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  • Rosa Emilia Moraes

Xenotransplantation: Acceptance of the procedure with a non-human organ



A questionnaire applied to waiting candidates and patients already submitted to

liver transplantation investigates how self-esteem, social relationships and religious

practices can influence the acceptance or refusal of the use of non-human organs.

Results indicate a positive perception of the procedure and provide new perspectives

for patients' understanding of xenotransplantation.

 

Article: Pavan CL, Godoy MF, Miyazaki ET, Silva RCMA, Goes CH, Castiglioni L, Silva RF. Influência de Fatores Clínicos e Psicossociais na Aceitação de Órgãos Não Humanos em Transplantes: Xenotransplantes. BJT. 2022.25(04):e0781.

 

Xenotransplantation: Acceptance of the procedure with a non-human organ is increased with patient education


The scarcity of human organs available for transplantation results in long waiting lists for surgery candidates. In the meantime, unfortunately, many patients end up dying while waiting for a donor. The possibility of a xenotransplantation - using organs or tissues derived from other animal species - is already a reality successfully applied in the correction of heart diseases, using porcine and bovine valves. With the development of this technology, it is expected to make viable the xenotransplantation of solid organs, such as the liver, reducing the waiting time and, consequently, the mortality of this period (JASANOFF, 2018).


However, when talking about a transplant between different species, in addition to the clinical aspects, it is necessary to consider the social, subjective and cultural impacts of the procedure. The relevance of psychological elements in the acceptance or rejection of a non-human organ had already been pointed out in a study by Rubaltelli et al. (2008).


Thus, in an attempt to find out patients' opinions about xenotransplantation, a team of researchers from São José do Rio Preto, in the interior of the state of São Paulo, Brazil, conducted a cross-sectional observational study published in the Brazilian Journal of Transplantation (v.25, n. 4) on the psychosocial factors involved in accepting an organ from a different species.


A total of one hundred patients, 50 candidates on the waiting list and 50 already submitted to liver transplantation, answered objectively (yes or no) to a questionnaire that covered aspects such as self-esteem, social relationships and religious practices of patients, and prospected the influence of these factors in the opinion formed by the interviewee in relation to xenotransplantation.


It was found that most patients in the sample, encompassing both groups, would accept the xenotransplantation. The results indicate that the strangeness and rejection caused by the use of organs and tissues from other animals comes from the lack of information and understanding of xenotransplantation, and from the fear of physiological rejection of the organ. During the evolution of the questionnaire, some interviewees even changed their first opinion, realizing that by opting for the transplant they would avoid risking their lives while waiting on the waiting list. This investigation serves to guide the multidisciplinary transplant team about the need to clarify the patient about the functioning and benefits of this therapeutic method.


The period of application of the questionnaires was from August 2019 to March 2020, and the data generated were compared between the groups according to their nature through tests (parametric or not), and tests of association. The rejection rate was slightly higher among patients on the waiting list, however the difference was too small for the authors to be able to draw any conclusions, although they pondered the relationship of that result with the symptoms and manifested severity of the disease in the candidates, which would be lower than that of patients who had already undergone transplantation.


Religious influence stood out as a significant divergence between the two groups of patients, being greater among those on the waiting list, and appearing as a positive contribution to the acceptance of the procedure. Respondents were also asked about a possible fear of having changes in personality or behavior after receiving the xeno-organ, to which most responded negatively. According to the article, there is no other research in the literature in English and Portuguese that explores the variables considered in the present study. And the discovery of a good acceptance and a generally positive perception of xenotransplantation by transplant patients and candidates is of great relevance, as it indicates the potential receptivity of this technique still under development, but which represents great hope for terminal patients with liver diseases, whose only treatment

option is organ replacement.


 

Read more (References):


Jasanoff S. Bodies in transition: Ethics in xenotransplantation research. Hastings Cent

Rep. 2018;48(Suppl 4):S67-9. https://doi.org/10.1002/hast.960

Rubaltelli E, Burra P, Sartorato V, Canova D, Germani G, Tomat S, et al. Strengthening

acceptance for xenotransplantation:The case of attraction effect. Xenotransplantation.2008;15(3):159-63. https://doi.org/10.1111/j.1399-3089.2008.00474.x


 

Author


Rosa Emilia Moraes, Scientific journalist at Linceu Editorial, São José dos Campos, SP, Brazil (rosaemiliamoraes@gmail.com)

 

Links


Brazilian Journal of Transplantation


Faculdade de Medicina de São José do Rio Preto


Faculdade de Ciências Médicas da Santa Casa de São Paulo


Hospital de Base de São José do Rio Preto 

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