Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

Table 1 Sample and completion data for university medical students according to geographical area, university and academic year

	1st		2nd		3rd		4th		5th		6th		TN0	TNR	TR
	N0	NR	N0	NR	N0	NR	N0	NR	N0	NR	N0	NR
N1	45	0	30	0	30	0	30	0	30	0	35	0	200	0
N2	96	91											96	91
N3	133	133	87	87	97	95	100	99	65	65	92	92	574	571
N4	100	100	89	88	84	84	58	58	73	73	72	71	476	474
NT	374	324	206	175	211	179	188	157	168	138	199	163	1346	1136	84.39%
C1									32	29			32	29
C2	107	107	116	116	61	61	73	73	62	52	77	77	496	486
C3	87	86	139	139	94	94	172	171	58	58	124	124	674	672
C4	95	93	128	128	53	53	42	42	62	62	123	123	503	501
C5	53	53	48	48	23	0							124	101
C6	120	120	29	0	23	22							172	142
C7	108	107	95	94	43	43	28	28	64	62	103	93	441	427
NT	570	566	555	525	297	273	315	314	278	263	427	417	2442	2358	96.56%
S1							12	0	25	25	38	38	75	63
S2	24	0	27	27	24	23	75	75	22	0	28	28	200	153
S3	193	193	241	238	155	153	99	98	144	143	145	143	977	968
S4	59	59	68	67	25	25	50	50	26	26	38	38	266	265
S5	181	179	116	125	86	85	115	114	152	141	119	112	769	756
NT	457	431	452	457	290	286	351	337	369	335	368	359	2287	2205	96.41%
L1	114	114	148	145	116	114	156	151	101	92	113	112	748	728
L2	69	69	122	122	98	98	76	76	84	84	110	110	559	559
L3	261	261	265	265	284	284	123	123	114	114	133	133	1180	1180
L4	83	82	57	57									140	139
L5	199	195	195	192	145	141	144	143	87	87	139	137	909	895
L6	49	48	28	27									77	75
NT	775	769	815	808	643	637	499	493	386	377	495	492	3613	3576	98.97%
NT	2176	2090	2028	1965	1441	1375	1353	1301	1201	1113	1489	1431	9688	9275	95.73%

N1 to N4: Medical schools in the North; C1 to C7: Medical schools in the Central Area; S1 to S5: Medical schools in the South; L1 to L6: Medical schools in the East; 1^st to 6^th years: Academic years; N₀: Questionnaires administered; N_R: Questionnaires obtained; TN₀: Total number of questionnaires administered; TN_R: Total number of questionnaires obtained; N_T: Total questionnaires in the corresponding column; TR (%): Completion rate.

Table 2 Socio-personal and university variables related to organ donation and transplantation affecting the attitude of university medical students toward unrelated and related living liver donation n (%)

	Unrelated living liver donation			Related living liver donation
Variable	In favor (n = 2937; 32%)	Not in favor (n = 6338; 68%)	P value	In favor (n = 8258; 89%)	Not in favor (n = 1017; 11%)	P value
Socio-personal variables
Age (21 ± 3 yr)	22 ± 4 yr	21 ± 3 yr	< 0.001	21 ± 3 yr	22 ± 4 yr	0.008
Sex			0.195			< 0.001
Male (n = 2702)	830 (31)	1872 (69)		2310 (86)	392 (14)
Female (n = 6499)	2086 (32)	4413 (68)		5889 (91)	610 (9)
DS/DK (n = 74)	21	53		59	15
University variables
Type of university			0.68			0.103
Public university (n = 8192)	2600 (32)	5592 (68)		7278 (89)	914 (11)
Private university (n = 1083)	337 (31)	746 (69)		980 (91)	103 (9)
Year of medicine			< 0.001			< 0.001
First (n = 2090)	521 (25)	1569 (75)		1811 (87)	279 (13)
Second (n = 1965)	544 (28)	1421 (72)		1736 (88)	229 (12)
Third (n = 1375)	422 (31)	953 (69)		1212 (88)	163 (12)
Fourth (n = 1301)	480 (37)	821 (63)		1166 (90)	135 (10)
Fifth (n = 1113)	443 (40)	670 (60)		1020 (92)	93 (8)
Sixth (n = 1431)	527 (37)	904 (63)		1313 (92)	118 (8)
Geographical location			0.109			0.013
North (n = 1136)	365 (32)	771 (68)		1002 (88)	134 (12)
Central area (n = 2358)	718 (30)	1640 (70)		2118 (90)	240 (10)
South (n = 2205)	741 (34)	1464 (66)		1993 (90)	212 (10)
East (n = 3576)	1113 (31)	2463 (69)		3145 (88)	431 (12)

