Inequalities – A United Kingdom Perspective 3 Gurch Randhawa Chapter 2 An Examination of Organ Donation in the News: A Content Analysis From 2005-2010 of the Barriers to Becoming an Organ Donor 11 Brian L. Quick, Nicole R. LaVoie and Anne M. Stone Chapter 3 European Living Donation and Public Health (EULID Project) 23 Martí Manyalich, Assumpta Ricart, Ana Menjívar, Chloë Ballesté, David Paredes, Leonídio Días, Christian Hiesse, Dorota Lewandowska, George Kyriakides, Pål-Dag Line, Ingela Fehrman-Ekholm, Danica Asvec, Alessandro Nanni Costa, Andy Maxwell and Rosana Turcu Chapter 4 Action Taken to Boost Donor Rate in Croatia 47 Mirela Busic and Arijana Lovrencic-Huzjan Chapter 5 Doctors’ Attitudes Towards Opting-Out and the Implication of This Legislation for a Small Island State 69 Mary Anne Lauri Chapter 6 Organizations as Communities: Creating Worksite Campaigns to Promote Organ Donation 87 Susan E. Morgan Chapter 7 Increasing the Likelihood of Consent in Deceased Donations: Point-of-Decision Campaigns, Registries, and the Law of Large Numbers 97 Tyler R. Harrison VI Contents Chapter 8 Social Capital and Deceased Organ Donation 115 Chloe Sharp and Gurch Randhawa Chapter 9 Live Donor Kidney Transplants: Psychological Aspects of the Donor-Receiver Relationship 141 Elisa Kern de Castro, Evelyn Soledad Reyes Vigueras and Caroline Venzon Thomas Part 2 Clinical Issues in Transplantation 147 Chapter 10 Posttransplant Lymphoproliferative Disorders Following Solid Organ Transplantation 149 Laura Rodriguez and Angela Punnett Chapter 11 Ischaemia Reperfusion Injury in Kidney Transplantation 173 Siddharth Rajakumar and Karen Dwyer Chapter 12 Ischemia-Reperfusion Injury in the Transplanted Kidney Based on Purine Metabolism Markers and Activity of the Antioxidant System 191 Leszek Domański, Karolina Kłoda and Kazimierz Ciechanowski Chapter 13 Chemical Oxygenation of Pancreatic Tissue Prior to Islet Isolation and Transplantation 271 Heide Brandhorst, Paul R. V. Johnson and Daniel Brandhorst Chapter 14 Bioartificial Pancreas: Evaluation of Crucial Barriers to Clinical Application 239 Rajesh Pareta, John P. McQuilling, Alan C. Farney and Emmanuel C. Opara Chapter 15 Transcranial Doppler as an Confirmatory Test in Brain Death 267 Arijana Lovrencic-Huzjan   Preface  Advances in medical technology have offered the hope of life to patients who would have otherwise had to face the prospect of death. This is especially so, in the area of transplantation where it is possible to replace organs such as the heart, kidney, liver, lung, and pancreas. Transplantation has succeeded in prolonging the lives of those fortunate enough to have received the gift of a body organ. What was once a rare and risky procedure for the privileged few has now become a well established routine treatment and a positive option for those with organ failure. Alongside this life-saving development, there lies another sadder side to the story - there are not enough organs to meet the ever increasing demand. One can only begin to understand the emotions of the patients who wake up each day, knowing that a transplant is the only realistic option for a healthy and prolonged life, but are in the agonising situation of waiting for a suitable organ to become available. This principally involves waiting for someone else to die and their loved one's consent for the organs to be used for transplantation. The sad fact is that this situation is relatively common and transplant patients continue to wait while the waiting lists consequently grow longer day by day. This does not only place increasing emotional and physical burden among the waiting patients and families but heaps a great financial burden upon health services. Thus we are in a unique position in the forum of transplantation as opposed to other areas of health care; the expertise and financial resources exist but the organs for transplant do not. This book attempts to provide an analysis and overview of public policy developments and clinical developments that will hopefully ensure an increased availability of organs and greater graft survival. Medical, policy, and academic experts from around the world, who are at the forefront of their respective fields, have contributed chapters to the book. Gurch Randhawa Professor of Diversity in Public Health & Director of the Institute for Health Research University of Bedfordshire UK [...]