The level of knowledge and attitudes toward organ transplantation
Transkrypt
The level of knowledge and attitudes toward organ transplantation
HEALTH AND WELLNESS 2/2015 WELLNESS AND SOCIETY CHAPTER XIX School of Public Health in Bytom Medical University of Silesia in Katowice Emergency Medicine Department of Child Neurosurgery and Emergency Medicine Clinic, Bytom Wydział Zdrowia Publicznego w Bytomiu Śląski Uniwersytet Medyczny w Katowicach Katedra Neurochirurgii Dziecięcej i Medycyny Ratunkowej Zakład Medycyny Ratunkowej, Bytom DARIUSZ MYRCIK, MAGDALENA TRZEPIZUR, JOANNA MAKARSKA, KAROLINA JĘDRYSZEK, KRYSTYNA SNEKA, ARKADIUSZ NICZYPORUK, TOMASZ STĘPIEŃ, BOGUSŁAW BUCKI, MAREK MANDERA The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa Poziom wiedzy i świadomość społeczna w zakresie transplantologii wśród studentów Śląskiego Uniwersytetu Medycznego i Politechniki Częstochowskiej Key words: transplantation, knowledge, students Słowa kluczowe: transplantologia, wiedza, studenci INTRODUCTION Organ transplantation is the moving of tissue or organs from one part of the body to another in the same organism (autotransplantation), between two organisms of the same species (homotransplantation), or between two organisms of different species (heterotransplantation, xenogenic transplantation). Tissue and organs may be retrieved from a living donor (ex vivo) or from a deceased donor (ex mortuo) [3, 5]. HEALTH AND WELLNESS 2/2015 Wellness and society In 2014, there have been 782 deceased donors registered in Poland, including 594 actual deceased donors. There have been 1531 organs retrieved from deceased donors in total. The retrieved organs include: 1064 - kidneys, 37 - kidney and pancreas, 336 - liver, 76 - heart, 18 – lungs. The first successful transplant in the world took place in 1954. It was a kidney transplant, where the organ was retrieved from a twin brother. The first successful kidney transplant from a deceased donor in Poland was on 26 th January 1966 in Warsaw. The kidney was transplanted by Prof. Jan Nielubowicz and his team, including Waldemar Olszewski, Wojciech Rowiński, Jerzy Szczerbań, and Tadeusz Orłowski. Transplantation has significantly developed in Poland owing to Prof. Zbigniew Religa. It was in Zabrze on 5th November 1985 that the first successful cardiac transplantation took place. It was also in Zabrze that the first successful simultaneous lung and cardiac transplantation took place on 24th October 2001. On 2nd April 2006, Prof. Jerzy Jabłecki and his team transplanted hand in Trzebnica, whereas in 2010 Prof. Adam Maciejewski performed a face transplant. Moreover, there has been a lot of controversy involved in the anterior cruciate ligament transplant retrieved from a pig. The ligament was transplanted by a team from the Hospital of Trauma Surgery (Szpital Chirurgii Urazowej) in Piekary Śląskie in February 2015. The beginnings of transplantation in Poland was rather difficult as there were no clear tissue and organ transplantation regulations. Due to a high percentage of transplantations in medical treatment, in the 80’s of the previous century, the Polish Ministry of Health decided to prepare a code of legal regulations for cell -, tissue- and organ retrieval and transplantation. This led to the creation of the cell -, tissue- and organ retrieval and transplantation act on 26th October, 1995. Currently the binding regulation is the Cell, Tissue and Organ Recovery, Storage and Transplantation Act of July 1st, 2005. In 1993, the National Transplantation Council was created. As a consequence, “Poltransplant” (a national organ recovery and transplantation team) was initiated. In 1996, the Organization and Coordination Center for Transplantation Issues “Poltransplant” was created. It is a national budget entity subordinate to the Minister of Health in Warsaw. The act regulating the activity of “Poltransplant” is the Minister of Health regulation of 2nd July, 2010 (Dz. Urz. Ministra Zdrowia of 21 st July, 2010, Nr 9, poz. 58)[11]. This regulation defines the specific goals of “Poltransplant” and implements the guidelines included in the Act of July 1st, 2005. “Poltransplant” operates across the whole country. Cells, tissue and organs are retrieved from deceased donors only for diagnostic, therapeutic, scientific and didactic purposes. According to Polish regulations, each person who has not refused to be a donor, may become a donor after death. There is a repository of permission granting refusals that is called the Central Refusal Register (Centralny Rejestr Sprzeciwów). A signed declaration or an oral declaration expressed in the presence of at least two witnesses is also legally binding. The witnesses are later obliged to confirm the oral declaration in writing. The refusal should be sent by post or submitted as a completed form sent to the Central Refusal Register at the Transplant Coordination Center (Centrum Organizacyjno- Koordynacyjne