DS/DK: Does not say/does not know.

Table 3 Variables of the university medical students' knowledge about, and attitude toward, related and unrelated living liver donation n (%)

	Unrelated living liver donation			Related living liver donation
Variable	In favor (n = 2937, 32%)	Not in favor (n = 6338, 68%)	P value	In favor (n = 8258, 89%)	Not in favor (n = 1017, 11%)	P value
Knowing a transplant patient
Yes (n = 2261)	813 (36)	1448 (64)	< 0.001	2026 (90)	235 (10)	0.296
No (n = 6992)	2121 (30)	4871 (70)		6210 (89)	782 (11)
DS/DK (n =22)	3	19		22	--
Knowing a donor
Yes (n = 1305)	482 (37)	823 (63)	< 0.001	1180 (90)	125 (10)	0.086
No (n = 7943)	2451 (31)	5492 (69)		7055 (89)	888 (11)
DS/DK (n = 27)	4	23		23	4
Possibility of needing a transplant
Yes (n = 7712)	2544 (33)	5168 (67)	< 0.001	6951 (90)	761 (10)	< 0.001
No (n = 118)	35 (30)	83 (70)		96 (81)	22 (19)
Doubts (n = 1372)	341 (25)	1031 (75)		1159 (85)	213 (16)
DS/DK (n = 73)	17	56		52	21
Attitude toward deceased donation
In favor (n = 7376)	2603 (35)	4773 (65)	< 0.001	6761 (92)	615 (8)	< 0.001
Against - undecided (n = 1899)	334 (18)	1565 (82)		1497 (79)	402 (21)
Donating a living kidney
Yes, I would donate one (n = 2784)	1965 (71)	819 (29)	< 0.001	2684 (96)	100 (4)	< 0.001
No, I would not donate one (n = 872)	111 (13)	761 (87)		656 (75)	216 (25)
I do not know (n = 5619)	861 (15)	4758 (85)		4918 (88)	701 (12)
Willingness to accept a living liver segment from a family member
Yes, I would accept it (n = 5342)	2187 (41)	3155 (59)	< 0.001	5146 (96)	196 (4)	< 0.001
No, I would wait on the waiting list (n = 907)	224 (25)	683 (75)		751 (83)	156 (17)
I do not know (n = 2932)	519 (18)	2413 (82)		2341 (80)	591 (20)
DS/DK (n = 94)	7	87		20	74

DS/DK: Does not say/does not know.

Table 4 Variables of social interaction and pro-social behavior affecting the attitude of university medical students toward unrelated and related living liver donation n (%)

