ORGAN DONATION AND ALLOCATION II

A. Sharif, P. Cockwell, G. Lipkin, S. Ball, R. Borrows
Nephrology And Transplantation, Queen Elizabeth Hospital, Birmingham/UNITED KINGDOM

Body: Introduction. There is an ever increasing disparity between the supply and demand of solid organs for transplantation. A complex array of factors influence refusal to donate organs,including religion. Of all religious groups, Muslims are acknowledged as resistant to organ donation despite theological approval from religious scholars and repeated initiatives promoting awareness.It is imperative for healthcare providers to explore Muslim opinion regarding organ donation and to identify these concerns we conducted a global population-based survey to look at this in greaterdetail. The aim of the project was to identify the causes of Muslim apprehension with regards to organ donation, thus allowing extrapolation into targeted, public health initiatives to increaseawareness.

Methods. We conducted an international survey inviting voluntary completion of an anonymous, 41-part survey. No limitations on participation were made. Survey promotion waselectronically conducted through Muslim groups/associations/internet forums and by hand distribution in local mosques. For a population target of approximately 1.5 billion, we targeted a completedsample size of 664 to achieve a 5% error margin and 99% confidence interval (assuming 50% response distribution). Logistic regression analysis was performed to assess multivariate associations withorgan donation approval.

Results. 812 participants took the survey with 673 full completions (82.9% completion rate). 68.5% of respondents agreed with organ donation, despite only 36.2% believing it wascompatible with Islamic belief (only 10.6% were registered organ donors). Only 2.2% of Muslims would categorically refuse an organ transplant if one were required, with the rest either happy toreceive (72.8%) or undecided (25.0%). 9.9% of Muslims would prefer organ donation from a fellow Muslim alone, but a disproportionate 24.5% would only want to donate to another Muslim. Predictors fororgan donation approval included younger age, lesser degree of self-rated religiosity, awareness of organ shortages, knowing someone with kidney disease/dialysis or respondent having kidneydisease/dialysis (all p < 0.05). 76.7% of respondents stated advertisement of organ donation issues amongst Muslims was poor. Only 24.3% of repondents agreed with the concept of presumed consent.The two biggest reasons cited by Muslims for reluctance to donate organs was interpretation of religious scripture (78.8%) and advice from their local mosque (70.8%). 60% felt that distrust of thehealth service was either moderately or very important as an explantation for poor donation rates.

Conclusions. Significant confusion remains amidst Muslims on the legality surrounding organ donation and this translates into poor donation rates. Due to their influence, failure toengage with religious scholars and mosques will prohibit initiatives to promote organ donation in the Muslim community. The results of this survey should be translated into a targeted and coherentengagement with the Muslim population to encourage organ donation in transplantation programmes for both the developed and developing world.

Disclosure: All authors have declared no conflicts of interest.