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

Abstract

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.