	Unrelated living liver donation			Related living liver donation
Variable	In favor (n = 2937, 32%)	Not in favor (n = 6338, 68%)	P value	In favor (n = 8258, 89%)	Not in favor (n = 1017, 11%)	P value
Variables of social interaction
Family discussion
Yes (n = 6565)	2255 (34)	4310 (66)	< 0.001	5946 (91)	619 (9)	< 0.001
No (n = 2689)	675 (25)	2014 (75)		2297 (85)	392 (15)
DS/DK (n = 21)	7	14		15	6
Discussion with friends
Yes (n = 6841)	2307 (34)	4534 (66)	< 0.001	6172 (90)	669 (10)	< 0.001
No (n = 2418)	627 (26)	1791 (74)		2074 (86)	344 (14)
DS/DK (n = 16)	3	13		12	4
A partner's opinion about donation and transplantation
Yes, it is favorable (n = 2740)	1045 (38)	1695 (62)	< 0.001	2511 (92)	229 (8)	< 0.001
I do not know (n = 2451)	603 (25)	1848 (75)		2101 (86)	350 (14)
Yes, he or she is against (n = 247)	71 (29)	176 (71)		204 (83)	43 (17)
I do not have a boyfriend/girlfriend (n = 3654)	1162 (32)	2492 (68)		3281 (90)	373 (10)
DS/DK (n = 183)	56	127		161	22
Donation of a family member's organs
Yes (n = 8424)	2776 (33)	5648 (67)	< 0.001	7592 (90)	832 (10)	< 0.001
No (n = 667)	128 (19)	539 (81)		536 (80)	131 (20)
DS/DK (n = 184)	33	151		130	54
Variable of pro-social behaviour
Participation in pro-social activities
Yes, regularly (n = 882)	348 (40)	534 (60)	< 0.001	778 (88)	104 (12)	< 0.001
Yes, occasionally (n = 1968)	710 (36)	1258 (64)		1756 (89)	212 (11)
No, nor am I going to (n = 598)	92 (15)	506 (85)		499 (84)	99 (16)
No, but I would be willing to (n = 5766)	1774 (31)	3992 (69)		5201 (90)	565 (10)
DS/DK (n = 61)	13	48		24	37

DS/DK: Does not say/does not know.

Table 5 Religious variables and attitude toward the body which affect the attitude of university medical students toward unrelated and related living liver donation n (%)

	Unrelated living liver donation			Related living liver donation
Variable	In favor (n = 2937, 32%)	Not in favor (n = 6338, 68%)	P value	In favor (n = 8258, 89%)	Not in favor (n = 1017, 11%)	P value
Religious variables
Respondent's religion
Catholic (n = 5102)	1629 (32)	3473 (68)	0.607	4603 (90)	499 (10)	0.138
Other religions (n = 266)	92 (35)	174 (65)		233 (88)	33 (12)
Atheist/agnostic (n = 3726)	1179 (32)	2547 (68)		3322 (89)	404 (11)
DS/DK (n = 181)	37	144		100	81
Knowing the attitude of one's religion toward donation and transplantation
Yes, in favor (n = 3049)	1074 (35)	1975 (65)	< 0.001	2755 (90)	1975 (65)	0.624
Yes, against (n = 723)	193 (27)	530 (73)		645 (89)	530 (73)
I do not know (n = 1152)	325 (28)	827 (72)		1035 (90)	827 (72)
DS/DK (n = 444)	129	315		401	43
Variable of attitude toward the body
Fear of mutilation or scars
Yes, I am concerned about it a lot (n = 1004)	262 (26)	742 (74)	< 0.001	860 (86)	144 (14)	< 0.001
I do not mind (n = 6318)	2230 (35)	4088 (65)		5746 (91)	572 (9)
I do not know (n = 1860)	427 (23)	1433 (77)		1582 (85)	278 (15)
DS/DK (n = 93)	18	75		70	23

DS/DK: Does not say/does not know.

Table 6 Variables affecting the attitude of university medical students toward related living liver donation, a multivariate study

