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Although India's organ donation rate is less than 1 per million population, significant disparities exist between the regions and centres within the country, leading to varying consent rates among different organ donation centres. Therefore, this study aimed to understand the experience of transplant coordinators and their barriers and facilitators in the deceased organ donation process across various organ donation centres in India. A phenomenological study using interviews was conducted among fourteen transplant coordinators purposefully recruited from public and private organ donation centres in India, with experience between six years and more than a decade. Audio recordings were transcribed and analysed using framework analysis. Five themes were identified namely: (1) supportive management policies, (2) infrastructure for the deceased organ donation process, (3) delays in the processing time, (4) active involvement in the identification process, and (5) explaining the concept of brain death. The study identifies that implementation priorities include strengthening teamwork, streamlining processes, optimising infrastructure for sensitive discussions, efficient donor identification, and empathetic handling of donor families' grief stages. Collaborating with law enforcement, applying successful medico-legal strategies, improving family communication, and clarifying brain death concepts ethically and legally can boost consent rates, fostering informed decisions and possibly achieving self-sufficiency in deceased organ donation., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The Institute for Health Research Ethics Committee (IHREC952), University of Bedfordshire, United Kingdom approved the present study. All participants provided informed consent and permission to record the interviews. Consent for publication: All study participants consented to publication of anonymised data via the ethics approval. All authors have contributed to publication and consented to publication., (© 2024. The Author(s).)

This study aimed to examine the barriers and facilitators of the public toward deceased organ donation in Chandigarh, and Chennai, India, from three major religious groups, Hinduism, Islamism, and Christianity. Twenty-five focus groups were conducted (n = 87) stratified by study region, religion, sex, and age. Data were analysed using framework analysis. The results revealed that individuals were primarily willing to donate their organs. However, their religious views regarding death, after-life beliefs, funeral ritual practices, and lack of knowledge regarding their religion's position toward deceased organ donation created tension and ambiguity in the decision-making. However, younger age groups (18-30 years) appeared more open and positive toward deceased organ donation. The conclusion demands a clear need for religious leaders and stakeholders to address their religion's stance, which creates tension and ambiguity in any uncertainties surrounding cultural and religious-based views among the Indian population., Competing Interests: Declarations Conflict of interest The authors declare no conflict of interest. Ethical Approval This study is a part of the PhD work of the principal investigator, and the whole study was approved by the Institute for Health Research Ethics Committee (IHREC949), University of Bedfordshire, United Kingdom. Consent to Participate A detailed participant information sheet was given to all the participants, and all participants participated only after consenting to participate in this study. Consent to Publish The participant information sheet also informed that this study would be published, and all the participants also consented to publish the study., (© 2024. The Author(s).)

Purpose: The Hospital Corneal Retrieval Program (HCRP) aims to counsel and encourage the family of a critically ill or deceased person in the hospital for eye donation. Adequately sensitized health-care workers (HCWs) may play a pivotal role in boosting HCRP., Study Design: Multicentric, cross-sectional, descriptive study., Methods: Study participants included all HCWs of three medical colleges, including one with eye bank and corneal transplant services. A pretested, structured questionnaire was used to record the awareness, knowledge, and attitude about eye donation among HCWs. The expected outcome was to seek differences in awareness, if any, among medical and paramedical workers of medical colleges with (group A) or without (group B) eye bank and corneal transplant facilities., Results: Of the 4060 study participants, 2100 HCWs were in group A and the rest (1960) were in group B. For eight out of 13 questions assessing awareness and perception, a statistically insignificant difference in responses was observed between the two groups. Regarding questions related to attitude, although the majority of HCWs in both groups were comfortable talking about eye donation, they did feel that counseling relatives of a terminally ill patient about eye donation was insensitive. Less than half of HCWs showed a willingness to donate eyes, and about half of the participants wanted to acquire more knowledge about eye donation., Conclusion: Awareness regarding eye donation among HCWs was mostly found to be at dismal levels, irrespective of whether they worked in an institute with or without eye bank and corneal transplant services. This warrants an accelerated effort at sensitizing HCWs as a strengthening measure for HCRP., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Background: In India, critical shortage of organ donations, particularly deceased donations, has led to a dire situation in India, with thousands of patients waiting for transplants and a significant number of them succumbing. One of the reasons for the shortage of organs for transplantation is unawareness and prejudiced information about organ donation. Being direct or indirect stakeholders, the knowledge regarding organ donation among healthcare workers may play an important role in the donation process., Aim: To assess the knowledge regarding cadaver organ donation among healthcare workers and their willingness toward organ donation., Materials and Methods: It is a cross-sectional offline self-administered questionnaire-based survey conducted among healthcare professionals at tertiary care teaching institutes. Survey was carried out between the months of August to December 2019. A structured questionnaire was used to assess knowledge and willingness toward organ donation. Statistical analyzed was done by using statistical package for social sciences (SPSS) 20.0. All p -values were considered significant at <0.05., Results: A total of 1,039 healthcare professionals participated in the survey. Out of them, 362 (34.8%) were males and 675 (65%) were females. Average age of the healthcare workers participating in survey was 30.81 years, and age ranged from 18 to 60 years. Awareness regarding corneal donation after brain death was found to be maximum (89.7%) and was comparable to that of kidney (86.6%) and heart (83.7%). Participants were unlearned of donation of lungs, pancreas, hands and unaware of heart valve donation. About 45% respondents considered that age affected the donors. About 40% respondents considered younger patients as ideal recipients, while 18.7% respondents considered waiting list patients as ideal recipients. Doctors had highest willingness (78. 3%) for organ donation, followed by nurses (69.9%) and support staff (59.3%) ( p < 0.001). Only 119 (11.5%) participants received organ donation cards as against 68.7% willingness toward organ donation ( p < 0.01)., Conclusion: We have observed fair awareness regarding overall cadaver organ donation concept among healthcare workers. There is a need to improve knowledge of extended age criteria and which organs can be retrieved from deceased donor. Authorities have to work hard on delivery of organ donation pledging card to promote donation program., (© Journal of the Association of Physicians of India 2024.)

