A LOOK AT XENOTRANSPLANTATION

A LOOK AT XENOTRANSPLANTATION
End-stage organ failure is one of the most highly publicized, controversial public health issues facing the industrialized world today. There is a worldwide shortage of organs for clinical transplantation and sadly, many patients who are listed to receive new organs die while waiting.
Xenotransplantation is the transplantation of organs, tissues or cells between different animal species including humans. There have been advances in understanding the mechanisms of organ transplant rejection. Such discoveries have allowed for reasonable consideration to the usage of organs from other species, such as pigs, specifically engineered to minimize the risk of serious rejection. Also, the use of pig tissue as an alternative to human tissues will eliminate human organ shortages. Other procedures, some of which are being investigated in early clinical trials, aim to use cells or tissues from other species to treat life-threatening illnesses such as cancer, AIDS, diabetes, liver failure and Parkinson's disease.
Xenotransplantation, however, raises many novel medical, legal and ethical issues. Medical concerns partly center on organ rejection, but also include the possible risk of infection. Organisms in host animals may be transferrable to humans and crossover of disease from species to species will therefore be a risk. The effects of xenotransplantation on the human gene pool and possible long-term genetic problems offer a note of caution. Equally, any permanent alteration to the genetic code of animals is a cause for concern.
Should we develop technologies which would allow us to use the organs of other animals in human beings? There are arguments both for and against, but most people really aren't very aware of them. This is unfortunate, because the time when it will be possible to perform such transplants is fast approaching. The first xenotransplants were failures, but things are changing, and usage will be radically increased before we know and we need to be equipped to handle the debate.
There are very good reasons for seriously considering the idea of using organs from other animals. The biggest of these is the fact that almost all of the major problems involved with human-to-human transplants would be eliminated. We wouldn't need to wait until a person is nearly dead before doing a transplant.The surgery could be done earlier when the patient is healthier and has a better chance of surviving. We also would not need to wait until another person has died to find an organ, meaning we don't need to debate when someone has "really" died and when to remove their organs. Also, the transplanted organs do not have to travel several hours from person to person which means that they will be fresher and healthier. The quality of the organs would also be better. In addition, organs will be more plentiful, eliminating concerns about availability and even eliminating some of the cost. Organs for infants would become available, saving even more human lives. These considerations have room for debate and promote continuing dialogue on the ethical, moral, and economic benefits.
Given all of these benefits, is it a realistic possibility to use the organs from other animals. There have been attempts to use primate organs, but those haven't worked as well. One would think that primate organs would be the best candidates, and for a number of different reasons that might be true. However, primates are difficult, time consuming, and costly to rise. Moreover, being primates, people are uncomfortable with killing them for organs. The same is not true of pigs. Pigs breed quickly, grow quickly, and are already consumed for food in large quantities. Moreover, their physiology is close to human physiology, thus they are among the best candidates for non-human organs in large quantities and good quality. The are some health issue related to xenotransplantation of pigs. Such concerns are the transmission of many viruses that humans do not have at this point but can acquire via transplants of the pig animal organs. Consequences may include infections such as influenza, bacterial infections and retroviruses carried naturally by pigs. Here another ethical and medical question rises, “Could it mutate into something which is not neutral, as with pigs, but which is instead harmful?” Yes, that is a possibility.
We just don't know what will happen. We can't. So what do we do? We could save hundreds of thousands of lives if we are able to use pig organs in xenotransplants. We could kill millions the same way, however. How do we weigh the risks? How do we balance the interests of those who would be saved against those who might die? These questions and more create the ethical dilemma in using xenotransplantation. Until we have a consensus with the general public and the scientific world, the use of xenotransplantation will be placed on hold.

Ethics and law
February, 2008