Variable	Regression coefficient (β)	Standard error	OR (CI)	P value
Sex
Male (n = 2702)			1
Female (n = 6499)	0.304		1.356 (1.602-1.146)	< 0.001
Academic year of degree in medicine:
First (n = 2090)			1
Second (n = 1965)	0.090	0.111	1.095 (1.360-0.880)	0.416
Third (n = 1375)	0.096	0.127	1.101 (1.412-0.858)	0.449
Fourth (n = 1301)	0.078	0.135	1.081 (1.408-0.830)	0.561
Fifth (n = 1113)	0.396	0.157	1.485 (2.024-1.091)	0.012
Sixth (n = 1431)	0.396	0.143	1.485 (1.964-1.123)	0.005
Attitude toward deceased donation
Against – Undecided (n = 1899)			1
In favor (n = 7376)	0.774	0.088	2.169 (2.577-1.824)	< 0.001
Donating a living kidney
I do not know (n = 5619)			1
Yes, I would donate one (n = 2784)	1.189	0.127	3.278 (4.219-2.557)	< 0.001
No, I would not donate one (n = 872)	0.914	0.109	2.494 (2.016-3.086)	< 0.001
Willingness to accept a liver segment from a family member
I do not know (n = 2932)			1
Yes, I would accept it (n = 5342)	1.872	0.096	6.493 (7.874-5.376)	< 0.001
No, I would wait on the list (n = 907)	0.347	0.115	1.414 (1.769-1.129)	0.003
The respondent's partner's opinion about donation and transplantation
Yes, he or she is against (n = 247)			1
Yes, it is favorable (n = 2740)	0.383	0.225	1.466 (2.277-0.943)	0.089
I do not know it (n = 2451)	0.157	0.220	1.169 (1.801-0.759)	0.477
I have not got a boyfriend or girlfriend (n = 3654)	0.450	0.219	1.569 (2.409-1.021)	0.040
Participation in pro-social activities
No, I have no intention to participate (n = 598)			1
Yes, regularly (n = 882)	0.482	0.193	1.620 (1.110-2.364)	0.012
Yes, occasionally (n = 1968)	0.332	0.171	1.394 (0.997-1.948)	0.052
No, but I would be prepared to (n = 5766)	0.168	0.154	1.183 (0.875-1.599)	0.276

Table 7 Variables affecting the attitude of university medical students toward unrelated living liver donation, a multivariate study

Variable	Regression coefficient (β)	Standard error	OR (CI)	P value
			1
Age (21 ± 3 yr)	0.026	0.012	1.026 (1.051-1.002)	0.037
Year of medicine
First (n = 2090)			1
Second (n = 1965)	0.082	0.120	1.085 (1.373-0.857)	0.496
Third (n = 1375)	0.205	0.131	1.226 (1.587-0.949)	0.118
Fourth (n = 1301)	0.362	0.131	1.436 (1.855-1.111)	0.006
Fifth (n = 1113)	0.467	0.141	1.594 (2.100-1.210)	0.001
Sixth (n = 1431)	0.556	0.138	1.745 (2.288-1.331)	< 0.001
Attitude toward deceased donation
Against - Undecided (n = 1899)			1
In favor (n = 7376)	0.546	0.106	1.724 (2.123-1.402)	< 0.001
Donating a living kidney
I do not know (n = 5619)
Yes, I would donate one (n = 2784)	2.552	0.078	12.820 (14.925-10.989)	< 0.001
No, I would not donate one (n = 872)	0.099	0.146	1.104 (0.830-1.469)	0.495
Willingness to accept a liver segment from a family member
I do not know (n = 2932)			1
Yes, I would accept it (n = 5342)	1.137	0.089	3.115 (3.717-2.617)	< 0.001
No, I would wait on the waiting list (n = 907)	0.257	0.144	1.293 (1.715-0.974)	0.074
A partner's opinion about donation and transplantation
I do not know it (n = 2451)			1
Yes, it is favorable (n = 2740)	0.367	0.099	1.443 (1.751-1.187)	< 0.001
Yes, he or she is against (n = 247)	0.336	0.227	1.398 (2.183-0.896)	0.139
I do not have a boyfriend/girlfriend (n = 3654)	0.344	0.094	1.410 (1.694-1.173)	< 0.001
Donating a family member's organs
No (n = 667)			1
Yes (n = 8424)	0.395	0.162	1.483 (2.040-1.078)	0.015
Participation in pro-social activities
No, I do not intend to particpate in them (n = 598)			1
Yes, regularly (n = 882)	0.690	0.219	1.992 (3.067-1.297)	0.002
Yes, occasionally (n = 1968)	0.611	0.200	1.841 (2.724-1.243)	0.002
No, but I would be willing to (n = 5766)	0.518	0.190	1.677 (2.439-1.157)	0.006
Knowing the attitude of one's religion toward donation and transplantation
Yes, against (n = 723)			1
Yes, in favor (n = 3049)	0.336	0.110	1.398 (1.736-1.127)	0.002
I do not know it (n = 1152)	0.249	0.123	1.282 (1.633-1.008)	0.043