ds. Transplantacji) in Warsaw. A confirmation is sent by post to notify that the refusal has been successfully 236 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa registered. The refusal may later be withdrawn. The refusal withdrawal procedure is analogous to the refusal registration steps [9, 10]. If there is no individual pre-stated refusal of permission, there is a presumption of permission for being a deceased donor. The presumption is called a presumed consent. In practice, the reality is not as easy as it seems. Bereaved family members are not always willing to see the beloved one as a donor. The refusal expressed by the family often makes doctors desist from retrieval in order to avoid claims. In Poland, there is no possibility to register a consent to donation after death. However, there is still a possibility to complete a pre-stated acceptance form where an individual may declare that they are willing to become a deceased donor. The form mentioned should include one’s name, surname, personal ID Number (PESEL), address and signature. Owing to the pre-stated acceptance form, it is easier for the family to decide whether the organs of the dead family member should later be retrieved or not. Cell-, tissue- and organ retrieval is possible only in the case of an irreversible cessation of cerebral and brain stem function that is characterized by absence of specific neural responses and lack of spontaneous respiratory activity. The person is examined by a committee including three doctors, at least one of them being an anaesthetist and/or intensive therapy specialist, and one of them being a neurologist and/or a neurosurgeon. Brain death is diagnosed when irreversible cessation of brain functions occurs. The examination procedure involves two stages. The first stage is the presumption of brain death based on the statements and exclusions included in the regulations. The next stage involves a set of tests also provided in the regulations to confirm brain death. In the case of a potential deceased donor, death cause, medical case history, risk factors potentially impacting future recipients and their tissue- and organ perfusion are taken into account and examined. Organ retrieval is out of the question when bacterial-, viral- and fungal infections are involved, as well as malignant tumours, arteriosclerosis, systemic diseases and drug addiction [6]. Retrieval is possible also in the case of living donors. However, in such situation, only double organs and/or cells and tissue that can be regenerated should be retrieved. Only a lineal blood relative, siblings, an adopted family member or spouse may become a living donor. In Poland, transplantations of organs from living donors are not paid for. In 2014, there were 55 kidney transplantations from living donors and 30 liver parts transplantations from living donors. Kidney transplantations from living donors are more effective that the transplantations from deceased donors. The history of bone marrow transplantation in Poland goes back to the times before World War II. In Lviv, Jan Reszka and Franciszek Groer were the first who attempted transplanting bone marrow. In Poland, the first allogeneic bone marrow transplantation was performed by Prof. Cezary Szczylik and Wiesław Wiktor Jędrzejczak. Each healthy, adult person not older than 50 years old may become a bone marrow donor. The person may be a relative of the recipient but does not necessarily have to [1, 2]. 237 HEALTH AND WELLNESS 2/2015 Wellness and society In order to find potential non-related bone marrow donors, the Central Register of Donors of Bone Marrow and Cord Blood (Centralny Rejestr Dawców Szpiku i Krwi Pępowinowej) was created in 2000 as commissioned by the Ministry of Health. The current name of the repository is the Central Register of Unrelated Donors of Bone Marrow and Cord Blood (Centralny Rejestr Niespokrewnionych Dawców Szpiku i Krwi Pępowinowej). Each potential bone marrow donor residing in Poland may be registered in the repository. The bone marrow donors registers from all over the world have been compiled in 1988 by the register Bone Marrow Donor Worldwide (BMDW) [1]. The aim of the article is to assess the level of transplantation knowledge and awareness in young people. The research presents the point of view of young people on retrieving organs from living- and deceased donors. Moreover, the surveyed have been asked if they would see themselves as donors. Finally, the level of the respondent’s knowledge of formal aspects of transplantation has been determined. MATERIAL The study was conducted on a group of 357 students at the Medical University of Silesia Katowice and Częstochowa University of Technology. The group included students aged 20 to 31, involving 234 (65.55%) female- and 123 (34.45%) male respondents. Research participation was voluntary and the questionnaires were anonymous. METHOD The method applied