Work

Public perception of facial vascularized composite allotransplants-insights from a cross-sectional survey of healthy individuals in the USA

Year: 2025

Type: article

Abstract: Background: Facial vascularized composite allotransplantation (fVCA) is an advanced reconstructive procedure for extensive facial defects. While clinical outcomes have improved, public perceptions remain underexplored. Gaining insights into societal attitudes is crucial for patient education, informed decision-making, and guiding future research. Methods: A cross-sectional survey was conducted among 100 volunteers from the United States via the Prolific platform. The study population reflected the demographic distribution of the general population. The survey assessed awareness, willingness to undergo fVCA, decision-making factors, and ethical concerns. Responses were collected through Likert scales, multiple-choice questions, and aesthetic evaluations of post-transplant outcomes. Results: Fifty-eight percent of participants had never heard of fVCA, with social media being the most common source of information (50 %) for those who had. Eighty-seven percent were potentially open to undergoing fVCA in case of an accident, although concerns about graft rejection risks (65 %) and lifelong immunosuppression (65 %) influenced decision-making. Functionality was prioritized over aesthetics by 51 % of respondents, yet 72 % preferred donor-recipient matching based on age, gender, and ethnicity. Psychological adaptation was a major concern for 51 %, with 82 % emphasizing the importance of pre- and postoperative psychological counseling. Ethical concerns included donor consent (61 %) and fairness in allocation (69 %). Respondents rated photographs of postoperative aesthetic outcomes with a mean score of 7.9 out of 10. Conclusion: While public perception of fVCA is generally positive, concerns regarding rejection, immunosuppression, and psychological adaptation remain significant. Increased education, ethical transparency, and advancements in immunosuppressive strategies are needed to enhance acceptance and feasibility. Future research should explore novel immunosuppressants and psychological programs to improve long-term concerns.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2025.11.015