“Xenotransplantation challenges us as a society”

Heart transplantation is the only long-lasting lifesaving option for patients with terminal cardiac failure. The number of available human organs is however far below the actual need, resulting in substantial mortality of patients while waiting for a human heart. Mechanical assist devices are used to support cardiac function but are associated with a high risk of severe complications and poor quality of life for the patients. Consistent success in orthotopic transplantation of genetically modified pig hearts into baboons indicates that cardiac xenotransplantation may become a clinically applicable option for heart failure patients who cannot get a human heart transplant. In this overview, we project potential paths to clinical cardiac xenotransplantation, including the choice of genetically modified source pigs; associated requirements of microbiological, including virological, safety; optimized matching of source pig and recipient; and specific treatments of the donor heart after explantation and of the recipients. Moreover, selection of patients and the regulatory framework will be discussed.

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“…and ethically justifiable procedures. 141 The pillars in the regulation of xenogeneic heart transplantation are summarized in Figure 6.…”

Section: Regulatory Challengesmentioning

confidence: 99%

“…A recent citizens’ conference concluded that the benefits of xenotransplantation outweigh the risks, but strict regulatory measures are required to ensure the development of sustainable and ethically justifiable procedures. 141 The pillars in the regulation of xenogeneic heart transplantation are summarized in Figure 6.…”

Section: Regulatory Challengesmentioning

confidence: 99%

Pathways to Clinical Cardiac Xenotransplantation

Reichart¹,

Längin

Denner

et al. 2021

Transplantation

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“… 159 , 160 Recent polls in the United States have determined that the general public has an overall positive view towards xenotransplantation. 161 The complex ethical and moral profile surrounding the technology remains an omnipresent concern. There is, however, a growing realization that xenotransplantation could provide critical help to those individuals with life-threatening conditions.…”

Section: Discussionmentioning

confidence: 99%

Chimeric Livers: Interspecies Blastocyst Complementation and Xenotransplantation for End-Stage Liver Disease

Blake,

Steer

2024

HMER

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Orthotopic liver transplantation (OLT) currently serves as the sole definitive treatment for thousands of patients suffering from end-stage liver disease; and the existing supply of donor livers for OLT is drastically outpaced by the increasing demand. To alleviate this significant gap in treatment, several experimental approaches have been devised with the aim of either offering interim support to patients waiting on the transplant list or bioengineering complete livers for OLT by infusing them with fresh hepatic cells. Recently, interspecies blastocyst complementation has emerged as a promising method for generating complete organs in utero over a short timeframe. When coupled with gene editing technology, it has brought about a potentially revolutionary transformation in regenerative medicine. Blastocyst complementation harbors notable potential for generating complete human livers in large animals, which could be used for xenotransplantation in humans, addressing the scarcity of livers for OLT. Nevertheless, substantial experimental and ethical challenges still need to be overcome to produce human livers in larger domestic animals like pigs. This review compiles the current understanding of interspecies blastocyst complementation and outlines future possibilities for liver xenotransplantation in humans.

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“…Johnson points to the importance of xenotransplantation if this procedure could be used as a reaction to the organ-shortage [ 78 ]. Kögel and Marckmann, on the other hand, suggest that the use of animal organs in the human body might not change our conception of humanity, but it might influence the human-animal relationship [ 69 ]. Entwistle, Sade, and Drake also focus on the ethical issues surrounding these biomedical interventions, such as animal welfare, assessment of risks, access, financial requirements, or regulatory oversight institutions [ 81 ].…”

Section: Persons With Ad and Special Considerationsmentioning

confidence: 99%

Ethical Aspects of Human Induced Pluripotent Stem Cells and Alzheimer’s Disease: Potentials and Challenges of a Seemingly Harmless Method

Kropf

2023

ADR

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Dementia currently affects more than 55 million people worldwide, and scientists predict that this number will continue to rise. The most common form is Alzheimer’s disease (AD), which is triggered, among other things, by dysfunctional cells in the human brain. Stem cell research attempts to counteract neurodegenerative processes, for example by replacing or treating diseased cells. In addition to human embryonic stem cells, since the successes of Takahashi and Yamanaka in 2006, there has been an increased focus on human induced pluripotent stem cells (hiPS cells). These cells avoid ethically challenging questions about the moral status of human embryos, but there are numerous problems, such as high production costs, side effects from the reprogramming process, or a potentially new moral status. These ethical issues will be examined primarily in relation to AD. The first part will be a discussion of hiPS cells and their importance for stem cell research, after which the focus turns to AD. Based on scientific studies, the relationship between hiPS cells and AD will be outlined as well as ethical implications presented. While potential limitations of hiPS cells have been discussed by numerous authors, an ethical perspective on the link between hiPS cells and AD seems to be neglected in the scientific community. The following risk analysis aims to identify a possible research agenda. In conclusion, the focus on individuals with AD may help to adopt an ethical stance that recognizes existing limitations and constructively engages with the possibilities of research.

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“Xenotransplantation challenges us as a society”

Abstract: A citizen's conference on xenotransplantation delivers a cautious ‘Yes, but…’ endorsement. It also shows how additional knowledge and debate shifted peoples’ opinion on this technology.

Cited by 15 publications

References 5 publications

Pathways to Clinical Cardiac Xenotransplantation

Pathways to Clinical Cardiac Xenotransplantation

Chimeric Livers: Interspecies Blastocyst Complementation and Xenotransplantation for End-Stage Liver Disease

Ethical Aspects of Human Induced Pluripotent Stem Cells and Alzheimer’s Disease: Potentials and Challenges of a Seemingly Harmless Method

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