Organ Allocation for Liver Transplantation According to the Public Opinion

authors:

avatar Ahmad Danesh 1 , avatar Saharnaz Nedjat 2 , avatar Fariba Asghari 3 , avatar Ali Jafarian 4 , avatar Akbar Fotouhi 1 , *

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
Hepatobiliary and Liver Transplantation Research Center (Imam Khomeini Hospital), School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
Hepatitis Monthly: Vol.12, issue 8; e93038
published online: August 20, 2012
article type: Research Article
received: May 06, 2019
accepted: June 27, 2012
DOI: https://doi.org/10.5812/hepatmon.6183

how to cite: Danesh A, Nedjat S, Asghari F, Jafarian A, Fotouhi A. Organ Allocation for Liver Transplantation According to the Public Opinion. Hepat Mon. 2012;12(8):e93038. https://doi.org/10.5812/hepatmon.6183.

Abstract

Background: Although liver transplantation is the last resort for treating end stage liver diseases, this medical procedure is not available for all needful patients because of inadequate organ supply. Therefore, guidelines have been developed by medical experts to regulate the process. Some professionals believe that medical criteria are inadequate for organ allocation in all situations and may not secure fairness of organ allocation.
Objectives: The current study has been designed to identify decision criteria about allocation of donated liver to potential recipients from public points of view.
Patients and Methods: This is a qualitative study that was conducted through individual interviews and Focus Group Discussions. Individual interviews were conducted among patients’ companions and nurses in one of the two liver transplant centers in Iran. Group discussions were conducted among groups of ordinary people who had not dealt previously with the subject. Data was analyzed by Thematic Analysis method.
Results: Most of the participants in this study believe that in equal medical conditions, some individual and societal criteria could be used to prioritize patients for receiving donated livers. The criteria include psychological acceptance, ability to pay post-operative care costs, being breadwinner of the family, family support, being socially valued, ability to be instructed, lack of mental disorders, young age of the recipient, being on waiting list for a long time, lack of patient’s role in causing the illness, first time transplant recipient, critical medical condition, high success rate of transplantation, lack of concurrent medical illnesses, not being an inmate at the time of receiving transplant, and bearing Iranian nationality.
Conclusions: Taking public opinion into consideration may smooth the process of organ allocation to needful patients with equal medical conditions. It seems that considering these viewpoints in drafting organ allocation guidelines may increase confidence of the society to the equity of organ allocation in the country. This strategy may also persuade people to donate organs particularly after death.

References

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    The references are available in the PDF file.