Purpose: To assess and analyze the rate of knowledge, attitude, and practice patterns about eye donation among medical and healthcare professionals in a tertiary care hospital in eastern India., Methods: This was a cross-sectional, descriptive study conducted on medical students, resident doctors, and nursing and paramedical staff at a tertiary institute in the year 2020. A pretested, structured questionnaire consisting of 28 questions in the three subsections based on knowledge and awareness, attitudes and beliefs, and practice patterns mainly willingness to donate eyes by pledging, was noted. All the responses were individually scored, and the total scores were calculated. Univariate analysis was done to find out the factors that had a positive or negative influence on the knowledge and willingness about eye donation., Results: Around 270 participants responded to this survey. The majority of the respondents (206, 76.3%) were below 30 years and 64.4% were males. Awareness about eye donation was 95.6% but a willingness to pledge was observed in 51.5% of participants. The total practice score was lower among nonmedicos compared with medicos (3.33 ± 1.22 vs 3.74 ± 0.64), (P < 0.001). On univariate analysis, the Crude Odds Ratio with a 95% confidence interval was 25.787 (5.18-128.33) in the occupational category (P < 0.001)., Conclusion: The study reported an adequate knowledge level among doctors and healthcare workers. The practice pattern among the nursing staff and paramedical workers needs to be improved as they can play a pivotal role in strengthening the hospital corneal retrieval program. They can also be the key messengers during public awareness campaigns for eye donations in our country., Competing Interests: None

Background : Organ shortage is a global issue and it is imperative to take steps to bridge this gap. In the Indian context, despite its demographic dividend, the rate of organ donation has been abysmally low. This emphasizes a need to demystify the antecedents of organ donation intention among the Indian population. Methods: Using a cross-sectional research design and adopting a post-positivism research philosophy, this study identified 259 respondents by adopting a purposive sampling approach and data on knowledge of organ donation was collected using a structured, pretested questionnaire. Results: Awareness of organ donation law in India is low on specific issues and respondents from the health science & medicine discipline scored better on knowledge about organ donation. The findings show that most participants had heard about organ donation and had a favourable attitude toward it. The primary sources of information on organ donation were television and newspapers, and healthcare service providers. A complementary partial median is established (β = .217, t = 5.889, p < .001) which implies that willingness to discuss with family significantly mediates the association between attitude towards organ & tissue donation and willingness to sign the donor card. Conclusion : This study revealed that there is a general awareness of organ and tissue donation among the Indian population, but they lack clarity on certain specific issues. Mass media has to be effectively used to build awareness campaigns revolving around enhancing knowledge on a specific issue and building acceptance of the concept of organ and tissue donation., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Nayak VC and Nayak S.)

Competing Interests: The authors declare no conflicts of interest.

Background: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process. Objective: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students. Methods: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1-13), positive attitude (Q14-24) and practice habits (Q25-27) regarding organ donation with dichotomous scale (Yes/No). Results: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p<0.001). While second year dental students had higher scores for their knowledge (8.55±1.56) and practice (1.02±0.44) compared to other year of training, third year students showed a significant higher mean attitude score (1.73±1.17) (p=0.02). Hindus and Muslims scored significantly lower mean knowledge, attitude and practice habits compared to others (Christians, Jains and Athesists) (p<0.001). There was a positive correlation between mean knowledge, attitude, and practice habits. Conclusion: There are an average level of knowledge and low levels of positive attitude and practice habits among studied dental students towards organ donation and transplantation. [ABSTRACT FROM AUTHOR]

Purpose: To assess the perception of college-going girls toward corneal donation in Northern India., Methods: An online survey with a pre-structured, pre-validated questionnaire was conducted on 1721 college-going girls in Northern India. The knowledge and attitude scores were regressed, and latent class analysis was carried out., Results: The average of scores for all participants was computed individually for the knowledge questions and the attitude questions, and based on this score, total participants were divided into two groups: Better corneal donation behaviors (BCDB) and poor corneal donation behaviors. The binomial logistic regression model of knowledge domain for predicting BCDB, age of the participant, their awareness about corneal donation, and willingness to discuss eye donation among family members were found significant. Similarly, for the attitude domain, awareness about corneal donation, knowledge about hours within which ideal eye donation needs to be undertaken, and knowledge about eye donation during coronavirus disease 2019 (COVID-19) pandemic were found to be significant. Latent class analysis identified one subset of participants having poorer knowledge and attitude scores and that they were more from a rural background, were having more than first order as birth order, were belonging to SC/ST classes, had illiterate or secondary education of father and mother, and were living in rented houses., Conclusion: The findings of the study significantly contribute to devising a mechanism to improve knowledge and influencing the attitude about eye donation among the youth, especially young women, who can act as counselors and motivators for the masses as well as their own families, in the generations to come., Competing Interests: None

