Human or not? An Experimental Investigation of Xenotransplantation Acceptability Across Donation Contexts

Background: Xenotransplantation (XT) has recently been promoted as a potential solution to the organ shortage. While public attitudes toward XT have received increasing attention, little is known about people's XT attitudes when contextualised within the existing human organ supply (deceased, living and research), and whether XT influences preferences regarding human organ donation.
Methods: This study examines (i) how donation context shapes XT attitudes, (ii) whether framing XT as an alternative acts as a decoy to increase support for human organ donation, and (iii) ethnic differences in XT attitudes in the UK. An online experiment (N=3,142: 1,633 White, 600 Asian, 555 Black, 354 Mixed) employed a 3 (donation focus: deceased organ donation, living organ donation, or donating tissue for research) by 2 (XT decoy nudge: present, absent) between-subjects design.
Results: Those exposed to the living donation condition and the XT-decoy were more likely to find XT morally justifiable and say that their trust in the NHS would not decline if pig organs were used as transplants. The XT-decoy did not influence support for human organ donation. UK Ethnic minorities strongly oppose XT but showed support for the NHS doing more to encourage human organ donation, particularly the Black community.
Conclusion: These findings show, for the first time, that presenting XT with living donation increased support for XT and reduced concerns that NHS trust would fall if XT were introduced. This has implications for future XT communications and underscores the need for public consultations tailored to ethnic minorities in the UK.