Racial differences in attitudes to clinical pig organ Xenotransplantation

Abstract

Introduction In addition to an organ donor shortage, racial disparities exist at different stages of the transplantation process. Xenotransplantation (XTx) could alleviate these issues. This study describes racial differences in attitudes to XTx among populations who may need a transplant or are transplant recipients. Methods A Likert‐scale survey was distributed at outpatient clinics to parents of children with congenital heart disease (CHD) and kidney patients on their attitudes to pig organ XTx. Data from these two groups were stratified by race and compared. Results Ninety‐seven parents of children with CHD (74.2% White and 25.8% Black) and 148 kidney patients (50% White and 50% Black) responded to our survey. Black kidney patients’ acceptance of XTx although high (70%) was lower than White kidney patients (91%; P .003). White kidney patients were more likely to accept XTx if results are similar to allotransplantation (OR 4.14; 95% CI 4.51‐11.41), and less likely to be concerned with psychosocial changes when compared to Black kidney patients (receiving a pig organ would change your personality OR 0.08; 95% CI 0.01‐0.67 and would change social interaction OR 0.24; 95% CI 0.07‐0.78). There were no racial differences in attitudes to XTx among parents of children with CHD. Conclusion There are differences in attitudes to XTx particularly among Black kidney patients. Because kidneys may be the first organ for clinical trials of XTx, future studies that decrease scientific mistrust and XTx concerns among the Black community are needed to prevent disparities in uptake of possible future organ transplant alternatives.

The 2021 IXA Keith Reemtsma Lecture: Moving xenotransplantation to the clinic

“…Paris and his colleagues have indicated a general support for xenotransplantation-if the results are likely to be comparable to those of allotransplantation. [50][51][52][53][54][55][56][57] Of course, this cannot be guaranteed and, indeed, is not likely to be achieved in the initial clinical trials. Patients awaiting a kidney transplant and their families had a more positive attitude than others in the community, though African Americans were more cautious, probably as a result of some unethical trials to which they were exposed in the past.…”

“You cannot stay in the laboratory forever”*: Taking pig kidney xenotransplantation from the laboratory to the clinic

“…The opinions of patients, health care professionals, and members of the public need to be sought. A number of surveys and focus groups have been organized by Paris and his colleagues during the past three years, which indicate that the public is largely supportive of xenotransplantation [80] , [81] , [82] , [83] , [84] , [85] , [86] . The influence of religious beliefs has also been explored [ 87 , 88 ].…”

Factors influencing attitudes toward xenotransplantation clinical trials: A report of focus group studies

“…While clinical considerations, including further immunological and safety‐related aspects of XTx, must be overcome, ethical and social aspects also need to be considered before clinical trials can be initiated. To date, there have been a number of quantitative survey‐based studies assessing attitudes of various persons toward XTx, with much of the research showing that potential acceptance of XTx is high 4‐7 . However, the use of qualitative methodology, which is designed to elicit viewpoints that may not be present in surveys, has been limited and not with a broad array of stakeholders 8 …”