[Knowledge, attitudes and behavior regarding organ transplantation: the impact of the first transplantation from a brain-dead donor under the organ transplantation act].
OBJECTIVE: To investigate knowledge, attitudes and behavior regarding organ transplantation, and to estimate the impact of the first organ transplantation from a brain-dead donor under the Organ Transplantation Act. SUBJECTS AND METHODS: A telephone survey was made using the Random Digit Dialing method in May 1999. People living in the Tokyo Metropolitan area ages 20 years or over were asked about their knowledge, attitudes and behavior regarding organ transplantation, and their opinions on the first organ transplantation conduced in February 1999. The results were compared with an opinion poll made 7 months previously to estimate the impact of this first case. RESULTS: The number of respondents was 489 (response rate: 46.0%). 1) Knowledge of organ transplantation: most people knew that organ donation from brain-dead donors was possible under the act, and that written consent on a form and family member's agreement were necessary before donating. More people knew about donor cards. 2) Organ transplantation: more people were willing to donate their organs when they die, and to agree to donation when a family member died who had wanted to donate his/her organs on their death. In the poll 7 months before, fewer people were willing to donate their organs or to agree to donate their family member's organs after brain death compared with after heart arrest. However, no such difference between brain death and heart arrest was found in this later study, suggesting that the distinction between the two was no longer considered to be so important. 3) Respondents themselves having donor cards constituted 15.2%, showing a marked increase from 7 months earlier. Another 39.7% wished to carry a donor card; the most common reason for not carrying one was they did not know how to acquire it. 4) The first transplantation was considered to have contributed to the increase in knowledge, and a favorable change in attitudes and behavior toward organ transplantation. 5) Respondents who agreed to that organ donation from children aged under 15 should be possible constituted 46.4%, of the to be this not being allowed at the present time. 6) The majority of respondents considered that the brain death was diagnosed properly in the first case and that the donation was made voluntarily, concluding that the transplantation was made fairly. 7) Respondents who considered that the privacy of the donor and the recipients was violated were 46.2% and 36.1%, respectively. The attitude of the mass media toward the first transplantation was criticized by 56.9% of the respondents. 8) Respondents who had a favorable impression of the organ transplantation were 61.9%. Such people are likely to donate their organs, to agree to a family member's donation, and to have a donor card than people who had not gained a favorable impression. The two groups exhibited no difference in their knowledge concerning organ transplantation. CONCLUSIONS: An increase in knowledge and a favorable change in attitudes and behavior regarding organ transplantation was confirmed in this survey, as compared with results 7 months earlier, probably because the first transplantation took place. The majority of the respondents considered that the first transplantation was made fairly, although they criticized the attitude of the mass media invading the privacy of the donor and the recipients. Further studies should be made to facilitate effective delivery of donor cards to people who want to carry them, and to change the rules on organ donation from children.