In India, the most densely populated state is Uttar Pradesh in the Northern region. This state has a huge base of corneal blind population due to cornea infections, ocular trauma, and (chemical) burns.Successful cornea transplantation using human post-mortem donated cornea is a treatment modality. In India lack of availability of donated cornea is a public health challenge. Thus, there is great need to reduce the huge demand and supply gap by increasing the donations for supply of cornea to patients.The Eye Bank at the Dr. Shroff's Charity Eye Hospital (SCEH) and the German Society for Tissue Transplantation (DGFG) collaborate in a project to enhance cornea donation and eye bank's infrastructure in Delhi. The project is supported by the Hospital Partnerships funding programme which is a joint initiative of Germany's Federal Ministry for Economic Cooperation and Development (BMZ) and the Else Kröner-Fresenius Foundation (EKFS) and carried out by the German Society for International Collaboration (GIZ GmbH).The project aims to increase the number of cornea donations by the SCEH eye bank through establishing two new eye collection centers where donation is coordinated and that are integrated into the existing and well-established eye bank and donation infrastructure of SCEH. Further, data management of the eye bank will be improved by developing a concept for an electronic database system that allows faster monitoring and evaluation of the processes. All activities are carried out according to a defined project plan. The basis of the project is an open-minded analysis and understanding of processes of both partners in relation to the respective legislations plus the environment and conditions in both countries.Aside from intercultural exchange and personal contacts both partners benefit from mutual on-site visits and exchanging best practices in eye donation and banking as well as sharing expertise in research topics.This project is a great example on how strong and sustainable relationships can be build across the globe improving the infrastructure for cornea donations to help corneal blind patients., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Although medical mistrust (MM) may be an impediment to public health interventions, no MM scale has been validated across countries and the assessment of MM has not been explored using item response theory, which allows generalisation beyond the sampled data. We aimed to determine the dimensionality of a brief MM measure across four countries through Mokken analysis and Graded Response Modelling. Analysis of 1468 participants from UK ( n = 1179), Ireland ( n = 191), India ( n = 49) and Malaysia (n = 49) demonstrated that MM items formed a hierarchical, unidimensional measure, which is very informative about high levels of MM. Possible item reduction and scoring changes were also demonstrated. This study demonstrates that this brief MM measure is suitable for international studies as it is unidimensional across countries, cross cultural, and shows that minor adjustments will not impact on the assessment of MM when using these items.

Purpose: This study aimed to evaluate the knowledge, awareness and attitude of eye donation among non-clinical staff of tertiary eye hospitals and to convey a positive attitude toward eye donation by enhancing their awareness and knowledge., Methods: An online cross-sectional study was conducted among the non-clinical staff from all centers of a tertiary eye care hospital across Tamil Nadu. Quiz link was emailed to non-clinical staff of all the centers. On completion of the quiz, the participants viewed their respective scores and the correct answers to all questions. This activity was presumed to subsequently improve their knowledge and clear up the myths on eye donation., Results: Two hundred twenty-eight non-clinical staff from 11 hospitals participated in the quiz. Mean age was 35.3 ± 9.8 years and 130 were female staff (57.05%). One hundred eighty-one participants (79.39%) scored over 50% of the total 17 queries. One hundred eighty-six (81.58%) and 142 (62.28%) participants scored over 50% in the awareness section and knowledge section, respectively. Eye bank volunteers (73, 32.02%) were the main source of information. Twenty-four (10.53%) had already taken pledge for eye donation and 175 (76.75%) were willing to pledge, 29 (12.72%) were not willing to pledge. Twenty-two out of these 29 (75.86%) had no specific reason for not pledging. Family, religious reasons, lack of clarity and fear were least cited reasons (13.79%)., Conclusion: Non-clinical staff of an eye hospital are easily approachable and are expected to be more knowledgeable by the general public around them. They might act as primary motivators in raising awareness within their family, friends, relatives and neighbors., Competing Interests: None

Competing Interests: None

Purpose: To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic., Methods: This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records., Results: Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 ± 20.54 years, whereas the median age was 51 (inter-quartile range: 35-68) years. The mean age of males (49.3 ± 19.47 years) was lesser than the mean age of females (56.72 ± 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 ± 20.51 years in 2018 to 44.35 ± 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021., Conclusion: Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic., Competing Interests: None

Purpose: To report the factors influencing eye donation among families of successful eye donors in India., Methods: The consenting family members of 434 deceased individuals who donated eyes between April 2019 and March 2020 were retrospectively interviewed via a telephonic questionnaire survey. Details regarding the donors and their families, motivating factors for eye donation, and time taken for tissue recovery were collected and analyzed., Results: The mean age of donors was 66.8 years, and only 13.9% of them had pledged to donate their eyes before death. For 62.3% of donations, children of donors were the primary consenters for eye donation. In 18.8% of donors, there was a previous history of eye donation in the family. Many donations were motivated by a non-governmental organization volunteer (40.5%) or by a grief counselor at the hospital (27.4%). Hospital-based corneal retrieval programs and donations where the first eye bank contact was made through hospital personnel had the greatest percentage of rapid enucleations (performed within 3 h after death) (48.7% and 49.1%, respectively; P = 0.001 and P = 0.02, respectively)., Conclusion: Children of donors, typically in the working-age group, most often make the decision for donation, and hence, future awareness programs should focus on this specific population. All types of hospitals should advocate for eye donation as they are a common point of contact for a grieving family, and health-care professionals at all levels should be considered for training as motivators for eye donation., Competing Interests: None

