移植相关人群对异种肾移植的态度及影响因素

徐莹; 陈佳弘; 何松哲; 李涛; 齐津浩; 王毅

doi:10.3969/j.issn.1674-7445.2023118

移植相关人群对异种肾移植的态度及影响因素

doi: 10.3969/j.issn.1674-7445.2023118

徐莹^1,,
陈佳弘²,
何松哲²,
李涛²,
齐津浩¹,
王毅^{1, 2, 3, ,}

1.
570100　海口，海南医学院公共卫生与全健康国际学院
2.
海南医学院第二附属医院肾移植科
3.
海南医学院移植医学研究所

基金项目: 国家自然科学基金（82260154）；海南省科技厅重大科技计划项目（ZDKT2019009）；海南医学院研究生创新科研课题（HYYS2021A14）

详细信息

作者简介:

通讯作者:
王毅（ORCID：0000-0001-7152-0757），博士，主任医师，研究方向异种器官移植，Email： wayne0108@126.com

中图分类号: R617, R19
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-13
- 网络出版日期: 2023-07-20
- 刊出日期: 2023-09-15

Attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation

Xu Ying^1
,,
Chen Jiahong²,
He Songzhe²,
Li Tao²,
Qi Jinhao¹,
Wang Yi^{1, 2, 3
, ,}

1.
International School of Public Health and One Health, Hainan Medical University, Haikou 570100, China

More Information

Corresponding author: Wang Yi, Email: wayne0108@126.com

摘要

摘要: 目的调查移植相关人群对于异种肾移植的态度及影响因素。方法 2022年6月至2023年1月，对等待肾移植患者、肾移植术后患者、患者家属及医学生进行分层随机抽样，每个群体抽取400名，共1 600名进行自制问卷调查。分析受访者的一般资料、对异种肾移植的态度及不能接受异种肾移植的原因。分析受访者对异种肾移植态度的影响因素。结果共回收有效问卷1 493份，回收有效率93.31%。能接受同种异体肾移植手术的占93.10%；知晓异种肾移植的占66.78%。795名受访者表示“在异种肾移植与同种异体肾移植有着相同结果及风险时”能接受异种肾移植；698名表示“不能”或“不确定”能否接受异种肾移植（χ²=16.409，P=0.001）。698名表示“不能”或“不确定”能否接受异种肾移植的受访者中，在不符合同种异体肾移植的条件下，愿意接受异种肾移植的占10.9%；如果与同种异体肾移植相比，异种肾移植有着更小的风险及更好的预后的条件下，愿意接受异种肾移植的占35.8%；如果与同种异体肾移植相比，异种肾移植等待时间更短，愿意接受异种移植的占21.2%；如果与同种异体肾移植相比，异种肾移植花费更少，愿意接受异种肾移植的占24.5%。受访者不能接受异种肾移植的主要原因为担心手术风险及担心其他未知风险。多因素分析结果显示，长期居住在城镇的受访者、能接受同种异体肾移植的受访者、知晓异种肾移植的受访者对异种肾移植态度更积极。结论不同移植相关人群对异种肾移植态度存在差别，总体态度良好。积极推进异种肾移植的研究、开展相关科普教育有利于提高公众对异种肾移植的接受度。
- 异种移植 /
- 肾移植 /
- 器官捐献 /
- 器官短缺 /
- 患者家属 /
- 医学生 /
- 态度 /
- 终末期肾病
Abstract: Objective To investigate the attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation. Methods From June 2022 to January 2023, stratified random sampling was performed from patients awaiting kidney transplantation, patients after kidney transplantation, patients' relatives and medical students. Four hundred subjects were collected from each population and 1600 subjects were investigated using a self-designed questionnaire. Baseline data of the respondents, their attitudes towards kidney xenotransplantation and the reasons of rejecting kidney xenotransplantation were analyzed. The influencing factors of attitudes towards kidney xenotransplantation were also identified. Results A total of 1 493 valid questionnaires were collected, and the questionnaire retrieval rate was 93.31%. About 93.10% of the respondents accepted allogeneic kidney transplantation, and 66.78% had heard of kidney xenotransplantation. Seven hundred and ninety-five respondents suggested that they could accept kidney xenotransplantation "when kidney xenotransplantation and allogeneic kidney transplantation yielded the same results and risks". Six hundred and ninety-eight respondents indicated that they were "unable" or "uncertain" whether they could accept kidney xenotransplantation (χ²=16.409, P=0.001). Among these 698 respondents, the proportion of them who were willing to accept kidney xenotransplantation when they did not meet the conditions of allogeneic kidney transplantation was 10.9%. About 35.8% of respondents were willing to accept kidney xenotransplantation if it yielded less risk and better prognosis compared with allogeneic kidney transplantation. If the time of awaiting kidney xenotransplantation was shorter than that of allogeneic kidney transplantation, 21.2% were willing to accept kidney xenotransplantation. If the cost of kidney xenotransplantation was less than that of allogeneic kidney transplantation, 24.5% of them were willing to accept kidney xenotransplantation. The main reasons of rejecting kidney xenotransplantation included surgical risk and other unknown risks. Multivariate analysis showed that respondents residing in cities and towns for a long period of time, those who accept allogeneic kidney transplantation and those who have heard of kidney xenotransplantation showed more positive attitudes towards kidney xenotransplantation. Conclusions Different transplantation-related populations have different attitudes towards kidney xenotransplantation, and the overall attitudes are positive. Active promotion of kidney xenotransplantation research and carrying out relevant popular science education contribute to improving public attitudes towards the acceptance of kidney xenotransplantation.
- Xenotransplantation /
- Kidney transplantation /
- Organ donation /
- Organ shortage /
- Patient’s relatives /
- Medical student /
- Attitude /
- End stage renal disease

