Investigation of Risk Acceptance and Expectations in Hand and Foot Allotransplantations.

Lee, Do Heon; Kim, Ji Hoon; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(4):427-437.
Published online July 1, 2011.

Investigation of Risk Acceptance and Expectations in Hand and Foot Allotransplantations.

Do Heon Lee, Ji Hoon Kim, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee

Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea. pskim@chonnam.ac.kr

Abstract

PURPOSE
Composite tissue allotransplantation is a new therapeutic modality to reconstruct major tissue defects of the head and neck region and extremities. However, there is a serious ethical debate about whether the risks posed by the life-long immunosuppression that a recipient would have to take justify the benefits of receiving this non-life saving procedure. The purpose of this study is to examine differences between expert and non-expert groups in risk acceptance and expectations regarding hand and foot allotransplantations. METHODS: The author conducted a survey of 345 subjects in total (lay public n=110; medical students, n=120; doctors, n=115), using a questionnaire-based instrument, the Louisville Instrument for Transplantation (translated to Korean).
RESULTS
Of the three groups studied, risk acceptance was found to be lowest in the doctor group and highest in the non-expert group, and the difference was significant (p < 0.05). The expectations of aesthetic and functional improvement from the procedure, however, were found to be highest in the non-expert group and lowest in the doctor group, and the differences were also significant (p < 0.05).
CONCLUSION
The results of this study shows that the three populations have noticeable differences in risk acceptance and expectations regarding hand and foot allotransplantations. Therefore, accurate and sufficient information on these procedures should be provided to patients from both medical and ethical perspectives.

Keywords: Hand; Foot; Allotransplantation; Risk acceptance; Expectations

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