Purpose: To determine the awareness on eye donation and willingness to pledge eyes for donation among the population aged ≥40 years in the northeastern state of Tripura, India., Methods: A population-based cross-sectional study was carried out among 2,500 participants. The investigators conducted a detailed interview on awareness of eye donation and willingness to pledge eyes for donation. 'Awareness' was defined as having heard about eye donation. Those who reported awareness of eye donation were asked a question on willingness to pledge their eyes., Results: A total of 2,440/2,500 (97.6%) participants responded to the questionnaire. Among these, 1,216 (49.8%) participants were men, and 859 (35.2%) had no education. The mean age of the participants was 54.7 years (standard deviation:12.1 years). Overall, 61.4% (95% CI:59.5-63.4; n = 1,499) reported awareness of eye donation; of those only 3.8% (95% CI:2.9-4.9; n = 57) were willing to pledge their eyes for donation. On multivariable analyses, the odds of awareness were higher among those who had school education (OR:2.12; 95% CI: 1.73-2.56) or higher education (OR:11.79; 95% CI:7.35-18.93). Deformity associated with eye donation (n = 327;76.9%) followed by religious reasons (n = 63; 14.8%) and a belief that those who donate eye are 'born blind in the next birth' (n = 23; 5.4%) were the main reasons for lack of willingness to pledge their eyes for donation., Conclusions: Although the awareness regarding eye donation was satisfactory, there was lack of willingness to pledge eyes for donation. There is a need for focussed information, education, and communication campaigns to encourage eye donation in Tripura.

To bridge the gap between demand and supply of organs, deceased donors with extreme ages can be utilized. The object of this study was to compare elderly with non-elderly donors and to assess the predictors of organ utilization or wastage. This was a retrospective chart analysis. Univariate and multivariate logistic regression analysis of cohorts was carried out to predict organ utilization or wastage. Of the 716 deceased donors, 16.2% were elderly (≥60 years) and 83.8% were not elderly (≤59 years). Donors in the elderly cohort were more likely to be diabetic, hypertensive, overweight, and smokers compared with non-elderly donors. They had deranged terminal creatinine and succumbed to cerebrovascular accident or intracerebral hemorrhage. They had a high kidney donor risk index (KDRI) of 1.83 ± 0.46. Those in the younger donor cohort, were more likely to have succumbed to road traffic accident-associated traumatic brain injury, were subjected to more efforts to revive them in the intensive care unit via cardiopulmonary resuscitation, had deranged liver function tests, and had a KDRI of 0.93 ± 0.28. The kidney discard rate (KDR) and liver discard rate (LDR) in the elderly donors was 50% and 8.6%, respectively (vis-a-vis the non-elderly at 13.3 % and 7.5%). The KDR was significantly higher than the LDR in elderly donors. The main reason for this was the high number of "marginal kidneys". We revealed that elderly donors formed a significant proportion of deceased donors. The utilization of the liver from deceased donors was more frequent compared with the kidney.

Competing Interests: The authors declare no funding or conflicts of interest.

Objectives: This study aimed to assess awareness toward eye donation and the effects of COVID-19 on perceptions about eye donation in an urban community of West Bengal, India., Materials and Methods: Eligible adults residing in the area under study were chosen by simple random sampling and interviewed using a predesigned and pretested data collection schedule to assess awareness and perception. Based on their total awareness score, the participants were classified as having good awareness or poor awareness toward eye donation., Results: Among 423 participants, 52.0% were male, 34.0% were 18 to 30 years old, 38.3% were educated up to secondary level, and 85.6% had eye disease in their family. Of total participants, 70.2% had heard about eye donation, with 59.9% of this group having knowledge of eye donation only after death and 57.9% having knowledge that donation must occur within 6 hours of death. In addition, 52.9% were aware about donation from home, 30.6% said only the cornea is transplantable, and 52.2% knew it can be preserved. Participants with higher education, higher socioeconomic status, and outside of the house occupational engagement had significantly higher chance of good eye donation awareness. Of total participants, 32.0% said that COVID-19 could be transmitted through eye donation, with 58.2% of participants opining that the pandemic was not a suitable time to consider donation of eyes., Conclusions: COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.

