Attitudes Toward Vascularized Composite Allotransplantation of the Hands and Face in an Urban Population

Abstract

Background: Almost 100 hand and face transplants have been performed worldwide. Their success has generated enthusiasm within the medical community, however, little is known about public attitudes toward vascularized composite allotransplantation (VCA) of the hands and face as compared to solid organ transplantation. The objective of this survey study was to assess these attitudes and the acceptability and potential barriers to the further growth of these procedures. Methods: Cooper University Hospital Emergency Department (Camden, New Jersey) patients, accompanying family members and friends ≥18 years of age were surveyed about knowledge of and attitudes toward organ, hand, and face transplants as well as preferences as a potential VCA donor or recipient. The socioeconomic aspects of VCA also were assessed. Results: A total of 1,027 individuals participated. Approximately 70% (69.7%) of respondents indicated that they would want to be organ donors, although only 37.1% reported donor registrations on their driver's license. Respondents demonstrated greatest willingness to donate solid organs upon death: kidneys (77.5%), liver (77.1%), and heart (76.4%). Willingness to donate was less for hands (54.6%) and face (44.0%). Similarly, respondents were more willing to receive a kidney (85.2%) than a hand (60.0%) or face (49.4%). Conclusions: Respondents were more willing to be donors or recipients of solid organs than of hands or face. However, substantial percentages of individuals indicated a willingness to donate or receive hands or a face. As VCA continues to evolve, knowledge of public attitudes toward VCA will be critical for organ procurement organizations, health system engagement, and funding for relevant research.