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图 1 受访者不能接受异种肾移植原因

Figure 1. Reasons why respondents cannot accept kidney xenotransplantation

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表 1 受访者对异种肾移植的态度

Table 1. Respondents' attitudes towards kidney xenotransplantation[n (%)]

项目	术前患者（n=187）	术后患者（n=151）	患者家属（n=196）	医学生（n=164）	χ²值	P值
不符合同种异体肾移植条件，您能接受异种肾移植吗?
能	17（9.1）	12（8.0）	15（7.7）	32（19.5）	16.347	0.001
不能/不确定	170（90.9）	139（92.0）	181（92.3）	132（80.5）
异种肾移植有着更小的风险及更好的预后，您能接受异种肾移植吗?
能	57（30.5）	61（40.4）	64（32.7）	68（41.5）	6.822	0.078
不能/不确定	130（69.5）	90（59.6）	132（67.3）	96（58.5）
异种肾移植等待时间更短，您能接受异种肾移植吗?
能	47（25.1）	32（21.2）	51（26.0）	18（11.0）	14.719	0.002
不能/不确定	140（74.9）	119（78.8）	145（74.0）	146（89.0）
异种肾移植花费更少，能接受异种肾移植吗?
能	58（31.0）	34（22.5）	55（28.1）	24（14.6）	14.588	0.002
不能/不确定	129（69.0）	117（77.5）	141（71.9）	140（85.4）

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表 2 受访者对异种肾移植态度的影响因素单因素分析

Table 2. Univariate analysis of influencing factors of respondents' attitudes towards kidney xenotransplantation [n (%)]

变量	接受（n=795）	不接受（n=698）	χ²值	P值
性别
男	452（56.9）	408（58.5）	0.388	0.533
女	343（43.1）	290（41.5）
年龄
18~29岁	335（42.1）	237（34.0）	19.276	0.001
30~39岁	154（19.4）	120（17.2）
40~49岁	168（21.1）	183（26.2）
50~59岁	96（12.1）	96（13.7）
>60岁	42（5.3）	62（8.9）
婚姻状况
未婚	343（43.1）	289（41.4）	5.695	0.058
已婚	419（52.7）	356（51.0）
离异及其他	33（4.2）	53（7.6）
有无子女
有	402（50.6）	355（50.9）	0.031	0.910
无	393（49.4）	343（49.1）
长期居住地
城镇	539（67.8）	412（59.0）	12.371	<0.001
农村	256（32.2）	286（41.0）
宗教信仰
有	89（11.2）	75（10.7）	0.077	0.781
无	706（88.8）	623（89.3）
教育程度
高中及以下	332（41.8）	376（53.9）	21.885	<0.001
大专或本科	449（56.4）	313（44.8）
硕士及以上	14（1.8）	9（1.3）
家庭人均月收入
< 5 000元	448（56.4）	434（62.2）	5.706	0.058
5 000~10 000元	256（32.2）	193（27.6）
>10 000元	91（11.4）	71（10.2）
直系亲属中有无从医人员
有	145（18.2）	102（14.6）	3.539	0.060
无	650（81.8）	596（85.4）
是否能接受同种异体肾移植
能	773（97.2）	617（88.4）	45.193	<0.001
不能/不确定	22（2.8）	81（11.6）
是否知晓异种肾移植
比较了解/知道一点	617（77.7）	380（54.4）	89.932	<0.001
没听说过	178（22.3）	318（45.6）

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表 3 受访者对异种肾移植接受度的多因素logistic回归分析结果

Table 3. Multivariate logistic regression analysis of respondents' acceptance of xenograft kidney transplantation

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
长期居住地为城镇	0.401	0.119	5.427	0.001	1.493	1.182~1.886
教育程度
高中及以下			1.660	0.436
大专或本科	0.145	0.128	1.280	0.258	1.156	0.899~1.487
硕士及以上	0.338	0.447	0.572	0.449	1.402	0.584~3.366
年龄
18~29岁			8.430	0.077
30~39岁	0.004	0.166	0.001	0.982	1.004	0.725~1.390
40~49岁	−0.377	0.158	5.713	0.017	0.686	0.504~0.934
50~59岁	−0.121	0.193	0.391	0.532	0.886	0.607~1.294
>60岁	−0.407	0.248	2.691	0.101	0.666	0.409~1.083
能接受同种异体肾移植	1.364	0.255	28.648	<0.001	3.912	2.374~6.447
知晓异种肾移植	0.948	0.120	62.083	<0.001	2.580	2.038~3.266

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