Abstract:Penile transplantation is accepted by most health professionals surveyed. Younger respondents and those informed through professional outlets are more favorable toward penile transplantation. Anticipated limitations include the risk of immunosuppression, lack of available donors, and the effect on healthcare utilization. Najari B, Flannigan R, Hobgood J, et al. Attitudes Toward Penile Transplantation Among Urologists and Health Professionals. Sex Med 2018;6:316-323.
“…Veterans were more willing to personally receive an extremity transplant than a face, penis, or uterus transplant if it was medically indicated, comparable to what has been reported elsewhere. 1,12,13,[31][32][33] Nearly half of veterans surveyed reported some media exposure to VCA, which is proportionally much higher than has been previously reported for non-veterans. While some veterans have been spotlighted as the beneficiaries of VCA transplants, 34,35 we did not assess the nature, number, or duration of exposures nor whether they involved stories of other veterans.…”
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.
“…Veterans were more willing to personally receive an extremity transplant than a face, penis, or uterus transplant if it was medically indicated, comparable to what has been reported elsewhere. 1,12,13,[31][32][33] Nearly half of veterans surveyed reported some media exposure to VCA, which is proportionally much higher than has been previously reported for non-veterans. While some veterans have been spotlighted as the beneficiaries of VCA transplants, 34,35 we did not assess the nature, number, or duration of exposures nor whether they involved stories of other veterans.…”
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.
“…In 2018, 64% of US healthcare professionals were in favour of penile transplantation . Two of the concerns identified by respondents were the lack of established donor sources and the impact on healthcare resource utilization.…”
Significant advances and increasing acceptance of vascularized composite allotransplantation (VCA) have contributed to emerging success of penile transplantation. The aims of penile transplantation are fourfold: adequate urinary function, enabling natural erections, restoration of erogenous sensation and appearance of external male genitalia. Successful penile transplantation also requires limiting risks and managing complications of lifelong immunosuppression. Given the limited experience with this procedure, potential recipients must understand that penile transplantation is not currently standard of care and long-term functional outcomes are unknown. Moreover, these transplants are associated with complex ethical issues. Nevertheless, as the efficacy and safety of penile transplantation are being evaluated, clear indications for transplant are needed. Although preliminary recommendations have been proposed, a more comprehensive framework is needed. We performed a literature review for English language publications related to penile transplantation and ethics. Based on the results of the search, a review of prior recommendations, and our experience performing the first whole male genital allotransplantation including penis, scrotum and abdominal wall; screening and identifying potential donors and recipients for the procedure; and addressing the associated ethical issues, we propose guidelines for responsible penile transplantation: The Baltimore Criteria for an Ethical Approach to Penile Transplantation.
“…The selected patient underwent a rigorous evaluation that included a comprehensive medical and surgical history, physical examination, a multitude of laboratory and radiographic studies, and an extensive psychological evaluation. The preparation included multiple laboratory experiments, as well as cadaveric dissections and surgical rehearsals [9]. The multidisciplinary team comprised nine plastic surgeons, two urologists, and other surgical, medical, and mental health professionals, as well as countless nursing and support staff.…”
Section: Penile Transplant Program At Johns Hopkinsmentioning
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