Xenotransplantation involves the transplantation of cells, tissues, and whole organs from one species to another. Interest in animal-to-human xenotransplants has been spurred by the continuing shortage of donated human organs and by advances in knowledge concerning the biology of organ and tissue rejection. The scientific advances and promise, however, raise complex questions that must be addressed. This book considers the scientific and medical feasibility of xenotransplantation and explores the ethical and public policy issues surrounding the possibility of renewed clinical trials. The volume focuses on the science base of xenotransplantation, public health risks of infectious disease transmission, and ethical and public policy issues, including the views of patients and their families.
This title provides an illuminating examination of the current state of xenotransplantation – grafting or transplanting organs or tissues between members of different species – and how it might move forward into the clinic. To be sure, this is a critical topic, as a major problem that remains worldwide is an inadequate supply of organs from deceased human donors, severely limiting the number of organ transplants that can be performed each year. Based on presentations given at a major conference on xenotransplantation, this title includes important views from many leading experts who were invited to present their data and opinions on how xenotransplantation can advance into the clinic. Attention was concentrated on pig kidney and heart transplantation as it is in regard to these organs that most progress has been made. Collectively, these chapters effectively highlight the many advantages of xenotransplantation to patients with end-stage organ failure, thereby encouraging the mapping of a concrete pathway to clinical xenotransplantation. The book is organized across 22 chapters, beginning with background information on clinical and experimental xenotransplantation. Following this are discussions addressing how pigs can be genetically engineered for their organs to be resistant to the human immune response through deletion of pig xenoantigens, and the insertion of ‘protective’ human transgenes. Subsequent chapters analyze complications that arise in practice, comparing allotransplant and xenotransplant rejection. The selection of the ideal patients for the first clinical trials is discussed. Finally, the book concludes with an analysis on the regulatory, economic, and social aspects of this research, including FDA perspectives and the sensitive, psychosocial factors regarding allotransplantation and xenotransplantation. A major and timely addition to the literature, Clinical Xenotransplantation will be of great interest to all researchers, physicians, and academics from other disciplines with an interest in xenotransplantation.
With profound implications for human health and longevity, "Xeno" is a fascinating exploration of the medical, ethical, legal, and social issues surrounding the future of organ transplantation. 17 halftones. Line illustrations.
Some developing biotechnologies challenge accepted legal and ethical norms because of the risks they pose. Xenotransplantation (cross-species transplantation) may prolong life but may also harm the xeno-recipient and the public due to its potential to transmit infectious diseases. These trans-boundary diseases emphasise the global nature of advances in health care and highlight the difficulties of identifying, monitoring and regulating such risks and thereby protecting individual and public health. Xenotransplantation raises questions about how uncertainty and risk are understood and accepted, and exposes tensions between private benefit and public health. Where public health is at risk, a precautionary approach informed by the harm principle supports prioritising the latter, but the issues raised by genetically engineered solid organ xenotransplants have not, as yet, been sufficiently discussed. This must occur prior to their clinical introduction because of the necessary changes to accepted norms which are needed to appropriately safeguard individual and public health.
Originally published in 2005. One of the leading causes of death is organ failure, that is, when one or other of the organs that run the machine we call the body gives out. However, whereas with a machine spare parts can usually replace faulty parts, in the case of humans the supply of these is limited as it is dependent on organs being obtained from living or dead donors. Due to the limitations of supply, increasing attention is being paid to alternative schemes for obtaining organs. One of these possibilities is xenotransplantation: using organs from animals. In this book, the authors examine the legal and ethical issues surrounding xenotransplantation and consider the implications for the future. As they point out, xenotransplantation represents a major deviation from standard medical practice and the possibility of transplantation of large segments of tissue, or whole organs, from animals into humans poses an entirely novel set of considerations - ethical, legal and scientific - which it is necessary to evaluate and understand.
Recently, remarkable progress has been made in the area of preclinical xenotransplantation experiments. Surprisingly, a heterotopic heart from the gene-editing pig continued to beat for almost 2.5 years, when implanted in the monkey abdomen, and a pig life-supporting kidney could also function for over 1.3 years in monkeys. Concerning islets, islets from gene-editing pigs could work for more than one year in monkeys. It is noteworthy that one group reported a survival of adult wild-type pig islets of over 600 days. On the other hand, the progress in these preclinical trials strongly affected not only the xenotransplantation study itself but regeneration studies to use pigs as a scaffold to foster human induced pluripotent stem cells.
It is like a fairy story! Or at least a beautiful epic, a truly significant page in the history of medicine, a staggering scene in which several actors come into play, both fundamentalists and clinical practitioners, eager to place all these new developments at the disposal of those suffering from ill health. Everyone is passionate about their work, be it providing new knowledge or perfecting new therapeutic methods. Man has always been fascinated by the possibility of replacing a damaged organ with a healthy one. Several attempts have been made over the centuries, and some miracles have been reported, such as those of Saint Damien and Saint Come as illustrated by Fra Angelico. The modern saga, however, started more modestly on the mouse. It is on the mouse that the first tissue group was discovered; yet the study of human tissue groups could only be carried out on a human. One human must be subjected to the thousands of tests that have enabled us to unravel the extraordinary complexity of the HLA system.
Xenotransplantation involves the transplantation of cells, tissues, and whole organs from one species to another. Interest in animal-to-human xenotransplants has been spurred by the continuing shortage of donated human organs and by advances in knowledge concerning the biology of organ and tissue rejection. The scientific advances and promise, however, raise complex questions that must be addressed. This book considers the scientific and medical feasibility of xenotransplantation and explores the ethical and public policy issues surrounding the possibility of renewed clinical trials. The volume focuses on the science base of xenotransplantation, public health risks of infectious disease transmission, and ethical and public policy issues, including the views of patients and their families.
This title was first published in 2003. Xenotransplantation - the transplantation of animal organs into humans - poses a fascinating moral dilemma. Should this ability to extend the lives of millions of older people be permitted given that it might trigger a new pandemic similar to AIDS? This study examines the moral dilemma from a combination of humanistic, legalistic, bioethical, economical and technological perspectives. The first part of the book demonstrates that xenografts are the only realistic near-term technological answer to the organ shortage problem. The balance of the book is devoted to assessing whether doctrines such as the 'right to health care' trump the moral and ethical conundrums posed by xenotransplantation. The book concludes with a 'geoethical' solution that proposes authorization of xenotransplantation subject to the prior implementation of a new international organization for epidemiology and basic health care. It also suggests that the costs of operating such an organization could be covered by a global tax on xenografts.
