title: Risk acceptance in composite-tissue allotransplantation reconstructive procedures.
abstract: Composite-tissue allotransplantation (CTA) is a new therapeutic modality to reconstruct major tissue defects of the face, larynx, and extremities. Unlike most life-saving organ-transplantation procedures, CTA is considered to improve quality of life. Therefore, the question arises, do the risks posed by the immunosuppression drugs that patients must take to prevent rejection justify the benefits of these procedures? The purpose of this study was to assess the relative risk that individuals are willing to accept in order to receive the benefits of CTA procedures. We used a psychometrically reliable and valid instrument to question two primary populations of individuals: those who live with the risks of immunosuppression, and healthy individuals. The level of risk acceptance for the seven transplant procedures tested (foot, single hand, double hand, larynx, kidney, hemiface, and full face) showed significant differences in research participants' risk acceptance for the different transplant procedures, but no significant differences between groups. Based on these findings, we conclude that certain CTA procedures convey benefits to recipients that are perceived by subjects, including individuals who live with the risks of immunosuppression, to warrant the risks of these procedures.
authors.affiliation: Department of Surgery, University of Louisville, Louisville, KY 40202, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Brouha
authors.forename: Deepak
authors.initials: D
authors.lastname: Naidu
authors.forename: Michael
authors.initials: M
authors.lastname: Cunningham
authors.forename: Allen
authors.initials: A
authors.lastname: Furr
authors.forename: Ramsey
authors.initials: R
authors.lastname: Majzoub
authors.forename: Federico V
authors.initials: FV
authors.lastname: Grossi
authors.forename: Cedric G
authors.initials: CG
authors.lastname: Francois
authors.forename: Claudio
authors.initials: C
authors.lastname: Maldonado
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Banis
authors.forename: Serge
authors.initials: S
authors.lastname: Martinez
authors.forename: Gustavo
authors.initials: G
authors.lastname: Perez-Abadia
authors.forename: Osborne
authors.initials: O
authors.lastname: Wiggins
authors.forename: Moshe
authors.initials: M
authors.lastname: Kon
authors.forename: John H
authors.initials: JH
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005145:Face / Q000601:surgery; D005260:Female; D005528:Foot / Q000637:transplantation; D063987:Hand Transplantation; D006801:Humans; D016030:Kidney Transplantation; D007830:Larynx / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016377:Organ Transplantation / Q000379:methods / Q000523:psychology; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000523:psychology; D018570:Risk Assessment; D016378:Tissue Transplantation / Q000379:methods* / Q000523:psychology; D014184:Transplantation, Homologous