Abstract: SA-PO1159
Attitudes to Clinical Pig Kidney Xenotransplantation Among Medical Providers and Patients
Session Information
- Transplantation: Clinical - Rejection, Recurrent Disease, Incompatibility
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Padilla, Luz A., University of Alabama at Birmingham, Birmingham, Alabama, United States
- Kumar, Vineeta, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Cooper, David Kc, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Paris, Wayne, Abilene Christian University, Abilene, Texas, United States
Background
In addition to governmental regulation and scientific expertise, the World Health Organization requires an extensive review of local opinions and attitudes prior to xenotransplantation (XTx) clinical trials. The current work will report the initial-phase of a multi-level public data collection process in preparation for clinical trials.
Methods
After university Institutional Review Board (IRB) approval, an anonymous online survey was emailed about attitudes towards XTx to medical center nephrologists, transplant surgeons, and nurses (“providers”). Pre and post-kidney transplant patients were randomly approached in the transplant clinic (“patients”). Both groups were requested to complete a 16-item likert scale survey with identical content. A total of 40 providers (51%; 40/78) and 163 patients (85%; 163/192) participated. Data were analyzed via SAS software.
Results
Eighty percent (32/40) of providers and 69% (113/163) of patients were agreeable to clinical XTx. Kidney providers rated the influence of religious beliefs (45%vs15%) and genetic engineering (43%vs25%) as being more important than patients (p<0.05). If risks and results were likely to be similar to kidney allotransplantation, providers were more supportive of XTx than patients (80%vs69%; p<0.05). If the results were likely to be less beneficial, patients were more likely to accept XTx as a bridge to allotransplantation (41%vs30%; NS). Both groups included <15% who identified concerns about (i) potential change in personality, (ii) how others would interact, (iii) a perception of being ‘less human’, or (iv) moral or ethical concerns. Logistic regression found that the odds of patients accepting XTx are 25 times greater if there are no religious concerns, and 82% more likely if it is a bridge to allotransplantation.
Conclusion
(i) There was strong support for XTx among both health providers and patients; (ii) providers over-estimated the influence of religious beliefs and genetic engineering on patient decisions, although religious beliefs still influenced patient attitudes; (iii) patient acceptance of XTx was not associated with likely medical outcome, per se; and (iv) there were few psychosocial concerns for either group. Overall, our findings would suggest that there is support for future clinical trials of XTx.