**4. Education**

The teaching of basic concepts regarding transplanting and organ donation has been insufficient.

An efficient education on the need to modify the current reluctant negative behavior toward organ donation by society constitutes a potential possibility to improve this urgent medical-social crisis. Education and information will increase the value of altruism by protecting the population from exploitation, increasing the meaning and value of organ donation [48, 49].

*The hypertensive and diabetic donor*: patients who received cadaveric kidneys from donors with a history of either diabetes or hypertension ("non-ideal") were compared with recipients of "ideal" organs. Although the overall graft survival of the non-ideal organs was somewhat less (69% versus 74%), these differences were not significant. Again, these kidneys should be

*The donor with hepatitis C*: the use of the hepatitis C (HCV) + donor organ has been controversial and was a subject of debate. Nevertheless, today advances in the treatment of hepatitis C

Prevalence of HCV positivity in organ donors has been reported to be between 2 and 6% with contradictory data with respect to the risk of transmission of HCV from positive organ

*Non-heart beating donors (NHBD)*: the use of NHBD has been increasing all over in recent years. In controlled and uncontrolled trials, delayed graft function is 60–80% of cases. Nevertheless, no matter this consequence of longer periods of warm ischemia, long-term results and graft

Until other options such as xenotransplantation or tissue engineering become realistic, the challenge for the millennium will be to identify which donor organs previously considered

*Paired kidney donation*: increased living donation (LD) rates are determined by less invasive

In recent years, a number of strategies have been introduced to expand living donation programs beyond the classical direct donation, to overcome immunological barriers of blood

New strategies in LD include paired kidney exchange. In order to overcome the sometimes difficult barriers of incompatibility in blood groups or the hyper immunized receptor, the pair

The procedure consists of combining the pair of incompatible donor recipients with each compatible member of different pair. Other alternative programs are: altruistic donation, altruistic donor chains and list exchange programs, and desensitization of hyper immunized

The transplant community is challenged to address the ongoing crisis in organ transplant access. A discarded organ may be a missed opportunity to save a life. While careful judgment and prospective monitoring is crucial, a blanket "no" to these organs will help neither you

The teaching of basic concepts regarding transplanting and organ donation has been insufficient. An efficient education on the need to modify the current reluctant negative behavior toward organ donation by society constitutes a potential possibility to improve this urgent medical-social

evaluated on an individual basis by biopsy and donor history [42].

58 Organ Donation and Transplantation - Current Status and Future Challenges

suboptimal can be safely used to expand the organ donor pool.

kidney donation technique has been a significant advance.

patients and transplantation across the blood-type barrier [46].

approaches to donor nephrectomy and by the excellent long-term results.

have change acceptance criteria for these donors.

donors [44].

survival rates are excellent [45].

group or HLA sensitization of recipients.

nor your patients [47].

**4. Education**

Organ donation and transplantation education at all levels of society have been a matter of interest for decades. Nevertheless, the results observed to date must be considered inadequate because organ donation and procurement have not improved worldwide. With regard to medical education on transplantation, multiple polls show a severe lack of knowledge [3–7].

When searching for new alternatives to modify ancestral prejudices and barriers inhibiting the use of the body after life, priority should be given to youth education starting with children in schools.

The rationale of this proposal is that young people, particularly children, are free of prejudices, and are able to easily learn new ideas, sometimes much more easily than adults. Modern psychology suggests that childhood is the best developmental stage to start prevention programs against harmful prejudices. In addition, new notions learned by children at schools can be a way to offer clear and unprejudiced knowledge to their families [50, 51].

The central task of education is to implement facilities to learn; it should produce learning people. The truly human society is a learning society, where grandparents, parents and children are students together.

At present, young people have not been sufficiently informed of their future organ transplant needs and their potential role in the development of educational programs.

No one has yet realized the wealth of sympathy, the kindness and generosity hidden in the soul of a child. The effort of every true education should be to unlock that treasure [52].

Organ and tissue donation can also involve children. Because of its sensitivity, this topic requires careful decision-making. Children have the ability to carefully reflect on this subject and enjoy participating in family discussions about it [53].

