| Abstract|| |
To evaluate factors affecting the knowledge and/or attitudes of the Saudi Arabian public with respect to organ donation and transplantation, a cross sectional study was conducted on a random sample of 948 Saudi citizens between 20 -60 years of age during 2005. The collected data included: knowledge about organ donation campaigns, knowledge of the Saudi Center for Organ Transplantation (SCOT), religious knowledge towards related issues, attitudes toward organ donation and self or close-relative experience of organ transplantation. The study revealed that 58.5% of participants heard about the existence of SCOT, 91.1 % knew the need for organ donation, and 92.7 knew that organ donation could save lives. The organ donation campaign was known to 62.3% of the participants. Of these participants, 57.9% were made aware of organ donation campaigns through TV ads, 52.8% from magazines and newspapers and 11.7% from scientific sources. While 23.7% of the participants were unaware of any issued Islamic fatwa regarding organ donation, another 36.1% did not respond to this question revealing a lack of knowledge. Forty-two percent of the respondents agreed to donate their organs after death. Among the various reasons against organ donation, 27.5% feared that the act of organ donation contradicted their religious beliefs, while 3.5% believed that there was no benefit to organ donation. It is concluded that a need for proper information dissemination exists. A multidisciplinary approach is suggested including government support backed by strong recommendations from knowledgeable religious sources.
|How to cite this article:|
Alam AA. Public Opinion on Organ Donation in Saudi Arabia. Saudi J Kidney Dis Transpl 2007;18:54-9
| Introduction|| |
The Saudi center for organ transplantation (SCOT) was established by the government of Saudi Arabia in 1984 as a national organ procurement center that supervises all activities of organ donation and transplantation in Saudi Arabia in accordance with the Senior Ulama Commission decree issued in 1982. The decree permitted organ donation and transplantation from living and deceased donors. The SCOT achieved considerable success rates and its efforts benefited a significant number of patients.
Strategies of the SCOT to improve the public and medical communities awareness of the significance of organ donation and transplantation included opinion surveys, distribution of donation cards, public debates, training courses, and hospital visits etc. , Accordingly, there have been steady increases in the total number of organ transplantation with each passing year due to the programs initiated by the SCOT.
Although the public generally express favorable views toward organ donation, few actually agree to donate before they die or agree to have family members' consent for organ donation upon their death. This may be due to inadequate awareness of the importance of organ donation and transplantation. Studies have demonstrated that the presence of positive or negative attitudes regarding transplantation can determine an individual's commitment to organ donation.
Reviewing the psychological aspects of organ donation revealed that several knowledge and religious beliefs play a significant role in influencing an individual's decision to donate their organs following death. Factual knowledge allows individuals to refute false beliefs, which increases the willingness to donate organs. Moreover, a greater number of people would agree to donate organs if they are supported by religious communities and leaders. Accordingly, family and patient characteristics, their attitudes and beliefs about organ donation were significantly associated with the decision to donate organs.,
The aim of this study was to explore the current public knowledge and opinion towards organ donation. Studying factors that affect knowledge and/or attitude and practices can aid in better planning for future awareness programs.
| Methods and subjects|| |
This cross sectional study included a randomized sample of adult Saudi men and was conducted during 2005 in various regions of Saudi Arabia. A standard questionnaire included various socio-demographic factors to ascertain the knowledge, attitude and practices on organ donation and transplantation-related issues. The following points were considered when designing the questionnaire:
- Knowledge on organ donation and organ transplantation in Saudi Arabia.
- Knowledge of the existence of the SCOT.
- Attitude/s toward organ donation.
- Documentation of self or close-relative experience/s on organ donation and transplantation.
| Statistical analysis|| |
Data gathered through the questionnaires were entered into Microsoft Excel spreadsheet and were analyzed by Statistical Package for Social Sciences (SPSS) volume 11.1. Frequency distribution and analysis were expressed as mean ± standard deviation (SD). Appropriate statistical methods were employed to correlate variables and statistical significance was set at a p value was less than 0.05.
| Results|| |
A total of 948 respondents agreed to participate in the study. The distribution of respondents by socio-demographic factors are shown in [Table - 1]. There were 519 (54.7%) respondents in the age group 20 to 30 years old, and 579 (61.1%) were university graduates. The monthly income of 210 (22.2%) respondents ranged between >7000-10,000 riyals (~2500-3000 US dollars). The geographical distribution of respondents showed that 468 (49.4%) were from the Central region, 273 (28.8%) from the Western region, 105 (11.1%) from the Northern region and 102 (10.8%) were from the Eastern region.
[Table - 2] shows the various responses towards knowledge of the inquiries. With respect to respondents' knowledge of the existence of SCOT, 555 (58.5%) were aware of SCOT, while 393 (41.5%) never heard of it. Eighthundred sixty four (91.1%) respondents knew the benefits behind organ donation, i.e., "it could save lives of other people".
