Xenotransplantation public perceptions: rather cells than organs.

The aim of this study was to describe some of the factors that might play a role in influencing attitude to xenotransplantation: first, the consideration of receiving cells and tissue from xenotransplants in relation to whole xeno-organs; secondly, the fact that there is greater uncertainty regarding the result and risk of infection associated with xenotransplantation than with allotransplantation. We also describe the attitude to research on xenotransplantation, and the relationship between the attitude to receiving a xenotransplant and an allotransplant. Finally, we describe the attitude to xenotransplantation in relation to treatment for renal failure and waiting-time for allotransplantation. A questionnaire was sent to randomly selected members of the public aged 18 to 75 (n=1,000) and to all patients in the same age range who were waiting for kidney transplants in Sweden in the spring of 1998 (n=460). The response rate was 60% among the public and 87% among the patients. Both study groups were positive to a greater extent in their attitude to receiving cells and tissue than to receiving a whole organ such as a kidney. The response 'rather positive' to receiving organs was generally favored by the public, whereas the most generally favored response to receiving cells and tissue was 'very positive'. When there was suggested to be a greater uncertainty regarding the outcome with xenotransplantation compared with allotransplantation, the number of negative and uncertain respondents increased, both among the public and the patients. Eighty percent of the public and about 90% of the patients were in favor of continued research on xenotransplantation. Of those members of the public who responded, the attitude to receiving an organ from a human was positive in 86% of cases, with an emphasis on 'very positive'. There was a moderate relation between the attitude to receiving an organ from a human and to receiving a xenotransplant. Among the patients, there was no systematic or strong relation between the attitude to xenotransplantation and the kind of dialysis treatment they were on. Neither was there any systematic or strong relation to the waiting-time. The overall impression is that the attitude to xenotransplantation seems to be most influenced by whether the xenotransplant would involve whole organs or cells and uncertainty regarding the outcome.

Kidneys from marginal donors: views of patients on informed consent.

BACKGROUND: Considering the fact that donor age is a major risk factor for graft survival, and taking into account the importance attached to the principle of autonomy in the Swedish Health Care Law, we decided that allocation of kidneys from marginal donors should be restricted to patients who have given their informed consent. Written information was given to the patients on the waiting list for kidney transplantation in the southern part of Sweden. Patients were asked to state whether they would accept either a single kidney or dual transplantation kidneys from marginal donors. The aim of this study was to investigate the views of patients on the information they received about kidneys from marginal donors and their reaction to being asked to make a decision on this issue. METHODS: A questionnaire was posted to 61 patients who had already replied to the question of whether or not they would accept kidneys from a marginal donor for themselves. The median age of the patients was 52 years (range 22-74 years). Answers were given anonymously. RESULTS: Among the 53 respondents, 48 considered the information to be comprehensible. The extent of the information was considered sufficient by 43 patients. No patient thought that the information was too extensive. According to 41 patients, it is totally right to be asked to make a decision on this type of issue. Two patients thought it was totally wrong. Finally, 33 patients thought it was easy to make a decision on this issue. CONCLUSIONS: This study indicates that patients on the waiting list for kidney transplantation accept information on donor-related risk factors and most patients want to be involved in the decision concerning transplantation with a kidney from a marginal donor.