Purpose: Cognizant and well aware medical and nursing students are expected to influence and positively mold the eye donation rates in India. Keeping this in view, this study was designed to assess and compare eye donation awareness among medical and nursing students., Methods: A cross-sectional and comparative study undertaken on the occasion of eye donation fortnight among 112 medical and 115 nursing students. A pretested semi-structured questionnaire on eye donation was given to each student after getting informed consent. The software used for analysis of data was SPSS version 22.0., Results: All the medical students and 91.3% of nursing students (P < 0.0016) had heard about eye donation. Eye donation fortnight is celebrated every year to create awareness was known to 42% of medical students and 29.5% of nursing students (P < 0.05). Television, newspaper, magazines, and posters were found to be important sources of information in both groups. Eye donation can give vision to the blind was the primary motivational force both among medical and nursing students (P < 0.001). The ideal time of eye donation is within 6 h of death was known to 69% of medical students and 60.9% nursing students. Lack of awareness and objection of family members are the two significant perceived responses to non-donation in both groups. 88.4% of medical students and 79.1% of nursing students are willing to donate their eyes in future., Conclusion: The awareness of eye donation among medical students is better than nursing students. However, the willingness to pledge their eyes is almost equal in both groups., Competing Interests: None

Introduction: Nearly 6.8 million people in India have vision less than 6/60 in at least one eye due to corneal diseases; of these, about a million had bilateral involvement., Purpose: To identify the challenges faced; the trends in collection, storage and utilisation of corneal tissues in an eye bank in north India., Materials and Methods: The past records of Eye Bank linked to a tertiary hospital in northern India were analysed from November'1999 to October'2015 with respect to number of eye donations per year, donor demographics and utilisation of corneal tissues., Results: The number of donations during the first 6 years were 100, 279 in the next 5 years and 473 in the last 5 years. The mean donor age was 63.2 ± 19.5 years. The percentage of donors less than 30, 31-60 and more than 60 years was 10%, 28% and 62%. Forty-two percent donations were from the hospital. The average time between the death and enucleation was 4.74 ± 5.31 hours. The percentage of corneas used in the donor age groups less than 30, 31-60 and above 60 years was 61.9%, 61.6% and 53.8%, respectively. The usability rate of the corneas from home and hospital was 63.7% and 55.3%, respectively., Conclusions: The eye bank had a lukewarm response in the beginning, but gained momentum with time. The myths and beliefs prevalent in our society deter people from donating eyes freely. Each eye bank needs to individualise its problems and find solutions for adequate procurement and utilisation of tissue.

Background: There is lack of data on feasibility and safety of kidney transplants from living donors who recovered from COVID-19., Methods: Here, we present a retrospective cohort study of 31 kidney transplant recipients (KTR) from living donors who recovered from polymerase chain reaction confirmed COVID-19 across 19 transplant centers in India from July 3, 2020, to December 5, 2020. We detailed demographics, clinical manifestations, immunosuppression regimen, treatment, and outcomes. Donors with a previous diagnosis of COVID-19 were accepted after documenting 2 negative polymerase chain reaction tests with complete symptom resolution for at least 28 days and significant social distancing for 14 days before surgery., Results: COVID-19 clinical severity in donors ranged from completely asymptomatic (71%, n = 22) to mild infection (29%, n = 9). None progressed to moderate or severe stages of the disease in the entire clinical course of home treatment. Patient and graft survival was 100%, respectively, with acute cellular rejection being reported in 6.4% (n = 2) recipient. All recipients and donors were asymptomatic with normal creatinine at median follow-up of 44 days after surgery without any complications relating to surgery and COVID-19., Conclusions: Our data support safety of proceeding with living donation for asymptomatic individuals with comprehensive donor, recipients screening before surgery, using a combination of clinical, radiologic, and laboratory criteria. It could provide new insights into the management of KTR from living donors who have recovered from COVID-19 in India. To the best of our knowledge, this remains the largest cohort of KTR from living donors who recovered from COVID-19., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To identify factors affecting family members' decision whether to donate eye organs., Methods: A community-based case-control study based on in-home interviews with families of deceased individuals who had or had not donated eye organs, in Madurai district, Tamil Nadu, India. Data collected were knowledge and awareness of eye donations, whether the deceased individual had expressed or pledged willingness to donate, and family members' attitudes and willingness to donate their own eye organs., Results: Seventy-six families of donors and 256 families of non-donors completed the survey. Multivariable analysis showed that the following variables were significantly associated with a donation: age, whether the deceased had registered for eye donation, pre-expressed willingness of deceased to donate, whether family members personally know beneficiaries of eye donations, and higher score on a scale evaluating knowledge and awareness about eye donation. The majority of donors' families (71%) had been encouraged by someone to donate. Among non-donor families, a substantially larger fraction (52.8%) indicated they would have donated had someone reminded or encouraged them to do so, in comparison with those who indicated lack of awareness or knowledge (14.5%)., Conclusion: Community programs are likely to be effective if they encourage individuals to pledge their eyes or express their willingness to donate their eyes to family members in advance of death; they increase public awareness of the value of eye donation. A friend, family member, neighbor or counselor approaching bereaved families and having a dialogue about eye donation would substantially increase the probability of a decision to donate., Competing Interests: None

Introduction: Corneal blindness, though treatable, contributes largely to the burden of blindness. With 1.2 million existing cases of corneal blindness in India, the demand for cornea collection is increasing. 69349 corneas were collected in 2018-19 but it is much less than what is needed. Faulty perceptions and unwillingness are two major hurdles against a scenario favourable towards eye donation. The objectives of the study was to assess the perception and willingness towards eye donation and the socio-demographic variables that affect such perception and willingness, in an urban community of West Bengal., Materials and Methods: In this cross-sectional study conducted among adult residents of the urban field practice area of Medical College Kolkata, data was collected from randomly selected eligible members, one each from all the available families by interviewing them using a validated pre tested schedule., Results: Eighty nine (52.3%) among 170 interviewed participants had Secondary level education or higher, 49.4% had outdoor engagement. 128 participants reported ocular morbidity in the family but only 126 had heard about eye donation. 98 (77.8%) of these 126, had favourable perception towards eye donation. Among these 98 participants, 40 were willing to pledge for eye donation. Higher education and outdoor engagement significantly predicted favourable perception, while willingness significantly increased with participants belonging to higher socio-economic class and with higher education., Conclusions: Compared to favourable perception, willingness of pledging eyes was lesser due to various false notions. Proper education through usage of means of mass communication and stress upon school education is needed to address these hurdles., (© NEPjOPH.)

