Luz A Padilla1, Daniel Hurst2, Raymond Lopez1, Vineeta Kumar3, David K C Cooper1, Wayne Paris4. 1. Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 2. Department of Family Medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey. 3. Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 4. Department of Social Work, Abilene Christian University, Abilene, Texas.
Abstract
Background: In addition to governmental regulation and scientific advancements, the World Health Organization requires extensive review of local opinions before initiating clinical trials of xenotransplantation (XTx). The purpose of this study was to assess the attitudes of health care providers and patients regarding XTx. Methods: An anonymous Likert-scale survey regarding attitudes toward XTx was distributed to pre- and post-kidney transplant patients, nephrologists, transplant surgeons, and nurses ("providers"). Patient and provider responses were described and compared. Regression analysis using patients' responses was performed to identify factors associated with XTx acceptance. Results: Eighty percent (32/40) of providers and 69% (113/163) of patients were agreeable to clinical XTx if the risks and results were likely to be similar to kidney allotransplantation (P<0.05). Kidney providers rated the influence of religious beliefs in medical decisions (45% versus 15%) and genetic engineering (43% versus 25%) as being more important than did patients (P<0.05). A small proportion in both groups (<15%) reported concerns about (1) potential personality changes, (2) how others would interact, (3) a perception of being "less human," or (4) morals or ethics. Logistic regression found that the odds of patients accepting XTx were greater if they had no religious concerns (OR, 25.10; 95% CI, 2.59 to 243.00), but acceptance was less likely if they were not willing to use XTx as a bridge to allotransplantation (OR, 0.18; 95% CI, 0.51 to 0.70). Conclusions: (1) If outcomes were similar to allotransplantation, XTx support was strong among both providers and patients; (2) providers overestimated the influence of religious beliefs and genetic engineering on patient medical decisions, although religious beliefs are associated with XTx acceptance; (3) XTx use as a bridge to allotransplant was associated with XTx acceptance; and (4) psychosocial concerns were low for either group. Future studies among other communities are warranted to assess if similar attitudes exist.
Background: In addition to governmental regulation and scientific advancements, the World Health Organization requires extensive review of local opinions before initiating clinical trials of xenotransplantation (XTx). The purpose of this study was to assess the attitudes of health care providers and patients regarding XTx. Methods: An anonymous Likert-scale survey regarding attitudes toward XTx was distributed to pre- and post-kidney transplant patients, nephrologists, transplant surgeons, and nurses ("providers"). Patient and provider responses were described and compared. Regression analysis using patients' responses was performed to identify factors associated with XTx acceptance. Results: Eighty percent (32/40) of providers and 69% (113/163) of patients were agreeable to clinical XTx if the risks and results were likely to be similar to kidney allotransplantation (P<0.05). Kidney providers rated the influence of religious beliefs in medical decisions (45% versus 15%) and genetic engineering (43% versus 25%) as being more important than did patients (P<0.05). A small proportion in both groups (<15%) reported concerns about (1) potential personality changes, (2) how others would interact, (3) a perception of being "less human," or (4) morals or ethics. Logistic regression found that the odds of patients accepting XTx were greater if they had no religious concerns (OR, 25.10; 95% CI, 2.59 to 243.00), but acceptance was less likely if they were not willing to use XTx as a bridge to allotransplantation (OR, 0.18; 95% CI, 0.51 to 0.70). Conclusions: (1) If outcomes were similar to allotransplantation, XTx support was strong among both providers and patients; (2) providers overestimated the influence of religious beliefs and genetic engineering on patient medical decisions, although religious beliefs are associated with XTx acceptance; (3) XTx use as a bridge to allotransplant was associated with XTx acceptance; and (4) psychosocial concerns were low for either group. Future studies among other communities are warranted to assess if similar attitudes exist.
Authors: Wayne Paris; Rabbi Jerry H Seidler; Kevin FitzGerald; Aasim I Padela; Emanuele Cozzi; David K C Cooper Journal: Xenotransplantation Date: 2018-04-24 Impact factor: 3.907
Authors: Chace Mitchell; Alan Lipps; Luz Padilla; Zoie Werkheiser; David K C Cooper; Wayne Paris Journal: Xenotransplantation Date: 2020-01-19 Impact factor: 3.907
Authors: Ceara Tess Cunningham; Hude Quan; Brenda Hemmelgarn; Tom Noseworthy; Cynthia A Beck; Elijah Dixon; Susan Samuel; William A Ghali; Lindsay L Sykes; Nathalie Jetté Journal: BMC Med Res Methodol Date: 2015-04-09 Impact factor: 4.615