Attitudes Toward Xenotransplantation Among Kidney Transplant Recipients, Candidates, and Living Donors: A Cross-Sectional Survey in Japan.

BACKGROUND

Genetically engineered pig kidneys have entered early clinical use, but attitudes among kidney transplant-related individuals remain poorly characterized.

METHODS

In this preliminary, exploratory, single-center cross-sectional survey, 101 consecutive eligible adults attending a kidney transplant clinic were approached, and 100 kidney transplant candidates, recipients, and living donors completed a paper, self-administered questionnaire (99.0% participation). We descriptively assessed acceptability, conditions for acceptance, and preferred kidney source. Group comparisons and analyses of factors associated with acceptance were exploratory secondary analyses.

RESULTS

Overall, 79.0% (95% CI, 70.0%-85.8%) were accepting of xenotransplantation: 27.0% were willing and 52.0% were conditionally willing. Among conditionally willing participants, 82.7% required assurance of safety and 63.5% required long-term outcome data. Among 87 participants who ranked kidney sources, only 6.9% ranked a pig kidney first and 64.4% ranked it last. Acceptance rates were similar among candidates, recipients, and donors in exploratory comparisons. Physician-related trust was associated with acceptance in exploratory analyses, but interpretation was limited by conceptual overlap between the trust and acceptance items.

CONCLUSION

In this preliminary survey, acceptance of xenotransplantation was high but predominantly conditional, and a pig kidney was rarely preferred. Larger multicenter studies are needed to confirm the exploratory secondary findings.