Attitudes Toward Organ, Tissue, and Vascularized Composite Allograft (VCA) Donation and Transplantation: A Survey of United States Military Veterans

Abstract

Original Clinical Science-GeneralBackground. There are 20 million living US armed forces veterans; however, the organ donation attitudes of veterans have not been examined. Methods. Over a 17-month period, a convenience sample of 1517 veterans in New England completed a survey to assess attitudes about organ, tissue, and vascularized composite allograft (VCA) donation. Results. Most veterans (96%) supported the donation of organs and tissue for transplantation, and 59% were registered as an organ and tissue donor. Being younger (adjusted odds ratio [aOR]: 0.96 0.97 0.98 ; P = 0.01), female (aOR: 1.06 1.46 2.03 ; P = 0.02), non-Hispanic white (aOR: 1.30 2.07 3.30 ; P = 0.01), Hispanic (aOR: 1.28 2.43 4.61 ; P = 0.01), and having more trust that the transplant process is fair and equal (aOR: 1.19 1.40 1.65 ; P = 0.01) were predictive of donor registration. Also, most veterans were willing to donate their face (57%), hands/arms (81%), legs (81%), penis (men: 61%), and uterus (women: 76%) at time of death; donation willingness was higher for upper and lower limbs than for face or genitourinary organs (P < 0.001). Those unwilling to donate VCA organs expressed concerns about identity loss, psychological discomfort of self and others, body integrity, funeral presentation, and religious beliefs. Most (54%) felt that VCA donation should require permission of legal next-of-kin at the time of one's death, even if the decedent was a registered donor. Conclusions. There is a high level of support for organ, tissue, and VCA transplantation and donation among veterans, despite limited educational campaigns targeting this population. There is high potential among veterans to further increase donor registry enrollment and raise awareness about VCA benefits for severely injured service members.

A mixed-methods examination of public attitudes toward vascularized composite allograft donation and transplantation

“… 13 A survey of the general public in 2016 (N = 1485) found that two-thirds of respondents were willing to donate their own face, legs, and hands/forearms, with a majority also expressing willingness to donate the penis and uterus. 14 Similar levels of support for VCA donation were found among veterans 15 and the general public when asked about a VCA donation from a deceased family member whose donation wishes were known. 14 A recent Gallup poll found strong support for solid organ donation (90.4%) but drastically lower support for VCA donation; 64% of respondents were willing to donate their own hands and 46.9% were willing to donate their own face after death.…”

Video Messaging to Increase Vascularized Composite Allograft Donation Willingness in United States Military Veterans

“…Indeed, veterans may have more favorable attitudes toward both traditional and VCA organ donation compared with the general population. 14,20 Video messaging is an effective and persuasive strategy for increasing favorable attitudes toward organ donation and donor registry enrollment. 22,[31][32][33] We extend these findings by showing that video messaging is also effective at increasing behavioral willingness to donate VCA organs.…”

“…First, a survey of veterans was done to assess VCA attitudes and to identify knowledge gaps. 20 Second, 6 focus groups of 43 veterans were held in 4…”

“… 18 , 19 In a recent survey of 1517 military veterans, we found highly favorable attitudes toward VCA transplantation, although willingness to donate VCA organs was lower than that for traditional organs. 20 Also, VCA donation willingness differed by VCA organ type, with veterans more willing to donate extremities than the face or genitourinary organs. Importantly, most veterans reported no exposure to information about VCA transplantation or donation in the preceding year.…”

Opportunity to increase deceased donation for United States veterans

“…14 While veterans have been described as having high interest in donation, recovery of donors at Veteran Administration Medical Centers (VAMCs) is a rare occurence. 15 In this report, we describe historical organ donation performance and access to organ donation care for United States military veterans receiving care at VAMCs.…”