The Willingness to Donate Organs in Medical Students From an International Perspective: A Meta-Analysis

Abstract

Attitude toward organ donation mobilizes donation behavior and makes transplant surgery possible. As future health professionals, medical students will be a relevant generating opinion group and will have an important role in the organ requesting process. The goals of this meta-analysis were to obtain polled rates of medical students who are in favor, against, or indecisive toward cadaveric organ donation in the studies conducted around the world, and to explore sociocultural variables influencing the willingness to donate. Electronic search and revision of references from previous literature allowed us to locate 57 studies fulfilling the inclusion criteria. Data extraction and risk of bias assessment were performed by two independent investigators. Pooled estimations were computed assuming a random-effects model. Despite the fact that willingness to donate was elevated in medical students, estimated rates in studies from different geographical areas and sociocultural backgrounds exhibited significant differences. The age and the grade of the students also influenced the rate of students in favor. Donation campaigns should take into account cultural factors, especially in countries where certain beliefs and values could hamper organ donation. Also, knowledge and skills related to organ donation and transplant should be acquired early in the medical curriculum when a negative attitude is less resistant to change.

Keywords: cultural; medical students; meta-analysis; organ donation; willingness.

FIGURE 1

PRISMA flow diagram.

FIGURE 2

Forest plots of individual rates and confidence intervals for each study (squares) and pooled estimations and confidence intervals for each cultural background (diamonds). (A) Forest plot of individual and pooled rates of students willing to donate in Western countries. Individual rates vary from 0.564 to 0.940. The pooled estimated rate by the random-effects model was 0.807. (B) Forest plot of individual and pooled rates of students willing to donate in Latin countries. Individual rates vary from 0.620 to 0.917. The pooled estimated rate by the random-effects model was 0.820. (C) Forest plot of individual and pooled rates of students willing to donate in Islamic countries. Individual rates vary from 0.224 to 0.878. The pooled estimated rate by the random-effects model was 0.577. (D) Forest plot of individual and pooled rates of students willing to donate in Oriental countries. Individual rates vary from 0.151 to 0.850. The pooled estimated rate by the random-effects model was 0.544.

FIGURE 3

Funnel plot of the individual observed rates for each study (circles) and observed (white diamond) and adjusted (black diamond) pooled rates of students willing to donate. The absence of imputed values to achieve symmetry in the dots’ distribution and the equivalence between observed and adjusted pooled rates allow for us to discard publication bias.