... ‘stakeholders’ to engage with their local community concerning the issue of organ donation and transplantation 8 Organ Donation and Transplantation – Public Policy and Clinical Perspectives In an effort to increase knowledge and awareness of organ donation among minority ethnic communities there have been a series of BME organ donor campaigns led by NHS Blood & Transplant since 2009 These campaigns... Khunti K.(2011) Type 2 diabetes and cardiovascular disease in South Asians Prim Care Diabetes, 5(1):45-56 Hayward, C., Madill, A (2003) ‘The meanings of organ donation: Muslims of Pakistani origin and white English nationals living in North England’, Social Science & Medicine, 57, 389-401 10 Organ Donation and Transplantation – Public Policy and Clinical Perspectives Morgan, M., Hooper, R., Mayblin,... more organ donors (Feeley et al., 2009; Harrison et al., 2010; Morgan et al., 2002) The framing of organ donation remains a critical concern among organ donation researchers and practitioners alike As Morgan and colleagues (2007) have found, television dramas run a successful counter-campaign (Harrison et al., 2008) by featuring plots around various 18 Organ Donation and Transplantation – Public Policy. .. Organ Donation and Transplantation – Public Policy and Clinical Perspectives Quick, B L., Kim, D K., & Meyer, K (2009) A 15-year review of ABC, CBS, and NBC new coverage of organ donation: Implications for organ donation campaigns Health Communication, Vol 24, pp 137-145, ISSN: 1523-0236 Quick, B L., Lavoie, N R., Scott, A M., Morgan, S E., & Bosch, D (in press) Perceptions about organ donation among... Brennan and Prediger’s kappa corrects for this by disregarding the marginal altogether and 14 Organ Donation and Transplantation – Public Policy and Clinical Perspectives assumes chance agreement is determined solely by the number of categories in the coding scheme 3.2 Categories The categories investigated in this study emerged from a careful review of literature on the benefits and barriers of organ donation. .. Chloë Ballesté, David Paredes, Leonídio Días, Christian Hiesse, Dorota Lewandowska, George Kyriakides, Pål-Dag Line, Ingela Fehrman-Ekholm, Danica Asvec, Alessandro Nanni Costa, Andy Maxwell and Rosana Turcu Hospital Clínic de Barcelona, España 24 Organ Donation and Transplantation – Public Policy and Clinical Perspectives Poland; Rikshospitalet, Oslo, Norway; Sahlgrenska University Hospital, Göteborg,... recommendations 26 Organ Donation and Transplantation – Public Policy and Clinical Perspectives should be applied for the evaluation of the risk in the donor and the definition of contraindications for donation 3.2.4 Living donation within the context of emergency For the EULID participants, there is a consensus to recommend that in the situation of liver transplantation in emergency, cadaveric donation should... transplant in UK as at 31 December 2008, by age decade and ethnic origin 6   Organ Donation and Transplantation – Public Policy and Clinical Perspectives Just 1% of people registered on the Organ Donor Register are South Asian and 0.3% of people registered are African-Caribbean 1.2% of people who donate kidneys after their death are South Asian and 0.7% are African-Caribbean (Table 4) Ethnic origin... a significant impact 20 Organ Donation and Transplantation – Public Policy and Clinical Perspectives 7 Acknowledgements The authors acknowledge Andy Herren for his many hours of coding television news transcripts The authors would also like to acknowledge Health Resources Services Administration’s Division of Transplantation (HRSA/DoT), United States Department of Health and Human Services for funding... scholars and practitioners charged with creating successful organ donation campaigns The following outlines the core assumptions of the HBM as described by Rosenstock The Health Belief Model (HBM) is a value-expectancy theory developed to explain and predict why people participate in efforts to prevent or detect disease (Rosenstock, 1974) It is 12 Organ Donation and Transplantation – Public Policy and Clinical . ORGAN DONATION AND TRANSPLANTATION – PUBLIC POLICY AND CLINICAL PERSPECTIVES Edited by Gurch Randhawa           Organ Donation and Transplantation – Public Policy and Clinical. issue of organ donation and transplantation. Organ Donation and Transplantation – Public Policy and Clinical Perspectives 8 In an effort to increase knowledge and awareness of organ donation. decade and ethnic origin Organ Donation and Transplantation – Public Policy and Clinical Perspectives 6  Just 1% of people registered on the Organ Donor Register are South Asian and 0.3%