Attitudes And Acceptance Of Xenotransplantation Among Pediatric Congenital Heart Surgeons And Pediatric Transplant Cardiologists
Luz Padilla, MD, MSPH, Wayne Paris, Robert Dabal, David Mauchley, Waldemar A. Carlo, David Cooper, David Cleveland.
University of Alabama at Birmingham, Birmingham, AL, USA.
Objective(s): Science in cardiac xenotransplantation (XTx) is advancing. We sought to understand the potential acceptance of XTx among surgeons and physicians involved in pediatric cardiac transplantation.
Methods: A Likert-scale survey sent to members of the Congenital Heart Surgeon and the Pediatric Heart Transplant Societies. Results were compared between the two physician groups. Potential acceptance of XTx was measured using the question: If a pig heart had similar risks and results to a human heart would you consider it for your patients? Regression was used to measure the association among variables and XTx acceptance.
Results: Ninety two pediatric congenital heart surgeons (CHS) and 42 pediatric transplant cardiologists (PTC) responded (N=134). Potential acceptance of XTx was high in both groups with no statistical difference (88.1% CHS vs 81% PTC). More CHS are prepared to offer XTx as a bridge even if the risks and results were worse than a human heart when compared to PTC (41.3% vs 16.7%, respectively; p = 0.02). Only a minority of both groups would opt against primary cardiac XTx over surgical palliation for hypoplastic left heart syndrome if XTx offered similar outcomes as allotransplantation. Although not significant, regression analysis revealed that females, those outside of the southeast, atheist/agnostics and organ donors were more likely to accept XTx.
Conclusions: Though continued advances are needed before XTx becomes a viable clinical option, potential acceptance of XTx among CHS and PTC is high. Future research is needed to determine the potential utilization of XTx within the congenital heart disease field.