Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.
Departments of Surgery and Psychiatry, Harvard Medical School, Boston, MA.
Am J Transplant. 2017 Oct;17(10):2687-2695. doi: 10.1111/ajt.14302. Epub 2017 May 15.
Vascularized composite allograft (VCA) transplantation has emerged as a groundbreaking surgical intervention to return identity and function following traumatic injury, congenital deformity, or disfigurement. While public attitudes toward traditional organ/tissue donation are favorable, little is known about attitudes toward VCA donation and transplantation. A survey was conducted of 1485 U.S. residents in August 2016 to assess VCA donation attitudes. Participants also completed the Revised Health Care System Distrust Scale. Most respondents were willing to donate hands/forearms (67.4%) and legs (66.8%), and almost half (48.0%) were willing to donate the face. Three-quarters (74.4%) of women were willing to donate the uterus; 54.4% of men were willing to donate the penis. VCA donation willingness was more likely among whites and Hispanics (p < 0.001), registered organ/tissue donors (p < 0.001), and those with less health care system distrust (p < 0.001) and media exposure to VCA transplantation (p = 0.003). Many who opposed VCA donation expressed concerns about psychological discomfort, mutilation, identity loss, and the reaction of others to seeing familiar body parts on a stranger. Attitudes toward VCA donation are favorable overall, despite limited exposure to VCA messaging and confusion about how VCA donation occurs. These findings may help guide the development and implementation of VCA public education campaigns.
血管化复合组织同种异体移植（VCA）作为一种开创性的外科干预手段，已在创伤、先天畸形或毁容后恢复患者的身份和功能。尽管公众对传统器官/组织捐献的态度是积极的，但对于 VCA 捐献和移植的态度却知之甚少。2016 年 8 月，对 1485 名美国居民进行了一项调查，以评估 VCA 捐献的态度。参与者还完成了修订后的医疗保健系统不信任量表。大多数受访者愿意捐献手/前臂（67.4%）和腿（66.8%），近一半（48.0%）愿意捐献面部。74.4%的女性愿意捐献子宫；54.4%的男性愿意捐献阴茎。白人和西班牙裔（p < 0.001）、登记的器官/组织捐献者（p < 0.001）、对医疗保健系统不信任程度较低（p < 0.001）和对 VCA 移植媒体报道较多（p = 0.003）的人更愿意捐献 VCA。许多反对 VCA 捐献的人表示担心心理不适、肢体残缺、身份丧失，以及看到陌生人身上熟悉的身体部位的反应。总体而言，人们对 VCA 捐献的态度是积极的，尽管对 VCA 信息的了解有限，并且对 VCA 捐献的方式感到困惑。这些发现可能有助于指导 VCA 公众教育活动的开展和实施。
