title: Attitude of healthcare professionals: a major limiting factor in organ donation from brain-dead donors.
abstract: Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P < 0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude.
authors.affiliation: Department of General and Transplantation Surgery, Medical University of Warsaw, 02-006 Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kosieradzki
authors.affiliation: Department of Health Psychology, Children's Memorial Health Institute, 00-999 Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Jakubowska-Winecka
authors.affiliation: CBOS Public Opinion Research Center, 00-503 Warsaw, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Feliksiak
authors.affiliation: CBOS Public Opinion Research Center, 00-503 Warsaw, Poland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Kawalec
authors.affiliation: Specialist Hospital in Jaslo, 38-200 Jaslo, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Zawilinska
authors.affiliation: Polish Transplant Coordinating Center "Poltransplant", 02-001 Warsaw, Poland ; Department of Surgical and Transplant Nursing, Medical University of Warsaw, 02-007 Warsaw, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Danielewicz
authors.affiliation: Polish Transplant Coordinating Center "Poltransplant", 02-001 Warsaw, Poland ; Department of Surgical and Transplant Nursing, Medical University of Warsaw, 02-007 Warsaw, Poland.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Czerwinski
authors.affiliation: Department of Surgical and Transplant Nursing, Medical University of Warsaw, 02-007 Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Malkowski
authors.affiliation: Polish Union for Transplantation Medicine, 00-820 Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Rowiński