Tamil Nadu, Gujarat, Telangana, Maharashtra, Kerala, Chandigarh, Karnataka, National Capital Territory of Delhi, and Rajasthan are states and union territories having active deceased-donor organ transplant programs in India. Transplant data (2013-2018) have been collected by the National Organ and Tissue Transplant Organization from all states and union territories of India and submitted to the Global Observatory on Donation and Transplantation. From 2013 to 2018, 49155 transplants were reported in India, including 39000 living-donor organ recipients and 10 155 deceased-donor organ recipients. These transplants were for kidney (living donor = 32584, deceased donor = 5748), liver (living donor = 6416, deceased donor = 2967), heart (deceased donor = 895), lung (deceased donor = 459), pancreas (deceased donor = 78), and small bowel (deceased donor = 8). According to 2018 data, India was the second largest transplanting country in the world in terms of the absolute number of transplants. Here, we discuss the status, progress, challenges, and solutions for deceaseddonor organ transplantation. The plan to increase rates of organ donation in India include the following points: teamwork and focus by intensive care unit doctors; public education on organ donation using social media; professional education and family donation conversation programs for brain death declaration and donor management; organ procurement organizations; international collaboration and regular meetings and updates for organizations working in the field of organ transplantation; grief counseling and reporting of potential donation for families of recently deceased people; nonfinancial incentivization to families of potential organ donors; expert committees and standard operating protocols for use of marginal donor organs, donation after circulatory death programs, and machine perfusion; maintenance of transparency and ethics in organ donation, allocation, and transplantation as directed by governmental, nongovernmental, and intergovernmental entities; and regular audit of progress and registry data.

The COVID-19 pandemic has brought with it the huge burden of mortality and morbidity across the world and the added effects of the mandatory lockdown measures to try and control the spread. A number of aspects of healthcare including eye donation and eye collection require adequate safety precautions in place to keep both the involved healthcare workers and patients safe. This paper highlights the consensus-based guidelines by an expert panel on how to restart eye banking and eye collection services and carry out emergency corneal surgeries during this COVID-19 time. These guidelines will be applicable to all eye banks across the country and should help ophthalmologists and eye banking staff to restart eye banking while safeguarding themselves and their patients., Competing Interests: None

Introduction: The need for organs is comparatively higher among people of Indian origin due to the higher prevalence of end-stage organ failure. In spite of the higher need, they have a lower number of organ donors. Studies have been carried out among people of Indian origin living globally to understand the reasons for the low donation rate, but there has been no systematic review that has integrated all of these studies to synthesise the current literature. Therefore, the purpose of this review is to examine the barriers towards organ donor registration and consent among Indians living globally., Methods and Analysis: A systematic search will be conducted using the following relevant databases namely CINHAL, MEDLINE, PsycINFO, Scopus, Web of Science, PubMed Central, Global Health and Grey literature. Studies from 1994 that satisfy our inclusion criteria will be included. Two reviewers will conduct the screening, data extraction and quality assessment of the studies; in event of any disagreement between the two reviewers at any stage, the third reviewer will reconcile any disagreements and consensus will be made., Ethics and Dissemination: As this study includes only secondary data, ethical approval for secondary data usage has been sought. This study will use Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines to report and the study outcomes will be disseminated through a relevant peer-review publication, related conferences and also to various non-governmental organisations globally which are working with this particular community; following which further research can be developed based on this evidence and also helps in building a culturally competent strategy., Prospero Registration Number: CRD42019155274., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: None

Background: We aimed to assess the knowledge and attitude of health professionals towards eye donation at an apex tertiary care centre of northern India., Methods: We interviewed 600 health professionals, comprising doctors, nurses, medical as well as nursing students, social workers and allied paramedical staff. A structured questionnaire (12 questions for assessing knowledge and 5 questions for assessing attitude) was used to estimate the awareness of eye donation and willingness to pledge eyes for donation. The responses pertaining to knowledge were graded as 'excellent', 'good' and 'poor' and those pertaining to attitude were grouped into 'positive' and 'negative'., Results: Of the 600 participants, 138 participants (23%) had 'excellent' knowledge and 234 participants (39%) had 'good' knowledge about eye donation. Awareness of eye donation was positively related to the level of literacy (odds ratio [OR] 8.5 [2.30-31.2]; p<0.001). Medical social workers and health supervisors had better knowledge about eye donation (OR 2.01 [1.08-3.72]; p=0.026) than other professional groups. Knowledge of eye donation had no significant association with age, gender, religion, family type and marital status of the respondent. Willingness to pledge eyes for donation was observed in only 6% of the participating health professionals. Pledging of eyes for donation was higher among older participants (OR 7.8 [2.67-22.77]; p<0.001)., Conclusion: Our study shows that there is sufficient knowledge about eye donation, but an alarmingly low willingness to pledge eyes for donation among health professionals. Concerted efforts are required to alter their attitude to strengthen the Hospital Cornea Retrieval Programme., Competing Interests: None

