Xenotransplantation: The Challenge to Current Psychosocial Attitudes

Abstract

Because of the limited availability of transplantable human organs, xenotransplantation, the use of animal organs as an alternative source, has received considerable attention in recent years. Xenotransplantation would provide an unlimited supply of organs, and these organs would be available whenever required. Although the pig is considered the best source for organs, significant immunologic barriers currently prohibit the implementation of a clinical trial of organ transplantation. However, as medical research gains more insight into the mechanisms underlying rejection of pig organs in primates, therapeutic xenotransplantation is becoming more feasible. Clinical trials of porcine cell transplants are currently underway. Although xenotransplantation will minimize the waiting period for an organ and obviate the feelings of guilt or indebtedness commonly experienced by recipients of human organs, several psychosocial issues may hinder the reintegration of patients into society. For example, concerns that infectious pathogens could be transferred to recipients of pig organs will necessitate life-long monitoring and perhaps even temporary isolation of patients. The possible risk of the spread of a xenozoonosis from the patient to other members of the community may inspire public controversy and even fear, which may have an adverse impact on the patient's emotional state. Additionally, some patients may be psychologically disturbed by the need to incorporate pig organs into their body. This article addresses these and other psychosocial issues that may be associated with clinical xenotransplantation.

Understanding of and attitude to xenotransplantation among Italian university students: impact of a 3‐yr university course

“…Xenotransplantation may represent an alternative to the use of human or artificial organs for patients with end-stage organ disease and no other effective therapeutic options, in order to balance the progressive increase in demand for organs and consequent deaths on the waiting list. Recent scientific advances, mainly concerning immunological and genetic improvements [4,16], suggest that xenotransplantation could become a practicable therapeutic option in the near future, although the risk of cross-species transmission of animal infectious agents into xenograft recipients could probably raise public concern [6, [16][17][18][19].…”

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

“…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]. In addition, xenotransplants raise specific concern about what is natural and unnatural, about the use of animals in biomedical research and genetic manipulation [11,32,33].…”

Attitudes to Cardiac Xenotransplantation by Pediatric Heart Surgeons and Physicians

“…Several recent advances in XTx research, particularly those associated with genetic engineering of the organ source pig, may be particularly applicable in the neonatal population whose immune system is immature. 4 While most work in XTx has been focused on its scientific and ethical aspects, 5,6 to our knowledge, no known studies have addressed the attitudes to XTx among surgeons/physicians who care for patients in need of cardiac transplantation. Physician engagement is particularly important, as their support for a particular procedure is crucial to patients’ medical decision-making and care.…”