Shoenberg consider that teaching young people about organ transplantation is not particularly difficult. He considered that helping young people understand the problem of transplant increases the possibility that they clearly understand its importance. Probably young people in response to this teaching will discuss this issue with their families or with their peers, thus multiplying the educational effect. Intense and persistent educational efforts focused specifically on young people are relatively rare. Consequently, this leading educator not related to medicine, suggested that "the transplant community has to offer strong stimuli that induce professors in various places to assume such a task" [54].

Undoubtedly, the insufficient results of people's education, without significant changes over the decades, indicate the need to review the current methodology of teaching society about this severe crisis, consequently of their current behavior toward organ donation.

The introduction to the permanent curricula of study, in the different levels of education; structured by a commission of experts, that will analyze the insufficient achievements obtained with the current education methodology.

Introducing a new conceptual line of teaching that will provides new approaches and even new slogans to be transmitted to society, could be a necessary test in a search for a progress in the results so far obtained.

This pilot test highlights the usefulness of a stable and universal introduction transplantation

The Society, the Barriers to Organ Donation and Alternatives for a Change

http://dx.doi.org/10.5772/intechopen.73756

61

Considering the stagnant rates of organ donation, it is important to mention that in the search for possible solutions the potential role of a different educational strategy has not yet been significantly promoted by the World Health Organization (WHO) and international trans-

In contrast, it is interesting to note that the WHO and The Transplantation Society have developed an intense and positive legal and ethical interest into the serious problem of organ commerce and transplant tourism. It would be of great utility to promote joint activity by the WHO, UNESCO and Transplantation Societies, and religious authorities, in order to generate international consensus meetings, looking for efficient educational policies and search for

Organ and tissue transplants provide the possibility of new life and improved health and well being. However, the number of patients who died due to lack of donated organs increases daily. The main cause of this paradox is inadequate social behavior regarding organ donation, both in life and after death. Education at all levels of society may offer the possibility of improving this critical situation. In this chapter, we suggest a change of methodology based primarily on a modification of the message. We emphasize the need to focus education at an early age, starting with primary school and intensifying it at the university level, especially

In the USA from 1988 to 2010, donation-related policies on organ donation and transplantation increased in number from 7 to 50. That is great progress with intentions to improve a crisis. Nevertheless as remarked by Chatterjee et al. strategies to encourage organ donation have had no observable effect [55]. Millions of dollars have been unsuccessfully spent on the education of society seeking to change feelings toward organ donation [27]. Consequently, international figures have suggested the controversial need to institute legal and economic

The current contradiction is that the global success of organ transplantation is growing as fast

Fundamental measures looking to improve the shortage of donated organs have been scientific and technical; however, there has not been a significant increase in the number of organs and tissues obtained for transplantation. Almost inexplicably, society's communication and education methodology has remained practically unchanged over time. It is clear that human behavior regarding organ donation should be critically analyzed to identify the most effective

**2.2. The role of international organizations responsible for health and education**

subjects in the curriculum of youth education [50].

other possible solutions to this global social emergency.

incentives to living and deceased donors [37].

as the waiting list and the mortality of its members.

plantation societies.

**3. Conclusions**

in medical sciences.

Clarify fundamental concepts previously mentioned and up-to-date information on organ donation and transplantation will help to understand fears and prejudices generated by ignorance.

Previous information to the teachers by experts in social communication and specialists in transplants will be fundamental as an initial step for the realization of a new program of education of the youth with transmission to the whole society.

Recent experiences in Argentina and Canada, inspired by the previously described conceptual suggestions, have produced positive results. In their responses to a questionnaire completed after the class, students (aged 10–16 years, from households of different socio-economic levels) showed a clear understanding of the concepts taught, and a coherent and logical interpretation of the problem.

The pilot trial consisted in a 45 min course followed by discussion and questions, with the following purposes:


#### **Materials and methods**


The following where the main topics included in the lecture:


This pilot test highlights the usefulness of a stable and universal introduction transplantation subjects in the curriculum of youth education [50].