in the study was diagnostic poll, whereas the technique selected was questionnaire. Finally, a specific Android-based mobile application including the question form was applied as the research tool. The application was created in a development environment that had been developed by Google on the basis of IntelliJ – Android Studio. There have been closed- and half-open format multiplechoice questions included in the survey. The data gathered by means of the application has been transferred to Microsoft Office Excel 2010 and presented in pictures and tables. RESULTS A vast majority of respondents included young people not older than 25. The study involved a group of 191 (53.5%) students at the Medical University of Silesia and a group of 166 (46.5%) students at the Częstochowa University of Technology. 238 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa Figure 1. The percentage of students’ responses to the question whether the students accepted the phenomenon of organ transplantation retrieved from deceased donors. The division into the two university backgrounds has been taken into account Out of the total number of respondents, there were 137 (71.73%) students at the Medical University of Silesia and 115 (69.27%) students at the Częstochowa University of Technology who declared a positive acceptance of transplantation of organs retrieved from deceased donors. 98 (27.45%) respondents declared that they were rather in favour of transplantation of organs retrieved from deceased donors. This number includes 52 (27.23%) of student at the Medical University of Silesia and 46 (27.71%) students at the Częstochowa University of Technology. There were two student at the Częstochowa University of Technology who were rather against transplantation of organs retrieved from deceased donors. The same number of students at the same university was strongly against transplantation of organs retrieved from deceased donors. Finally, there were three surveyed students (0.84%) who did not have any specific point of view on the issue in question. 239 HEALTH AND WELLNESS 2/2015 Wellness and society Figure 2. The percentage of students’ responses to the question concerning the meaning of pre-stated acceptance. One hundred and seventy (170 - 89%) students at the Medical University of Silesia declared to understand the meaning of pre-stated acceptance, 20 (10.47%) students reported that they had heard about pre-stated acceptance but were not sure how it really works. Among the students at the Częstochowa University of Technology, 129 (77.71%) stated that they knew what a pre-stated acceptance is, whereas 34 (20.48%) students at the same university declared that they had heard the notion but were not sure of its meaning. Out of the total number of respondents, there were four (1.12%) students who could not explain what a pre-stated acceptance is. Out of the 58 surveyed who were not sure of the meaning or did not know the meaning at all, there were 47 (81.03%) persons who were willing to receive more information concerning the notion of pre-stated acceptance. 240 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa Figure 3. The percentage of students’ responses to the question about the students’ attitude towards pre-stated acceptance. There were 28 (14.66%) students at the Medical University of Silesia and 18 (10.84%) students at the Częstochowa University of Technology who reported that they had already signed a pre-stated acceptance. 119 (62.30%) students at the Medical University of Silesia and 92 (55.42%) students at the Częstochowa University of Technology were willing to sign a pre-stated acceptance form. There was also a group of 100 (28.01%) respondents who declared that they had not signed and were not willing to sign the form in question. The last group consisted of 44 (23.04%) students at the Medical University of Silesia and 56 (33.74%) students at the Chęstochowa Univeristy of Technology. 241 HEALTH AND WELLNESS 2/2015 Wellness and society Figure 4. The percentage of responses to the question about the students’ willingness to consent to potential organ retrieval from their close person after the persons’ death. There were 147 (41.18%) participants of the survey who would probably consent to organ retrieval from their close person in case of the persons’ death. What is more, there were 89 (24.93%) respondents who were certain that they would consent to such a retrieval. Apart from that, there were 72 (20.17%) surveyed who would probably not accept the possibility of organ retrieval from their close person after the persons’ death and 14 (3.92%) students that were certain they would not express their consent in such situation. Finally, 35 (9.80%) surveyed could not say how they would react. Among the 86 (24.09%) respondents who would not consent to organ retrieval from their close person in case of the person’s death (being more or less certain about their potential decision), there were 65 (75.58%) students who expressed their point of view that the decision on a potential organ retrieval should be made by the potential donor when the donor is alive. There was also one (1.16%) person who would not consent to organ retrieval from a close person’s death body because of religious beliefs. To add to this, 17 (19.77%) students claimed that organ retrieval from deceased donors equals with lack of respect to the dead body, whereas three (3.49%) respondents provided other reasons. 