Xenotransplantation: Perspectives and Limits

Abstract

Xenotransplantation faces the dilemma of an unlimited supply of cells, tissues and organs on the one hand and severe obstacles and limits on the other. One reason for the limitations is that the source animal of choice, the pig, and the human recipient separated 90 million years ago during evolution, a time in which biological characteristics such as anatomy, physiology and immunology have had much time to drift far apart. The acceptance of such an evolutionary widely divergent organ, especially the heart of a pig, could evoke refusal of xenotransplantation in conservative and religious patients. New legal aspects of allocation of xenografts have therefore to be reflected upon and appropriate guidelines developed. Inquiries show, however, that the acceptance of all types of porcine organs would be high if the quality of life after receiving such a xenograft is comparable to that after receiving the same allograft. This individual benefit of a xenograft could lead to a disregard of the collective risk in terms of xenozoonoses, often presented as a catastrophic scenarium. Therefore, transplantation societies and ethics committees have published comments and even guidelines for handling future clinical xenotransplantation. All three monotheistic religions and Hinduism support the idea of saving and improving human life with the help of an animal organ.

Understanding of and attitudes to xenotransplantation: a survey among Italian university students

“…The general attitude of people involved in xenotransplantation and xenotransplantation research is positive, and they foresee a future in which animals will routinely provide organs for humans [24]. Although the perceived scientific aim is to reduce suffering and improve human health worldwide, xenotransplantation raises important issues regarding its acceptability for both biomedical and ethical reasons [13–15]. Advances are being made in the development of strategies to deal with the physiological and immunological problems involved [8,9], but the risk of zoonotic infections in xenotransplant recipients and their spread to the population at large is emerging as a public health issue [10,11,29–31].…”

“…The development of this biomedical technology demands careful consideration and monitoring, however, and many problems still have to be solved in biomedical and immunological fields, as cross‐species rejection [8,9] and the risk of zoonotic infections in xenotransplant recipients [10–12]. Moreover, the use of xenogenic tissues in transplantation is a topic prompting wide‐ranging ethical concerns and controversy as to its acceptability [13–15].…”