F. McCurdie

Medical students' knowledge about organ transplantation: a South African perspective.

BACKGROUND Educating physicians about transplantation during undergraduate training can improve organ procurement rates. The aim of this study was to evaluate and analyze the knowledge of medical students regarding transplantation. METHODS A previously validated self-administered anonymous questionnaire was distributed to all medical students. RESULTS Of the 346 participants, 217 (63%) were preclinical students. Their mean age was 21 years (range, 18-33) and 62% were women. Twenty-nine (8%) students were registered as organ donors. One third of all study participants received formal transplantation teaching; a greater proportion of clinical students received teaching compared with the preclinical group (52% vs 22%, P < .05). Knowledge was frequently reported for kidney (88%), liver (81%), bone marrow (78%), and heart (76%) transplantation. Small Intestine (13%), pancreas (9%), and pancreatic islets (4%) were the least recognized organs/tissues. Ninety-six percent and 62% of respondents were aware of kidney and liver living-donor transplants, respectively; the 27% of students with an interest in a surgical career had better knowledge of living-donor transplantation (P < .05). Only 22 (6%) students knew which solid organ transplants were performed in South Africa. CONCLUSION Medical students have limited knowledge about organ transplantation; there is a need for educational intervention early in the medical curriculum.

Attitudes and beliefs of South African medical students toward organ transplantation.

Sobnach S, Borkum M, Millar AJW, Hoffman R, Muller E, McCurdie F, Kahn D. Attitudes and beliefs of South African medical students toward organ transplantation. 
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01449.x. 
© 2011 John Wiley & Sons A/S.

Transplantation in South Africa.

Although some of the pioneering work in organ transplantation has originated in South Africa, the country has an urgent need for improving solid organ transplantation. South African hospitals are either funded by the South African Government (state hospitals) or by private companies. The former provide free health care to citizens who earn less than a specified minimum amount, whereas the latter are available to patients who pay cash for treatment or who have private medical insurance. Many state institutions, such as Groote Schuur Hospital, will only accept patients onto a dialysis program if they are also candidates for a renal transplant. This puts a further pressure on improving options for renal transplantation in South Africa.

PROSPECTIVE AUDIT OF DEATHS AT A TEACHING HOSPITAL

We undertook a prospective audit of all the deaths in the trauma unit, the emergency unit, and the intensive care units to estimate the number of potential organ donors in the hospital and identify the reasons for nonreferral of potential donors. The transplant coordinators undertook daily visits to the above units and documented all of the deaths occurring in the previous 24 hours. The patient records were reviewed, and the medical and nursing staff interviewed to determine the precise circumstances surrounding the death. Seven of the 14 deaths in the neurosurgical intensive care unit were related to the head injury, and five were certified brain dead and referred as an organ donor. Fifty-eight of 83 deaths in the trauma unit were head injury related; however, only eight were eventually certified brain dead and referred. In the emergency unit, only one of 76 patients who died was certified brain dead and referred as an organ donor. Although many of the deaths in the above units are related to a head injury or cerebral event, very few are actually certified brain dead. All potential donors who were certified brain dead were referred to the transplant team.