In India approximately 1 million people get burnt every year and most of them are from the lower or middle income strata. Therefore it is obligatory to find out an economic way of treatment for the affected populace. Since use of human skin allograft is the gold standard for the treatment of burn wound, in-house skin banking for a burn unit hospital is prerequisite to make the treatment procedure affordable. Although, there was one skin bank at India till 2009, but it was difficult for a single bank to cover the entire country's need. Looking at the necessities, National Burns Centre (a tertiary burn care centre) along with Rotary International and Euro Skin Bank collaborated and developed an effective cadaveric skin banking model in Mumbai, Maharashtra in 2009. Initial two to three years were formation phase; by the year 2013 the entire system was organized and started running full fledged. The model has also been replicated in other states of India to accommodate the large burn population of the country. This paper therefore, gives a step by step account of how the bank evolved and its present status., (Copyright © 2017. Published by Elsevier Ltd.)

Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation. Television (55.2%) and newspaper (45.8%) were the most popular sources of information. About 56.2% and 32.8% believed that a healthy person and a cardiac dead person can be donors, respectively. Nearly 29.4% believed that a brain-dead person can be a donor and 22.4% clearly stated as to be having no idea regarding the health status of a donor. Highest awareness was observed regarding eye donation (92%). High awareness was also observed regarding heart, kidney, and liver donations, that is, 71.1%, 61.2%, and 54.2%, respectively. Awareness regarding donation of other tissues and organs was poor. Only 46.8% believed that the family of the deceased person can give consent for organ donation if the donor had not signed the donor card. Awareness regarding both body and organ donation in rural India is high. However, there is lack of understanding regarding the concept of brain-death. Awareness regarding body and other organ and tissue donations besides eye, kidney, etc., needs further awareness drives., Competing Interests: None declared.

Globally, shortage of organs available for organ transplantation is a major problem. Studies assessing awareness and attitudes towards organ donation are limited from India. The aim of this study is to assess gender differences in the perceptions and attitude of general population toward organ donation. A cross-sectional descriptive study was carried out among randomly selected patient relatives (n = 193) at the outpatient department of a tertiary care center. Data were collected through face-to-face interview using a structured questionnaire. Our findings revealed that majority of men than women were aware and in favor of promoting organ donation (χ2 = 10.428, P < 0.001). Best part of men (70.9%) compared to 52.3% of women were willing to donate their organs after death (χ2 = 18.080, P <0.001). Similarly, more number of (48.5%) men were willing to sign on the organ donation card. There is an urgent need to uncover the myths and misconceptions of the general population toward organ donation. Further, healthcare providers and governmental and nongovernmental agencies should take active initiation in motivating the public to give their consent for organ donation.

Nurses play a significant role in identifying and securing potential organ donors in the clinical environment. Research among Indian nurses related to organ donation is sparse. The present study aimed to investigate nurses' attitudes towards organ donation. A cross-sectional descriptive survey was carried out among nurses (n=184) at a tertiary care centre. Data were collected through self-report questionnaire. A majority (81%) of the respondents were 'willing to sign the card' for organ donation; however, only 3.8% (n=7) of them actually 'signed the organ donation card'. There were significant associations found between intentions to sign the organ donation card and gender (x2=5.852; p<0.054), religion (x2=40.175; p<0.000), and experience caring for brain-dead patients (x2=22.790; p<0.001). The researchers strongly suggest continuing education for nurses to enhance skills and knowledge, as well as sensitivity to cultural, ethical, social, and religious issues, and advocacy in the area of organ donation. Furthermore, nurse administrators must take the initiative to develop guidelines clarifying the role of nurses in the organ donation and transplantation process to promote organ donation and improve rates.

Background: To determine the knowledge, attitudes and practices regarding organ donation in western India., Methods: Convenience sampling was used to generate a sample of 250; 200 interviews were successfully completed and used for analysis. Data collection was carried out via face to face interviews based on a pre-tested questionnaire in selected public areas of Ahmedabad, Gujarat state of India. Data entry was made in excel software in codes and analysis was done by SPSS software., Results: About 86% of participants were aware of the term organ donation but knowledge about its various aspects was low. About 48% aware people heard about organ donation through medical fraternity, whereas only about 21% became aware through mass media. About 59% of aware people believed there is a potential danger of donated organs being misused, abused or misappropriated. About 47% of aware people said they would consider donating organs, while only 16% said they would definitely donate irrespective of circumstances. Around 97.67% participants said they would prefer to donate to nonsmokers. About 74.41% participants were unaware about any legislation regarding organ donation. About 77% participants showed their will to donate to mentally sound persons, and 42.04% participants showed their will to donate even physically challenged people. Around 78 participants felt that they would donate organs to persons irrespective of their religion. About 81% of aware people were of the opinion that consent for organ donation after death should be given by family members. None of the interviewed participants had a donor card., Conclusion: Better knowledge and awareness will help in promoting organ donation. Effective campaign needs to be driven to educate people with relevant information with the involvement of media, doctors and religious scholars.

