(PO-175) Religious Motivation for Deceased and Living Donor Transplantation
The US leads the world in transplantation but the supply of organs still does not meet the demand. Increased living donor transplantation (LDT) can help meet the need for kidney and liver grafts. Religious motivation has been held in the US and abroad as an important factor which drives altruistic donor intentions. As more non-western countries have increased transplantation, we sought to understand variation in religious explanation for motivation for DDT and LDT.
Data from the 20 countries with the greatest number of transplants in 2019 were reviewed for rates of kidney and liver DDT and LDT. Countries with greater than expected LDT% were reviewed for predominant religions using Pew Research Center. We conducted a review through Pubmed (2010-2020) of surveys that probed for motivation for living donor transplantation related to religious identity. Surveys conducted in the countries with high volume of kidney and liver transplantation were analyzed for themes of forbidding or encouraging organ donation.
Eleven countries were found with LDT% higher than 50%. 16 Surveys met the search criteria; Muslim countries were most predominant including Turkey (7), Saudi Arabia (5), and Pakistan (2). India and Mexico produced one paper each. The surveys queried people of various backgrounds (religious, student, health professionals) about living “organ donation” and few commented specifically about the type of organ. Most queried living donation to a relative and only one about unrelated donation. No surveys concerning religion and LDT were found from populations in Sudan, Algeria, Philippines, Japan, Korea, or Israel
Theologians of various faiths have written that no religion formally forbids LDT or DDT but accept that varied cultural and diverse thought continues to exist at state, local and community levels. Countries such as Turkey, Saudi Arabia, and Pakistan have increased LDT partly due to low DDT rates. Those surveyed in these countries expressed the wish to help relatives through LDT. Islam emphasizes the importance of saving human life but local religious concerns about the medical criteria for death, informed consent, and bodily integrity at death contributed to the low DDT rates. With growth of transplantation in Asia and the Middle East in the past 10 years, LDT has grown faster than DDT. Religion along with economic and legal factors may help explain the LDT% in many countries.
Psychiatrists, psychologists, social workers, and transplant teams in countries with religious diversity will benefit from understanding religious motivation for DDT and LDT. Appreciation for diverse belief systems may help increase both types of donation.
Oliver M, Woywodt A, Ahmed A, Saif I. Organ donation, transplantation and religion. Nephrol Dial Transplant. 2011 Feb;26(2):437-44
Bendorf A, Pussell BA, Kelly PJ, Kerridge IH. Socioeconomic, demographic and policy comparisons of living and deceased kidney transplantation rates across 53 countries. Nephrology (Carlton). 2013 Sep;18(9):633-40