The New Chimaera: The Industrialization of Organ Transplantation

Abstract

Clinical organ transplantation has evolved through advances in patient care in parallel with investigations in associated biologies. It has developed from a cottage industry to an important medical specialty driven increasingly by the availability of newer and more effective immunosuppressive drugs, and dependent on consistently close collaborations between university-based clinical scientists and the pharmaceutical industry. Particularly during the past decade, however, this industry has undergone striking changes, consolidating into huge multi-national corporations, each competing for patients, their doctors, and for support of the allied hospitals. Because of the growth of "Big Pharma," the relationship between academia and industry has changed. There have been many advantages to such mutually dependent interactions. A combination of university-based expertise and the specialized knowledge and resources of industry have produced important scientific gains in drug development. Commercial sponsorship of applied research has been crucial. The orchestration of multicenter controlled clinical drug trials has provided invaluable information about the effectiveness of newer agents. But there are also disadvantages of increasing concern. Indeed, the power of "Big Pharma" in many medical fields including transplantation is such that presentation of data can be delayed, adverse results withheld, and individual investigations hampered. Clinical trials may be protracted to stifle competition. Monetary considerations may transcend common sense. Several measures to enhance the clinical relationship between the pharmaceutical industry and those involved with organ transplantation are suggested, particularly the use of third party advisors in the production of clinical trials, support for more basic research and in the dissemination of results. In this way, the increasingly problematic phenomenon of commercialization of the field of transplantation can be tempered and controlled.

Patterning the geographies of organ transplantation: corporeality, generosity and justice

“…The extension of organ transplantation has also led to organ shortages and the future of organ transplantation is increasingly framed in terms of crisis: a mismatch between the increasing numbers eligible for transplantation as technologies improve and populations age, whilst rates of organ donation remain static or decline 2 . Discussions of organ scarcity raise further questions of interest to social scientists: the growing commodification of human body parts (Joralemon 1995; Scheper‐Hughes 2000; Sharp 2000; Tilney et al 2001; Lock 2002b) and the acceptability of new sources to address this shortfall, for example, through the use of animal organs (Woods 1998; Brown 1999; Einsiedel 2002; Davies et al 2003). All raise profound political and ethical questions over who donates bodily material, who receives it and how these decisions get made (Parry 2004; Waldby and Mitchell 2006).…”