| Abstract |
Introduction: In recent decades, Organ Donation and Transplantation (ODT) has proven to be a crucial solution for many cases of end-stage organ failure. Acceptance of solid organ transplant programs has improved in various countries of the world, however, transplant programs are still today influenced by various socio-cultural and religious beliefs and attitudes.
Aim: Aim of the present study was to investigate and outline international knowledge regarding the opinions and attitudes of patients with chronic diseases, with the individual objectives of highlighting the characteristics that may change their opinions-attitudes, as well as the possible effect of self-efficacy in opinions-attitudes.
Methods: The present study followed the design of a systematic literature review, which was done according to PRISMA guidelines. It was conducted in three bibliographic databases: MedLine-PubMed, Cochrane and Google Scholar. The search period was set from 01/01/2003 till 05/15/2023. Inclusion criteria where: original studies (e.g., cohort, cross-sectional, ecological, patient-control, clinical trials), in English or Greek, with human subjects. In the end, 96 articles were included.
Results: In short, the main findings were the following. From the 96 studies included, the complexity of the actual donation processes governing organ donation in different countries and the multiplicity of influences on these acts became apparent. At the same time, it became obvious that more primary studies with a sample focusing on the patients themselves with various chronic diseases are needed, since such studies are absent. Regarding patients with chronic kidney disease, there were 18 studies that showed that in this population group, attitudes are positive, although there are some doubts regarding factors that influence attitudes. These are the following. Better graft survival, considering a living donor kidney transplant is better and can last longer in the recipient. Also, the risks to the donor were considered to be minimal and in some cases, there was a so-called desperate dialysis aversion, who, in order to avoid the dialysis process, were willing to defy risks or misgivings and procced for a transplant. Some found it difficult to consider prophylactic transplantation if they were asymptomatic and still had urine output and a normal life. Also, donation between blood relatives was implicitly considered obligatory, and participants with volunteer relatives felt that there was a mutual understanding that the participant would have donated if the roles were reversed. In this context, the need for social support became apparent. Some felt that by accepting or rejecting a relative's offer, they could spark family conflicts. Refusal to donate could create resentment and tension. Thus, the attitudes and perceptions of the family is an important factor in making a decision.
Conclusions: The views of the patients themselves are of utmost importance and together with the views of their families need further primary study, due to the absence of strong and sufficient evidence in the literature. Nevertheless, with the indications so far, the educational programs of the health team related to informing patients about organ donation or transplantation can be renewed, as well as the information and vigilance actions of the population in general can be more targeted.
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