Attitudes to Clinical Pig Kidney Xenotransplantation among Medical Providers and Patients

被引:25
|
作者
Padilla, Luz A. [1 ]
Hurst, Daniel [2 ]
Lopez, Raymond [1 ]
Kumar, Vineeta [3 ]
Cooper, David K. C. [1 ]
Paris, Wayne [4 ]
机构
[1] Univ Alabama Birmingham, Sch Med, Dept Surg, Birmingham, AL 35294 USA
[2] Rowan Univ, Sch Osteopath Med, Dept Family Med, Stratford, NJ USA
[3] Univ Alabama Birmingham, Dept Med, Div Nephrol, Birmingham, AL 35294 USA
[4] Abilene Christian Univ, Dept Social Work, Abilene, TX 79699 USA
来源
KIDNEY360 | 2020年 / 1卷 / 07期
基金
美国国家卫生研究院;
关键词
HEALTH;
D O I
10.34067/KID.0002082020
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:657 / 662
页数:6
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