Addressing religious and cultural differences in views on transplantation, including composite tissue allotransplantation.

Composite tissue allotransplantation is a rapidly developing field in plastic and reconstructive surgery and therefore imposes an obligation upon plastic and transplant surgeons to familiarize themselves with some unique aspects of this new discipline. The visible nature of extremities, and the face, presents a special hurdle when seeking the consent of the donor's family, as well as the recipient. Religious and sociocultural backgrounds of both the donor and recipient may have an important impact on the outcome of the donation and acceptance process. The purpose of this review is to present the current positions of major religious groups on allotransplantation and the cultural responses to the religious stances. In this context, we have investigated whether there are any specific religious or cultural restrictions against the practice of composite tissue allotransplantation.

Population study about the attitude toward organ xenotransplantation in the population from Eastern Europe resident in southeast Spain.

BACKGROUND: The objective of this paper is to analyze the attitude toward xenotransplantation and to determine the variables that influence this attitude in the population of southeast Spain who were born in Eastern European countries. METHODS: A random sample was taken of natives from Eastern Europe residing in southeast Spain (n=320). The sample was obtained randomly between November 2005 and April 2006 and stratified according to the respondents' nationality. Attitude was evaluated using a validated questionnaire which was self-administered and completed anonymously. The control group was a random sample of the native Spanish population (n=250). The statistical analysis used included Student's t-test, the chi-square test, Fisher's exact test, and a logistic regression analysis. RESULTS: The questionnaire completion rate was 83% (n=267). Regarding the use of animal organs for transplantation in humans, if the outcome were similar to that achieved when using human organs, 43% (n=114) would be in favor, 32% (n=86) undecided, and the remaining 25% (n=67) would be against it. This attitude is less favorable than in the control group (43% versus 74%, p<0.001). The attitude was related to the following factors: 1) the country of origin (p<0.001); 2) participation in social help activities (p<0.001); 3) discussion on organ donation and transplantation within the family (p=0.005); 4) previous experience of organ donation and transplantation (p=0.002); 5) the respondent's religion (p=0.002); 6) knowing that one's partner had a favorable attitude toward transplantation (p<0.001); 7) the respondent's belief that he or she might need a transplant in the future (p<0.001); 8) the attitude toward human donation, both from cadaver (p<0.001) and living (p<0.001) donors. The following were also independent variables in the subsequent multivariate analysis: 1) favorable attitude toward cadaver organ donation (OR=4.998); 2) previous experience of donation (0R=2.857); 3) partner's attitude against transplantation (OR=0.079); and 4) attitude toward living donation (OR=12. 703). CONCLUSIONS: The attitude toward xenotransplantation is less positive among Eastern Europeans living in Spain than in the native Spanish population and is influenced by many psychosocial factors that are mainly related to human organ donation.

Public dialogue and xenotransplantation.

Toi te Taiao: the Bioethics Council was established in 2002 to enhance New Zealand's understanding of the cultural, ethical and spiritual aspects of biotechnology and ensure that the use of biotechnology has regard for the values held by New Zealanders. In 2005, the Bioethics Council focused on xenotransplantation. A series of dialogue events were held, the public had the opportunity to participate in an online discussion forum and were able to make written submissions. There is worldwide interest in the potential of this biotechnology to cure or alleviate a number of serious health conditions. However, there are concerns about the risks, especially the potential for cross species infection. Such risks have not yet been reliably quantified, but any decision about safety and effectiveness is also about cultural, ethical and spiritual factors. This paper considers some of the outcomes from the dialogue process and the reflections of the Bioethics Council on these. It contrasts the process with that of classic consultation and concludes that, although the process may be more costly and time consuming than the traditional consultative approach, it enables the role of science to be appreciated in its full context, including appreciation of the uncertainties of natural systems and the relevance of cultural, ethical and spiritual human values. It will be suggested that the public are able to interweave ethical concerns with scientific knowledge to engage in meaningful dialogue, resulting in useful recommendations.

Organ transplantation from living donors, between bioethics and the law.

The lack of cadaver donors and the high requirements for organs cannot be met by present sources, leading to the need for xenoorgans or stem cell-derived tissues/organs. Actually, despite experimental suggestions, scientific and ethical doubts have been raised by both the scientific community and international organizations (World Health Organization, 1998; European Council of Parliamentary Assembly, 1999). Thus, to balance the shortage of organs, laws allowing living organ donations have been issued in several countries, including Italy, where there is an increasingly favorable attention to organ transplantation from living donors. Because of the prohibition of body commercialization issued by the Oviedo Convention (1997), the bioethics and legal debate as well as issued laws concern 2 major closely related aspects: the health-defense of the donor who accepts a decreased well-being and the counterbalanced possibility of an economic advantage/indemnity.