To the Editor,

There are not enough organ donations to cover the needs of transplants. For this reason, it is important to promote living donation, to try to meet these needs.1,2 In Spanish-speaking countries, living donation is still in its infancy. In this respect, cadaveric donor procurement units have played a key part in promoting organ transplants, and could possibly do the same for developing living donation.3 The aim of this study is to analyse the attitude towards living kidney (LKD) and liver (LLD) donation among hospital professionals in the cadaveric donor procurement units of Spain and Latin America, and to analyse the variables that bring about this attitude.

From the International Donor Collaboration Project, seven hospitals with cadaveric donor procurement units (intensive care unit, surgical resuscitation unit, and neurosurgery unit) were selected: 2 in Spain, 3 in Mexico, and 2 in Cuba. Random sampling stratified by professional category was performed in these units. The field study was carried out in 2006. Attitude was assessed with a validated survey4-6 which was self-administered and completed anonymously. A descriptive analysis was performed, and the student T and the Chi-square tests were applied.

The survey was completed by 283 professionals from the procurement units. Of these, 90% (n=254) were in favour of related LKD, 6% (n=16) against, and 4% (n=13) undecided. By countries, 95% (n=71) of Cubans were in favour, 92% (n=44) of Spaniards, and 87% (n=139) of Mexicans (P>.05). No significant differences were observed with regard to sociopersonal or occupational variables, except for employment conditions. The medical professionals with a permanent post were more in favour of this kind of donation than those with a temporary post (95% vs 85%; P=.007) (Table 1). Among the rest of the variables, a more positive attitude is seen among: those who are in favour of cadaveric donation (P<.001); those who would accept a kidney from a living donor if it were necessary (P<.001); those in favour of LLD (P<.001); those whose partner has a positive attitude toward donation and transplantation (P=.001); and those who perform or have performed prosocial activities (P=.013) (Table 1).

As for related LLD, 84% (n=237) were in favour, 11% (n=32) against, and 5% (n=14) undecided. By countries, 87% (n=65) of Cubans were in favour, 85% (n=41) of Spaniards, and 82% (n=131) of the Mexicans (P>.05). No significant correlations were observed between sociopersonal and occupational variables. Among the rest of the variables, a more positive attitude is seen among: those with personal experience with donation and transplants (P=.032); those in favour of cadaveric organ donation (P=.001); those in favour of LKD (P<.001); those whose would accept a liver from a living donor if necessary (P=.001); and those who perform or have performed prosocial activities (P<.001) (Table 1).

Hospital staff from cadaveric donor procurement units in Spain and Latin America have a very positive attitude towards both living kidney and liver donation. Their attitude is more favourable than that observed in other studies using the same questionnaire.4 The data obtained by our group3 in 2003 showed that 86% had a favourable attitude towards LKD and 68% towards LLD. Therefore, expectations for this kind of donation are becoming more and more positive and optimistic. LKD is generally more accepted than LLD, possibly due to the lower risk6,8 for the donor.

Attitudes towards living donation have been shown not to be influenced by sociopersonal or religious factors, or attitudes towards the body.7,9 However, there is a significant association between attitudes towards LKD and LLD. Therefore, it seems clear that the main problem of living donation is accepting it. It is worth noting that no differences exist with regard to occupational category, nor between healthcare professionals and those working in other settings.6,9

In conclusion, we can declare that the attitude of the staff of cadaveric donor procurement units in Spain and Latin America towards living donation is very favourable. Thus, they could play an important role in its promotion in these times of a desire to develop living donation, provided the socio-political and economic conditions are right for it.

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Table 1. Livng donation in donor procurement units in Spain and Latin America