الفهرس 
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Abstract
OD is the donation of biological tissue or an organ of the human body from a living or dead person to a living recipient in need of a transplantation. During the past few decades, it has increased widespread as the modality of treatment and in fact, is usually the only option of treatment in many end organ diseases. The issue of OD is a multifactorial and complex one, involving legal, ethical, medical, organizational, and social factors.
Despite all advances in organ and tissue transplantation over the past decades, there are many patients waiting for organ transplantation but the gap between available organs and patients waiting for transplantation is widening. The need for organs constantly exceeds available organ resources. Subsequently, organ shortage is becoming a global concern.
The worldwide shortage of donor organs in comparison to the need for transplantation has led to increase in the number of untreated people having organ failure, the development of organ trafficking and human rights violation which creating moral strains due to the exploitation of the poor, low socioeconomic and weak people.
Aim of the study:
This study conducted to determine the level of knowledge, attitude and ethical perception among undergraduate students of medical and non- medical faculties regarding organ donation and to detect barriers against organ donation among university students.
Research methodology:
This study is an observational descriptive study, included 688 students, 372 (54.1%) students of the fourth grade from faculty of medicine and 316 (45.9%) students of the fourth grade from faculty of Tourism and Hotels during the period from December to May 2018.
Data were collected from participants after explaining the nature of the study and taking a verbal consent from each of them, confidentiality, privacy and freedom to withdraw from the study on the participant’s decision were assured. The approval of the research ethical committee of Minia University, and of the faculties’ deans was obtained.
Data were collected by a self-administered structured questionnaire which was designed from previous validated questionnaires in similar studies and was modified by experet committee to suit and assess the situation in Egypt
The questionnaire included:
Students’ demographic characteristics (age, sex, religion, residence and faculty).
General knowledge about organ donation.
Attitudes and ethical perception of the respondents towards organ donation.
Barriers against organ donation.
Results:
The mean age of participants was 21.2 ± 0.59. Almost 54% of the students were females and 50.9% of students from urban areas. The majority of students, 79.5% were Muslims.
The most of students (64.8%) had an adequate knowledge, (35.2%) of them had inadequate knowledge about organ donation.
Regarding the mean knowledge score, urban residents and medical students had higher significant mean knowledge scores (7.08 ± 1.81) and (7.70 ± 1.49) respectively than rural residents and students of Tourism and Hotel’s faculty (6.62 ± 2.05) and (5.85 ± 1.94) respectively. But there was no significant difference of mean knowledge score between male and female students. One of the most important predictor of the knowledge score was the subject of study.
The majority of the students, 80.1% and 94.2% became aware of donation by living people as well as deacsed and knew the limit age of donor respectively. About 80% of students knew that OD process involved possible risks and both donors and recipients should pass immunological matching tests before donation. Additionally, 80.7% of students know the term of BD however, 68.8% of them didn’t know that person who have brain death but maintained on a life-support system be considered as potential organ donor or not.
The main source of knowledge about OD among the studied students from internet being the highest (49%), followed by medical staff (46.2%), then TV/radio (37.2%). As regard organs that could be donated among the studied students, kidney donation was the highest (87.6%), followed by blood (66.70%), liver (58.30%) and cornea (42.20%).
The overall attitude score was 16.01± 3.97 (range 15 to 24), that indicated a positive attitude of students towards OD, (57.7%) of students had a positive attitude while (42.3%) of them had a negative attitude towards OD. (71%) of medical students have positive attitude towards OD compared to (42.1%) of students of faculty of tourism and hotels. Male students had higher statistically significant attitude score than females. The most important predictors in determining of the attitude score were subject of study and the knowledge score.
The majority of students, 77.4% and 74.7% considered that OD was the greatest expression of humanity and life saving many people, respectively. Considerable proportions of students expressed positive attitude relative to willingness to be organ donor either during life or after death.
Among those willing to donate, the most reported factors hold the greatest importance near them when donating an organ by students of the faculty of medicine and the faculty of tourism and hotels was degree of consanguinity (relation to recipient) (91.6%), (89.7%) followed by health status of recipient (81.7%), (75.6%) respectively.
Concerning ethical issues as regard consent for post mortem OD, (78.8%) of medical students agreed that the individual himself should be the one giving consent during life compared to (57.3%) of students of faculty of tourism and hotels. Although (64%) of all students their religion allowed OD but only (26.3%) of them considered religious belief as a barrier. About two-third of students were against incentive based OD, didn’t agree with post mortem OD should be practiced unless there was a written notice of objection, might accepte an organ transplant (if necessary) to save their lives and not approved receiving organ from brain dead patient.
Even the highest reported rate of knowledge of legislative law among students to be 58.4%, only 7% of them thought that the existing laws regarding OD were playing an active role at present time.
The most reported barriers against donation were involving any risk to donor (51.3%) followed by (50.3%) of participants not confident in organ transplant process in Egypt and (46.4%) of them fear of traded donated organ and violation of human rights.
Comparing students of medical and non-medical faculties, reasons for non-donation were mostly reported by medical students; fear of recipient ’s body rejection to donated organ and might involve any risk to donor whereas, lack of information and distrust of the ability of the system to support organ donation process were mostly reported by others.
The most reported barriers by females were involving risks to donor and fear of surgical procedure. On the other hand, fear of traded donated organ and violation of human rights, distrust of the ability of the system to support this process and involved risks to donor were most reported by males.
Recommendations:
Comprehensive educational programs including lectures, campaigns and advertisements should be arranged on a regular basis to increase the awareness and develop positive attitude regarding OD among colleges in a religiously and culturally accepted background.
A multi disciplinary action should be taken through mass media, doctors and religious scholars in discussing issues of OD to general population as the better knowledge may ultimately translate into the act of donation.
There should be a comprehensive actively insurance program that can bear the costs of transplantoperation without payment requirements. Policy makers should also activate the present law of OD important to protect the impoverished sections of the society from exploitation.