Background: The attitude of healthcare workers towards organ donation can either facilitate or hinder the process of organ donation. We assessed the attitude of healthcare workers employed in intensive or emergency care units of our hospital towards organ donation, and the influence of various factors on willingness for self-organ donation after death., Methods: All doctors, paramedical workers, nursing staff and other staff members working in six distinct intensive or emergency care units in the hospital were requested to fill a completely anonymous, voluntary and self-administered questionnaire. Younger individuals, women and nurses constituted a majority of the study population., Results: The questionnaire completion rate was 99%. About 55% of the study population were agreeable to donating organs after death and 27% were undecided. The factors that positively influenced their willingness to donate organs after death were favourable attitude of the spouse, religious beliefs supporting organ donation, knowledge of hospital's organ transplant programme, personal experience of the organ donation scenario, having ever donated blood or involvement in social activities, willingness to become an eye donor and willingness to become a living kidney donor., Conclusion: A largely favourable attitude towards organ donation was seen in our study population. However, the study reflects incomplete knowledge leading to confusion and thus, desire to know more among participants with respect to various aspects regarding organ donation. The factors identify that positively influence decisions regarding organ donation can be used as direct interventions., (Copyright 2013, NMJI.)

Background: The poor progress in improving kidney donation rates in India spurred this research., Methods: We first explored the awareness level and attitude of adults in relation to kidney donation as a function of age, gender, and religion (study A). We then ascertained the attitude of individuals towards cadaver kidney donation (study B). The sample in study A consisted of 84 adults from Mumbai representing both genders, 2 age groups, and 3 major religions. The sample in study B consisted of 155 participants from Mumbai, representing both genders, 4 religions, and a varied age group. A questionnaire was employed in both studies., Results: Participants had an average level of awareness regarding kidney donation (M = 29.25; SD = 5.91) and a neutral attitude toward it (M = 255.71; SD = 93.4). Younger adults (M = 32.05) had a higher level of awareness than older adults (M = 28.63; P = .008). Females (M = 280.31) had a more positive attitude than males (M = 231.10; P = .01). Hindus (M = 32.39) had a higher level of awareness than Muslims (M = 28.42; P = .04). Hindus (M = 279.00) and Christians (M = 283.90; P = .006) had a more positive attitude than Muslims (M = 204.22). After death, 76% were willing to donate their kidneys and 63%, those of their family members. Improving the quality of life of the patient with chronic kidney disease was the primary reason for donating a kidney. Prohibition by religion and anticipated objection by other family members were reasons advanced for not donating kidneys., Conclusions: These findings can help to develop an education program to enhance kidney donation., (Copyright © 2013 Elsevier Inc. All rights reserved.)

RTx is best treatment for children with ESRD. Data scarcity on DDRTx outcome in children prompted us to review our experience. This study was undertaken to evaluate patient/graft survival, function vis-a-vis SCr, rejection episodes, and mortality in DDRTx performed in 37 children between 1998 and 2011. The most common recipient diseases leading to ESRD were congenital anomalies of kidney and urinary tract (48.6%) and chronic glomerulonephritis (18.9%). Mean recipient age was 13.8 ± 3.1 yr; 67.5% (n = 25) were men. Mean donor age was 38.8 ± 18.6 yr; 48.5% (n = 18) were men. Mean dialysis duration pre-transplantation was 15.5 ± 3.5 months. All recipients received r-ATG, and triple immunosuppression. Over a mean follow-up of 3.93 ± 3.5 yr, patient and graft survival rates were 72.9% (n = 27) and 83.7% (n = 31), respectively, with a mean SCr of 1.1 mg/dL; 21.6% (n = 8) of patients had acute rejection episodes; 24.3% (n = 9) of patients had DGF. A total of 27% (n = 10) patients died, mainly owing to infections (n = 6) and cardiovascular disease (n = 3). DDRTx is a viable option for children and achieves acceptable graft function with patient/graft survival over long-term follow-up, encouraging use of this approach., (© 2012 John Wiley & Sons A/S.)

With the attendant rise of the number of medical colleges in India over past few decades, the demand for cadavers used in medical education and research is growing. However, there is an insufficient supply of donated cadavers available for dissection. This study was undertaken to assess the general population's awareness of body donation programs and willingness to donate in the State of Maharashtra, India. The willingness of participants to donate was compared with age, gender, and education of the respondents. A total of 625 adult individuals from the State of Maharashtra participated in a survey composed of questions about age, sex, education, awareness of body donation programs, and willingness to donate. It was found that 90.9% of the medical colleges surveyed reported an inadequate supply of cadavers. Of the general population, 32.1% of respondents were aware of body donation, compared to 95.83% of health care professionals. However, only 19.5% of the general population and 44.9% of health care professionals were willing to donate their bodies for anatomical education. Younger age groups, males, graduates, and postgraduates were found more willing to donate their bodies. Organ donation was preferred over body donation. A lack of awareness about body donation was the main factor responsible for respondents' "no body donation" response in the general population, along with firm religious beliefs and customs, the fear that the donated body will not be treated with respect and dignity, and the unacceptability of the dissection of one's own body. To overcome the current shortage of donated cadavers, efforts should be undertaken to change the mindset of the wider Indian society toward body donation. The authors believe this is possible through awareness campaigns and that prospective donors' concerns should be addressed appropriately. Proper guidance and assistance regarding body donation should be easily available for potential donors., (Copyright © 2012 American Association of Anatomists.)