242 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa Figure 5. The percentage of responses to the question: “In case you needed an organ transplantation, would you accept an organ retrieved from a dead person’s body?” Each individual may need a transplantation in the future. Asked if they would accept an organ retrieved from a dead person’s body in case they needed an organ transplantation, 176 (49.30%) respondents would certainly accept the organ. This group of respondents consisted of 92 (48.17%) students at the Medical University of Silesia and 84 (50.60%) students at the Chęstochowa University of Technology. There were 74 (38.74%) students at the Medical University of Silesia and 59 (35.54%) students at the Częstochowa University of Technology who would probably accept an organ recovered from a deceased donor. Moreover, there was one person at the Częstochowa University of Technology who would certainly reject the possibility of having transplanted an organ retrieved from a dead body, as well as two (1.05%) students at the Medical University of Silesia and one (0.6%) student at the Chęstochowa University of Technology who would probably reject the option. Finally, at the moment the research was being conducted, there were 23 (12.04%) respondents at the Medical University of Silesia and 21 (12.66%) surveyed at the Częstochowa University of Technology who did not know what their decision would be. 243 HEALTH AND WELLNESS 2/2015 Wellness and society Figure 6. The percentage of responses to the question about the students’ attitude towards retrieving organs for transplantation purposes from living donors. There were 183 (51,26%) respondents who were in favour of transplanting organs from living donors. Among them, there were 9 (4.71%) students at the Medical University of Silesia and 7 (4.22%) students at the Chęstochowa University of Technology who fully supported the option in question. Further 144 (40.34%) respondents, including 70 (36.65%) students at the Medical University of Silesia and 74 (44.58%) students at the Częstochowa University of Technology, were in favour of a transplantation from a family member only. There were also two (1.20%) surveyed at the Częstochowa University of Technology who were rather against transplantations of organs recovered from living donors. Considering both universities, there were 7 (1.96%) participants of the questionnaire who did not accept such transplantations at all. Finally, there were 10 (5.24%) students at the Medical University of Silesia and 11 (6.63%) students at the Częstochowa University of Technology who could not express their opinion on the matter in question. 244 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa Figure 7. The percentage of responses to the question about the students’ attitude towards donating their kidney (as a living donor) to one of their family members 133 (69.63%) students at the Medical University of Silesia and 97 (58.43%) students at the Częstochowa University of Technology would certainly donate kidney to one of their family members if it was necessary. Further 98 (27.45%) respondents, including 44 (23.04%) students at the Medical University of Silesia and 54 (32.53%) students at the Częstochowa University of Technology would probably donate their kidney under the circumstances in question. Moreover, there were two (1.05%) respondents at the Medical University of Silesia and two surveyed at the Częstochowa University of Technology who would probably not be willing to express their consent in case their family member needed a kidney transplantation. To add to this, there was one (0.6%) student at the Częstochowa University of Technology who was definitely against donating kidney within genetically related kidney transplantation. There was also a group of 24 (6.72%) respondents who did not know what their decision would be if they had to donate kidney to their relative: 12 (6.28%) students at the Medical University of Silesia and 12 (7.23%) students at the Częstochowa University of Technology. The participant of the survey were also asked about an imaginary situation when they would need kidney transplantation. The results of the questionnaire indicate that 61 (31.94%) students at the Medical University of Silesia and 62 (37.35%) students at the Częstochowa University of Technology would definitely accept an organ recovered from a genetically related donor. 