There were 897 (94.6%) respondents who knew that the "kidney" was a transplantable organ, 639 (67.4%) who thought it was the "liver", 537 (56.6%) chose the "heart", and 531 (56%) knew that the cornea could be transplanted in KSA, [Table - 2].
591 (62.3%) respondents heard about the organ donation campaign that was previously launched in Saudi Arabia. Among them, 342 (57.9%) respondents knew of organ donation and transplantation from television advertisements, 312 (52.8%) read about it from magazines and newspapers, 198 (33.5%) received the information from relatives and friends and 96 (16.2%) heard about it from the radio.
225 (23.7%) participants did not know about the fatwa (Ulamas' decree) content on organ donation, while 342 (36.1%) did not respond to this question at all. However, 273 (28.8%) knew that the Fatwa allowed organ donation.
Various opinions related to organ donation are summarized in [Table - 3]. About 402 (42.4%) respondents accepted the concept of organ donation after their death, while 153 (16.1%) disagreed. When asked about possible reasons for organ donation refusal, 261 (27.5%) cited religious reasons and 219 (23.1%) did not want to have their bodies dissected after death. The two major reasons for accepting organ donation included humanity and religion as reported by 642 (67.7%) and 588 (62.0%) respondents, respectively.
The responses revealed that upon accepting organ donation, respondents preferred that recipients would be either of the same religion (48.7%), relatives (33.9%), or anyone in need (30.7%), respectively.
Among the surveyed sample, 138 (14.6%) respondents gave history of having previous organ transplanted, which were performed outside Saudi Arabia. [Table - 4] shows the given reasons for such choice, where the majority 81 (58.7%) experienced better availability of donated organs abroad.
| Discussion|| |
The study showed that majority of respondents knew that many lives could be saved by organ donation. This was supported by the fact that most of the respondents knew of SCOT's existence through plausible and vivid publicity campaigns via the media. Concerted efforts of the government and the religious authorities to properly educate the public on the benefits and religious aspects of organ donation are essential.
The public should be well informed on the religious aspects of organ donation. This was reflected in the results where in 27.5% of the respondents refused the concept of organ donation due to religious reasons. Uniformity and consistency on the information of the religious aspects of organ donation through the approval of the fatwa is very important in Saudi Arabia, since most people abide by Islamic law and reject any intervention that is forbidden by Islam.
A considerable percentage of respondents in the study agreed to donate their organs. This may be due to the fact that most of the respondents were educated individuals of high socioeconomic status, which made them wellinformed about organ donation and understood what was seen or heard in the media campaigns. However, negative attitudes still exist due to inadequate awareness of the religious aspects of organ donation and transplantation as reflected by the large percentage of responses in disapproval of organ donation, despite the high degree of knowledge and social status. The balance between culture and religion has to be addressed in this aspect towards better realization of the positive implications of organ donation in Saudi Arabia.
Outside the kingdom, organ transplantation has occurred for several years. Besides being less expensive, organ donors are readily available outside the kingdom. Most organ transplants abroad were performed in USA, Egypt, Pakistan and the Philippines. Saudi Arabia has cutting-edge medical technology and highly qualified medical teams to perform successful transplantations and follow-up patients appropriately. The majority of tertiary hospitals in Saudi Arabia are highly equipped with the latest diagnostic and medical technology tools to perform such a procedure. However, inadequate organ donation is the primary reason for the patients seeking transplantations abroad.
Major strategies exist to reach the goals of the organ procurement centers. These include improving awareness of the medical community to the importance of organ donation and transplantation, improving the awareness of the public at large to the importance of organ donation and transplantatation, and developing an efficient system to coordinate the activities of both donating hospitals and transplant centers. 
The increasing demand of organ donation is a pressing issue that deserves the coordination between more than one sector within the medical, social and religious leaderships. Due to the nature of dealing with sensitive issues such as transplantation, the gradual introduction of more detailed public surveys can open venues for better communication and intervention. The implications of the present study are promising; however, future representtative national studies are needed before any generalization can be assumed. Making the public better aware of others' suffering, may positively affect their perceptions of organ donation.
We conclude that there is a significant demand for organ donation in K.S.A. This demand can be alleviated by enhancing and encouraging people to donate their organs through concerted efforts from both the government and religious authorities. In a conservative society such as Saudi Arabia, where religion encompasses most people's belief, the fatwa for organ donation should be disseminated to all Ulamas through uniform and consistent information dissemination campaigns. Through this, a larger percentage of individuals may become better informed and readily accept the concept of organ donation.
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Awatif Ali Alam
College of Medicine, King Khalid University Hospital, P.O. Box 2925, Riyadh 11461
[Table - 1], [Table - 2], [Table - 3], [Table - 4]