Xenotransplantation. 2018;e12430. wileyonlinelibrary.com/journal/xen | 1 of 10 https://doi.org/10.1111/xen.12430 © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. 1 | INTRODUCTION Transplantation medicine is one of the most challenging and complex areas of modern medicine yet holds great promise regarding the po- tential cure of human diseases. Organ and tissue transplantation has many advantages; it saves lives and restores critical functions to un- treatable patients. The process involves the transfer of an organ or tissue, also known as a graft, from one body (the donor) to another (the patient’s own body) to replace the recipient’s damaged organ. Currently, there are at least four types of organ transplant. These include allotransplant (between two genetically different members of the same species), isotransplant (between members of the same species that are genetically identical, such as twins), autotransplant (transplant from one part of a person’s body to another) and xeno- transplant. 1 The first three types of organ transplant occur within the same species and thus are also known as allografts. However, the Received: 27 February 2018 | Revised: 30 April 2018 | Accepted: 24 May 2018 DOI: 10.1111/xen.12430 ORIGINAL ARTICLE Determinants of stakeholders’ attitudes to xenotransplantation Latifah Amin 1 | Hasrizul Hashim 1 | Zurina Mahadi 1 | Anisah Che Ngah 2 | Khaidzir Ismail 1,3 1 Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia 2 Faculty of Law, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia 3 Faculty of Social Science and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia Correspondence Latifah Amin, Pusat Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia. Email: nilam@ukm.edu.my Funding information Universiti Kebangsaan Malaysia, Grant/ Award Number: DCP-2017-005/2 Abstract Background: Advances in xenotransplantation have the potential to resolve the issue of organ shortages. Despite this, the procedure is expected to meet with a degree of resistance from the public. The purpose of this study was to identify the relevant factors influencing stakeholders’ attitudes towards xenotransplantation. Methods: A multidimensional survey instrument measuring attitudes to xenotrans- plantation, including the factors that predict such attitudes, was developed based on earlier studies and validated. It was then completed by 469 respondents who were stratified in accordance with stakeholder groups in Malaysia. A single-step SEM anal- ysis was then conducted to estimate the measurement and create a structural model using IBM SPSS Amos version 20 with a maximum-likelihood function. Results: The attitudes of Malaysian stakeholders towards xenotransplantation were moderately positive (mean score of 4.20). The most important direct predictor of at- titude to xenotransplantation was perceived benefit (β = 0.59, P < .001) followed by perceived moral concern (β = −0.32, P < .001). Perceived risk had a strong positive association with moral concern (β = 0.65, P < .001), while attitude to nature had a positive association with perceived benefit (β = 0.16, P < .01) and a negative associa- tion with perceived risk (β = −0.19, P < .01). Religiosity had a positive relationship with perceived risk (β = 0.13, P < .05) while engagement with biotechnology had a positive relationship with perceived benefits (β = 0.26, P < .001) and a negative as- sociation with risks (β = −0.15, P < .05) and moral issues (β = −0.11, P < .05). Conclusion: The Malaysian stakeholders were cautious about xenotransplantation. This study showed that their views regarding the application are complex and multifaceted. KEYWORDS attitudes, Malaysia, moral concern, perceived benefits, predictors, xenotransplantation