Ethical Issues of Xenotransplantation

SCEINCE & TECH/ ETHICS

• GS-3: Science and Technology- developments and their applications and effects in everyday life.
• GS-4: Ethics (Case studies)

Ethical Issues of Xenotransplantation

Xenotransplantation or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another.

• It involves the transplantation of nonhuman tissues or organs into human recipients.

History of Xenotransplantation

• The dream of animal-to-human transplants goes back to the 17th century, with stumbling attempts to use animal blood for transfusions. Early kidney and liver transplants were attempted from baboons and chimpanzees as these primates were considered closest to humans.
• By the 20th century, surgeons were attempting transplants of organs from baboons into humans. Over the last several decades experts have found it difficult to surmount the challenge presented by the immune system’s rejection of an alien organ, ending in deadly outcomes for patients.
• In the early 1960s, a surgeon Keith Reemtsma in New Orleans performed 13 chimpanzees-to-human kidney transplants. One of the recipients, a schoolteacher, lived for 90 days. However, most of these transplants failed and were gradually given up.

Recent Examples of Xenotransplantation

• In September 2021, at New York Hospital, a medical team attached a kidney from a gene-edited pig to a person declared brain dead to see if the animal kidney was able to do the job of processing waste and producing urine. It did. 
  • In the United States there are apparently 90,000 persons waiting for a kidney transplant and this successful experiment would go some way towards meeting that need.
• In January, 2022, is from the University of Maryland where a team of doctors used the heart of an animal, which had genetically modified features, as a replacement heart on a patient who had run out of available options
  • The earlier attempts of animal-to-human heart transplants have failed, largely because patients’ bodies rapidly rejected the animal organs. The most notable example was that of American infant Baby Fae, a dying infant in 1984 who lived 21 days with a baboon heart.
  • This time, the surgeons used a heart from a pig that had undergone gene editing to remove sugar in its cells that’s responsible for the hyper-fast rejection of organs.
• The third case is the news report that a doctor in Germany, who has been working in the area of xenotransplants, plans to develop a farm to cultivate genetically modified organs for such transplants
  • In his view, this will ease the pressure on the medical system. In Germany alone there are 8,500 patients waiting for organ transplants.

What are the ethical issues that these medical advances raise for human societies?

1. Medical Implications

• Even well-matched human donor organs can be rejected after they are transplanted – and with animal organs the danger is likely to be higher.
• While such treatments are very, very risky, some medical ethicists say they should still go ahead if the patient knows the risks.
• Some argue that before any surgery, the procedure must have undergone “very rigorous tissue and non-human animal testing” to make sure it’s safe.

2. Animal Rights

• The animal rights movement has objected to these advances in medical science, of xenotransplantation, because it ignores the rights of animals. They argue that animals also have rights and it is our moral responsibility to support these rights. 
• Such medical advances stems from a philosophy of anthropocentrism which places human beings at the centre of nature and regards all other living creatures as having only value if they can be of use to humans. Such anthropocentric thinking has been the basis of the ecological crises of climate change. 
• The animal rights perspective places on us the classic utilitarian dilemma of whether it is better to kill an animal and save a human being or to save an animal and let the human die. 
• People for the Ethical Treatment of Animals (PETA) has condemned pig heart transplant as “unethical, dangerous, and a tremendous waste of resources”. Campaigners say it is wrong to modify the genes of animals to make them more like humans. 

3. Religion

• Pigs are chosen as the relevant organs are a similar size to humans’ – and because pigs are relatively easy to breed and raise in captivity.
• However, in certain societies pig is considered a dirty animal, eating pork is considered disgusting and those who deal with pigs are given low social status. 
• Transplanting from pigs may affect Jewish or Muslim or Jain or Vegetarian patients, whose religions have strict rules on the animal. Their belief system may forbid them to have anything to do with a pig.

Conclusion

The wide adoption of xenotransplant procedures diminish the illegal and immoral market in human organs, where people, even children, are abducted so that their organs can be harvested. Therefore, we need to have more debate on this field so that the advances in medical sciences benefits humankind.

Connecting the dots:

• Synthetic Biology & Biosecurity
• Universal Bio-deterrence