185 (51.82%) respondents predicted that 245 HEALTH AND WELLNESS 2/2015 Wellness and society they would presumably accept kidney transplant from a relative. The latter group consisted of 105 (54.97%) students at the Medical University of Silesia and 80 (48.19%) students at the Częstochowa University of Technology. Furthermore, there was one student at the Medical University of Silesia who declared that they would accept organ only from a specific related person. Another point of view was expressed by 6 (3.14%) students at the Medical University of Silesia and 7 (4.22%) students at the Częstochowa University of Technology: these two groups of respondents would probably not accept kidney transplant from a genetically related person. Finally, a group of 35 (9.8%) surveyed did not know what decision they would make. There was no person among the respondents who would definitely reject kidney transplant from a relative. Figure 8. The percentage of responses to the question about the students’ attitude towards donating bone marrow to a non-related recipient Among the respondents, there were 109 (30.53%) persons who declared that they would certainly consent to donate bone marrow to a non-related recipient. The group in question consists of 61 (31.94%) students at the Medical University of Silesia and 48 (28.92%) students at the Częstochowa University of Technology. 132 (36.97%) participants of the study were rather willing to donate bone marrow to a genetically non-related person. Among them, there were 74 (38.74%) students at the Medical University of Silesia and 58 (34.94%) students at the Częstochowa University of Technology. Moreover, there was also a group of respondents, including 21 (10.99%) students at the Medical University of Silesia and 23 (13.86%) students at the Częstochowa University of Technology, who would donate bone marrow only to a genetically non-related person they knew. 8 (2.24%) respondents were rather not willing to donate bone marrow to a non-related person, whereas 3 (0,84%) would definitely not 246 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa do it. At the time the study was being conducted, there were 61 (17,08%) participants of the questionnaire who could not make any decision in this matter. Far more respondents would donate their bone marrow to a genetically related person. There were 247 (69,19%) participants of the survey who were certain that they would donate bone marrow to a relative with no hesitation in case the transplantation was needed. This group of surveyed consists of 145 (75.92%) students at the Medical University of Silesia and 102 (61.45%) students at the Częstochowa University of Technology. As much as 67 (18.76%) people involved in the research, including 33 (17.28%) students at the Medical University of Silesia and 34 (20.48%) students at the Częstochowa University of Technology, declared that they would probably express consent to retrieve bone marrow from them in order to transplant it to a genetically-related person. Furthermore, a group of three (1.57%) students at the Medical University of Silesia and 7 (4.22%) students at the Częstochowa University of Technology would be willing to donate bone marrow only to a specific individual. Out of all participants involved, another four (1.12%) respondents would probably not consent to donate bone marrow to a relative. There was only one person (a student at the Częstochowa University of Technology) who would definitely not donate bone marrow to a genetically-related person. 28 (7.84%) respondents could not specify what their choice would be. Figure 9. The percentage of respondents in relation to their level of knowledge of formal aspects of transplantation 247 HEALTH AND WELLNESS 2/2015 Wellness and society The participants of the survey were asked eight questions referring to formal aspects of transplantation. Eight correct answers were classified as a very high level of knowledge, six and seven correct answers indicated to a high level of knowledge, three to five correct answers were indicators of sufficient knowledge on the topic, whereas two or less than two correct answers were treated as signs of insufficient knowledge. As a result, there were 3 (0.84%) respondents at a very high level of knowledge of formal aspects of transplantation, one of them (0,52%) being a student at the Medical University of Silesia and the other two being students at the Częstochowa University of Technology. A group of 22 (6.16%) participants of the research were at a high level of knowledge, whereas a sufficient level of knowledge was presented by 76 (21.29%) respondents, including 53 (27.75%) students at the Medical University of Silesia and 23 (13.86%) students at the Częstochowa University of Technology. The level of knowledge of formal aspects of transplantation proved to be insufficient in the case of a majority of participants (256 e.i. 71,71%). According to 87 (24.37%) respondents, there is an easy access to transplantationrelated information. 