Attitudes toward pig islet xenotransplantation for type 1 diabetes: a scoping review

Background: Over 8 million people globally have type 1 diabetes. Islet allotransplantation offers an alternative to insulin therapy but is constrained by donor availability. Genetically modified pig islet transplantation presents a potential solution, yet understanding stakeholder attitudes is crucial before clinical adoption. Methods: This scoping review followed Joanna Briggs Institute methodology and PRISMA guidelines. CINAHL, EMBASE, PubMed, PsychINFO, and SCOPUS were searched for studies examining attitudes toward pig islet xenotransplantation among patients, healthcare workers, and other stakeholders. Results: From 199 sources, 16 met eligibility criteria, spanning ten countries from 2003 to 2023. The 23,780 participants included 1,535 (6.5%) patients/family members, 216 (0.9%) healthcare workers, and 22,029 (92.6%) students. Attitudes were generally positive but declined sharply in some studies when risks, such as viral transmission, were disclosed. Conclusion: Despite overall positive attitudes, risk perception significantly influences acceptance of islet xenotransplantation. The predominance of quantitative research highlights a need for qualitative studies and validated survey instruments to enhance understanding and comparability of stakeholder perspectives.