Psychosocial aspects of xenotransplantation: survey in adolescent recipients of porcine islet cells.
BACKGROUND
Transplantation is a process with several psychosocial challenges. Regarding the case of xenotransplantation, the perceived similarity between humans and pigs may be stressful. Adjustment disorders have been reported among transplantation recipients. We sought to assess the psychosocial aspects of xenotransplantation among porcine islet-cell recipients and their efforts to adapt themselves to this condition.


METHODS
Ten insulin-dependent diabetes mellitus patients aged 14.58 +/- 7.93 who received porcine islet-cells were included. The bioartificial steel/fibrous tissue chamber method was used. All patients and their relatives were interviewed about their expectations, overall functioning, and experiences. The quality of life, enjoyment, and satisfaction scale and the hospital anxiety and depression scales were used. A 1-year follow-up was done.


RESULTS
Their motivation was centered on autonomy; there were no troubles regarding the graft origin. Xenotransplantation was perceived with pragmatism, seeing pigs as an unlimited resource. The patients with best outcomes also had the greatest improvements in several quality of life areas (QOL) while the medium responders had fewer QOL improvements. The nonresponders experienced mainly frustration. Parents' concerns were not related to their children's health but to their recently gained autonomy.


CONCLUSIONS
In addition to enthusiasm, the perception of animals as an unlimited source of organs may affect patient compliance; in this group, xenotransplantation was seen as using as a long-lasting drug, with chamber walls considered as a physical, immunologic, and, in certain manner, a psychological barrier.
Terán-Escandón
D
D
Hospital Angeles del Pedregal, Mexico City, Mexico. dterane@yahoo.com.mx
Terán-Ortiz
L
L
Ormsby-Jenkins
C
C
Evia-Viscarra
M L
ML
White
D J G
DJ
Valdés-González-Salas
R
R
D000293:Adolescent; D000818:Animals; D001007:Anxiety; D003863:Depression; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D006801:Humans; D007407:Interviews as Topic; D016381:Islets of Langerhans Transplantation / Q000379:methods / Q000523:psychology*; D009042:Motivation; D010290:Parents / Q000523:psychology; D017060:Patient Satisfaction; D026684:Personal Autonomy; D013552:Swine; D014183:Transplantation, Heterologous / Q000379:methods / Q000523:psychology*