128 (35.85%) surveyed claimed that finding information about organ transplantation required some additional effort. A group of 39 (10.93%) participants reported that there is no easy access to transplantation-related data. 103 (28.85%) students could not assess accessibility of information sources referring to transplantation issues. As they pointed out, they had never been interested in the matter. According to 176 (49.29%) respondents, transplantation-related issues are present in the social awareness. Among them, there were 27 (7.56%) participants of the research who were strongly convinced about the presence in question. An opposite point of view was expressed by 107 (29.97%) respondents who claimed that the transplantation problematic does not rather exist in the social awareness. Among them, there were 14 (3.92%) students who expressed a strong conviction in this matter. Finally, 60 (16,81%) respondents found it difficult to provide their own assessment of the social situation in relation to transplantation. DISCUSSION Transplantation is a scientific branch that appeared years ago and relates to the transfer of cells, tissue and/or organs from a donor to a recipient. A crucial point in time for the development of transplantation was the identification of immune responses by P.B. Medawar in 1951. Medawar suggested that the application of immunosuppressive drugs may prevent transplant rejection [8]. Transplantation is still developing. One of the conditions of the development of transplantation is social acceptance of transplantation. The results of the study presented in this article indicate that a vast majority of respondents (252 e.i. 70.59%) definitely accepted transplantation from deceased donors, and further 98 (27.45%) participants of the survey rather accepted the idea. A research was conducted by the Public Opinion Research Center (Centrum Badania Opinii Publicznej) in 2007 and the results of the research were similar to the 248 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa results presented within this article. According to the information gathered by the Public Opinion Research Center, 90% of respondents were in favour of retrieving organs from deceased donors for transplantation purposes. Among them, 63% presented themselves as strong supporters of the idea of organ recovery from deceased donors [7]. In other words, one may say that there is a common acceptance of organ retrieval from dead bodies for transplantation purposes in the Polish society. There is a possibility to sign a pre-stated acceptance form to indicate that someone is willing to donate organs in case of death. A written pre-stated acceptance is a sign of a conscious decision made by a living individual. It is expected that, because of the specific background of studies, students at a medical university may have a better possibility to encounter information regarding transplantation. In fact, 89% of students at the Medical University of Silesia knew the idea of pre-stated acceptance. In the case of students at the Częstochowa University of Technology, there were 77.71% respondents who declared their understanding of the notion. One of the factors limiting the retrieval of organs from dead individuals is lack of family consent. Although family consent is not required to retrieve organs, doctors often desist from retrieval when refusal is expressed by family members. 147 (41.18%) respondents would probably express their consent to organ recovery for transplantation purposes in the case of a relative’s death. Further 89 (24.93%) participants would definitely agree to retrieval in the situation in question. In a research by Pirogowicz et al. [8], 78% of students at the Medical University of Silesia would express their consent to organ recovery in the case of the relative’s death. Moreover, in a study conducted in Pelotas, Brasil, Barcellos et al. have pointed out that a conversation about donation issues prior to the relative’s death has a significant impact on the family’s consent after the relative’s death. There were 80% of respondents who would consent to organ recovery from the close family member if only the member had expressed acceptance when alive [1]. Moreover, kidney transplant retrieved from a living donor is a safer and more successful transplantation method for the recipient. There is often a lot of controversy and doubts concerning kidney donations where the organ is retrieved from a living donor. Among the group participating in the study, there were 183 (51.26%) respondents who would accept transplants from living donors. It has also been supported by Lisiecki et al., who have analysed social attitude towards organ transplantation. In their study, 66% of the group involved in the research support retrieving organs from living donors [4]. Finally, the level of