title: Vascularized Composite Allograft Donation and Transplantation: A Survey of Public Attitudes in the United States.
abstract: 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.
authors.affiliation: 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.
authors.forename: J R
authors.initials: JR
authors.lastname: Rodrigue
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: D
authors.initials: D
authors.lastname: Tomich
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: A
authors.initials: A
authors.lastname: Fleishman
authors.affiliation: New England Donor Services, Waltham, MA.
authors.forename: A K
authors.initials: AK
authors.lastname: Glazier
mesh_terms: D001294:Attitude to Health; D064595:Composite Tissue Allografts; D005260:Female; D006801:Humans; D008297:Male; D016377:Organ Transplantation; D011639:Public Opinion; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous; D014481:United States
keywords: clinical research/practice; donors and donation; donors and donation: deceased; social sciences; survey; vascularized composite and reconstructive transplantation