Tomoko ASAI

OBJECTIVES: The gap between the numbers of organ donors and recipients is a common problem worldwide. This study was designed to investigate the importance of 'individual readiness', a here introduced novel concept in transplantation medicine and a measure of positive attitudes towards organ donation and transplantation. DESIGN: A cross-sectional online survey was used to collect the research data. PARTICIPANTS: The participants were recruited by a Japanese research company and affiliates in South Korea and Taiwan and fulfilled the following criteria: (1) laypersons aged 18-75 years, (2) residents of the countries and (3) understood the questions in their native languages. PRIMARY OUTCOME MEASURES: The survey investigated the interest and attitude of individuals regarding transplantation medicine by asking multiple choice questions. Based on answers concerning attitude, a positive group was identified as willing to be organ donors and recipients, and a non-positive group was identified as unwilling to be donors and recipients. The ratio between the positive and non-positive group, the P/N ratio, was introduced as an index of individual readiness. RESULTS: 1500 samples were included in this analysis. Individuals with interest agreed more with statements on organ donation than those without interest, and the P/N ratio per country was compatible with the actual deceased organ donors rate per million population (ADODR). CONCLUSIONS: Interest in transplantation medicine was associated with positive attitudes, and positive attitudes were associated with a higher ADODR. These results support that individual readiness is an important determinant for the number of donors. The P/N ratio can be used as an index to assess individual readiness in organ transplantation, at least in countries with minor to moderate popularisation. Further studies of individual readiness using the P/N ratio should be undertaken to develop policies and initiatives for increasing organ donations.

日本人の臓器提供の選択肢提示に対する受容性や選択肢提示を受け入れやすくするための条件を明らかにする目的で、インターネットによる全国的なアンケート調査を行った(有効回答は2000名)。その結果、家族が救命困難な場合に臓器提供を思い付く人は少なかったが、選択肢提示を良い取り組みと考える人は8割以上であった。臓器移植への関心がある人は選択肢提示に肯定的で、選択肢提示をされたくない人の理由の一つが「脳死になっても回復する可能性がある」であることが分った。選択肢提示の実施者は主治医が最も支持された。以上より、臓器移植に対する関心を高め、選択肢提示者が主治医と情報共有して脳死等について十分な説明を行うことにより、患者家族の受容性を高めることが示唆された。