knowledge of formal aspects of transplantation in the participants of the survey included in this study has been assessed as insufficient. In spite of the differences in the background of the students at the two universities involved (the students at the Medical University of Silesia should potentially have an easier access to transplantation-related information), the level of knowledge of transplantation was rather similar in both groups of students. Moreover, the generally low level of social awareness of transplantation should be a cause for concern. A higher level of 249 HEALTH AND WELLNESS 2/2015 Wellness and society knowledge and greater social awareness of transplantation-related issues would be beneficial to the development of transplantation. CONCLUSION 1. Among the students involved in the questionnaire, there was a general tendency of acceptance of organ retrieval for transplantation purposes from both living and deceased donors. 2. Among the respondents, 12.89% declared that they had signed a pre-stated acceptance and 59.10% was willing to sign it. 3. A vast majority of participants of the study was ready to donate kidney in case a relative needed kidney transplantation. 4. Taking into account the findings of this study, the level of knowledge of formal aspects of transplantation is generally insufficient. 5. An increased social awareness of transplantation may be beneficial to the development of this branch of study. REFERENCES 1. Barcellos F. C., Araujo C.L., da Costa J. D.: Organ donation: a population – based study. Clinical transplantation, 2005, 19 (1): 33 – 37 2. Cantarovich F.: Public opinion and organ donation. Suggestions for overcoming barriers. Annals of Transplantation, 2005, 10 (1): 22 – 25 3. Dar życia i jego społeczny kontekst, red. naukowa Pawlica B., Szczepański M., Śląskie Wydawnictwo Naukowe Wyższej Szkoły Zarządzania i Nauk Społecznych, Tychy, 2003. 4. Lisiecki T., Płocka – Molińska M., Kędziora – Kornatowska K., Postawy społeczeństwa wobec przeszczepiania narządów od dawców żywych i martwych. Polska Medycyna Rodzinna, 2004, 6, 1: 296 – 302. 5. Mała Encyklopedia Medycyny, Kostrzewski P., Ziółkowski J. (red), Wydawnictwo Naukowe PWN, Warszawa, 1999. 6. Obwieszczenie Ministra Zdrowia z dnia 17 lipca 2007 r. w sprawie kryteriów i sposobu stwierdzenia trwałego nieodwracalnego ustania czynności mózgu. 7. Opinie o przeszczepianiu narządów. Komunikat z badań. Centrum Badania Opinii Społecznej, Warszawa, 2007. 8. Pirogowicz I., Smolarek S., Kasprzak – Smolarek P., Reksa D., Hełmoniak I., Steciwko A.: Transplantacje – stan naszej wiedzy – badania ankietowe. Family Medicine & Primary Care Review, 2006, 8, 1: 37 – 42. 9. Rozporządzenie Ministra Zdrowia z dnia 1 grudnia 2006 r. w sprawie sposobu prowadzenia centralnego rejestru sprzeciwów oraz sposobu ustalania istnienia wpisu w tym rejestrze. 250 Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Krystyna Sneka, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Marek Mandera The level of knowledge and attitudes toward organ transplantation among students of Silesian Medical University and University of Technology in Częstochowa 10. Ustawa z dnia 1 lipca 2005 roku o pobieraniu, przechowywaniu i przeszczepianiu komórek, tkanek i narządów. 11. Zarządzenie Ministra Zdrowia z dnia 2 lipca 2010 r. w sprawie Centrum Organizacyjno-Koordynacyjnego do Spraw Transplantacji „Poltransplant”. ABSTRACT Organ transplantation is the moving of tissue or organs from one part of the body to another in the same organism (autotransplantation), between two organisms of the same species (homotransplantation), or between two organisms of different species (heterotransplantation).. Tissue and organs may be retrieved from a living donor (ex vivo) or from a deceased donor (ex mortuo). The aim of the article is to assess the level of transplantation knowledge and awareness in young people. Finally, the level of knowledge of formal aspects of transplantation in the participants of the survey included in this study has been assessed as insufficient. A higher level of knowledge and greater social awareness of transplantation-related issues would be beneficial to the development of transplantation. STRESZCZENIE Transplantacja czyli przeniesienie tkanek lub narządów w obrębie tego samego organizmu (autotransplantacja), z innego osobnika tego samego gatunku (homotransplantacja) lub z osobnika innego gatunku (heterotransplantacja). Tkankę lub narząd można pobrać od dawcy żywego (ex vivo) lub od dawcy zmarłego (ex mortuo). Celem pracy jest ocena poziomu wiedzy i świadomości młodzieży na temat zagadnień dotyczących transplantologii. Wiedza w zakresie formalnych aspektów transplantologii badanje grupy została oceniona na niedostateczną. Większa wiedza i zwięszona świadomość społeczeństwa z zakresu transplantologii może przynieść korzyści dla rozwoju tej dziedziny. Artykuł zawiera 33347 znaków ze spacjami + grafika 251