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Overcoming barriers and enhancing strategies in organ transplantation systems: a systematic review
Priya Sharma1, Nipin Kalal1, Nimarta Rana1
1College of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
Background:
Organ transplantation is one of the major achievements of modern medicine, yet the global shortage of organs remains a serious challenge. This shortage increases mortality among patients on waiting lists. Although up to 80% of people support organ donation, far fewer register as donors, creating a clear "knowledge-action gap."
Aim:
This systematic review aimed to identify key barriers to organ donation and evaluate strategies to improve donation rates.
Methods:
A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed studies published in the last decade. Following PRISMA guidelines, 33 studies were included, covering randomized controlled trials, cross-sectional, and mixed-methods designs. Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools.
Results:
Barriers to organ donation were found to be complex and interconnected, involving social, psychological, and systemic factors. Lack of knowledge was the most common issue, with up to 91% reporting poor awareness and only 11% aware of relevant laws. Sociocultural and religious concerns also influenced decisions, with 38.8% reporting misconceptions and 58% lacking family support. Psychological barriers were significant, with 69% fearing health complications and expressing mistrust in the healthcare system. At the system level, despite general willingness, only 37.3% of healthcare professionals had donor cards. However, targeted interventions showed positive outcomes. Educational programs increased willingness to register from 12% to 68% and improved knowledge from 36.4% to 88.5%.
Conclusion:
The main barrier to organ donation is the gap between willingness and action, largely due to uncertainty and lack of understanding. Bridging this gap requires a combined approach: providing simple, culturally appropriate education about donation and improving healthcare systems to build trust and reduce financial and practical burdens on donors.
Insights
Bridging the organ donation knowledge-action gap requires education and improved healthcare trust. Targeted interventions significantly increase willingness to register and knowledge about organ donation.
Area of Science:
- Medical Science
- Public Health
- Transplantation Medicine
Background:
- Organ transplantation is a medical advancement facing a global organ shortage, leading to increased patient mortality.
- A significant gap exists between public support for organ donation and actual donor registration rates.
Purpose of the Study:
- To identify key barriers hindering organ donation.
- To evaluate strategies aimed at improving organ donation rates.
Main Methods:
- A systematic review of 33 peer-reviewed studies published in the last decade.
- Searches conducted across major academic databases (PubMed, Scopus, Web of Science, Google Scholar).
- Study quality assessed using Joanna Briggs Institute (JBI) Critical Appraisal Tools, adhering to PRISMA guidelines.
Main Results:
- Complex barriers include social, psychological, and systemic factors, with lack of knowledge being most prevalent (91% unawareness).
- Sociocultural concerns, religious misconceptions (38.8%), and lack of family support (58%) were significant.
- Psychological barriers included fear of complications (69%) and healthcare mistrust; only 37.3% of healthcare professionals possessed donor cards.
- Educational interventions successfully increased willingness to register (12% to 68%) and knowledge (36.4% to 88.5%).
Conclusions:
- The primary barrier to organ donation is the willingness-action gap, driven by uncertainty and misunderstanding.
- Effective strategies involve culturally sensitive education and healthcare system improvements to foster trust and reduce donor burdens.
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