The Risks of Xenotransplantation and Ethical Concerns

As a world with a continually growing population, the organ shortage is coming to the forefront of debates. According to the U.S Department of Health & Human Services, there were over 113,000 people on the organ waiting list just in January of 2019. Along with that, 20 people die everyday while on the waiting list (Organ Donation Statistics, 2019). Those numbers continue to grow as each day passes. To try and combat this problem, scientists are researching different alternatives to find the most effective solution. Specifically, xenotransplantation, or the transplantation of organs between species, has been the center of many research studies. Some scientists argue that, if raised in sterile conditions, animals, such as pigs, would be prime candidates for humans in need of organs. However, the question then rises if the use of these animal organs is ethical. Although xenotransplantation is a step forward in medicine, there needs to be more precautions made considering the ethics of the transplantation. Moving forward with research, transmissible diseases, expenses, and animal rights should be considered in order to ensure that xenotransplantation is an ethical idea that meets societal standards for all involved parties. In order to do this, scientists must obey the many laws laid out by the government concerning human experimentation. According to the Office of History, National Institutes of Health, the 1947 Nuremberg Code requires every experiment to have informed consent, human trials preceded by animal trials, and the benefit of to science must outweigh the the risks for experimental subjects (Sparks, 2002). Scientists have to pursue every precaution before allowing humans to go through xenotransplantation to ensure the experiments are ethically solid.

Before diving into the ethical spider web that surrounds xenotransplantation, it’s important to examine its risk of spreading diseases and zoonoses {diseases that can be transmitted from animals to humans}. The threat that this poses to the human race is considerably large. According to a report done by the Hastings Center, “the risk may be small but the potential consequences of spawning a new pandemic are catastrophic” (Hanson, 2003). There would be no way to predict what exactly humans will be exposed to through xenotransplantation without testing the experiment. That within itself creates a lot of ethical  concerns as to whether or not humans should be subject to unknown outcomes from transplantation, especially considering the Nuremberg Code mentioned in the introduction. Along with that, researchers have found that xenotransplantation could expose the human body to “pig microorganisms including viruses, bacteria, fungi, and parasites” (Animal-to-Human Transplants Are a Failure, 2009). Allowing xenotransplantation to occur from animals that are kept in unsanitary conditions would most definitely raise the risk of zoonoses being transmitted to humans. If xenotransplantation gained popularity and those who sold animals for the transplantations could earn money from doing so, there would be no way to monitor every facility that breeds and sells those animals. The living conditions for the pigs, etc. would be completely up to breeders. The monitorization of transplants is currently overseen by The Health Resources and Services Administration along with the US Department of Health and Services. However, since there has never been breeding of animals before for this specific purpose outside of science labs, there’s no guarantee that these agencies would also oversee these breeding areas. Therefore, xenotransplantation would be incredibly risky as a mainstream alternative for organ donation. Some researchers would argue that diseases known to mankind are completely preventable. According to an article written by Alan Berger and Gil Lamont in 2000, protocols have been developed in order to eliminate any known pathogens from breeded pigs. Correct, in the right environment, it is possible to prevent known diseases. However, keeping all facilities in check would be impossible, especially if people began breeding these animals without the government’s knowledge. The unknown diseases that could be spread to humans provides a solid reason to discourage researchers from using this method of transplantation to solve the growing organ shortage crisis that the United States is experiencing. The unknown risks that this method of transplantation poses is due to the lack of significant research available to the public and other scientists.

Xenotransplantation is still largely in its early stages. As the organ shortage becomes an increasingly bigger issue, the amount of research needed to be done before the method could be implemented correctly is too extensive. For clinical trials of xenotransplantation to take place, there would need to be, “scientific investigation of disease transmission as thorough as possible, with information made widely available” (Hanson, 2003). Despite the fact that this doesn’t give an estimate on how much time will be needed to obtain this information,  readers can easily infer that the effort would be just too extensive. This article, although written in 2003, is still relevant today because the American population is still largely unaware of what xenotransplantation is. The sixteen year time period between this article and today should be alarming to any researcher since the public is still not very well educated on the topic. To address the cost of xenotransplantation, an article written by PETA UK, the biotechnology industry is currently the main funder for research who has no plans to stop experiments from occurring. The industry themselves is offering at least $6 billion to the first group that can prevent the human body from rejecting animal organs. Along with that offer, they’ve consistently spent ample amounts of time and money for this cause. (People for the Ethical Treatment of Animals UK, 2009). Considering that research is nowhere close to being finished, it’s impossible to ignore the fact that the efforts made through both time and money have been inefficient. The whole goal of solving the organ shortage is to find a cost effective and quick way to provide people in need with the organs they need. The estimated costs for continued research largely goes over any consideration of this method being cost effective. However, scientist David White, who is the research director of a large biotechnology company based in the UK, believes that xenotransplantation research is extremely close to being completed. In a 2000 Saturday Evening Post interview, White claimed that he would, “be very disappointed if [he] [doesn’t] start [his] transplantation program before the end of the millennium” (Animal-to-Human Transplants Could Save Lives, 2000). Answers to the organ shortage crisis are not needed in a thousand years, they’re needed now. At a certain point, scientists must make the decision as to whether or not a research opportunity is worth the constant supplying of money and time. In this situation, xenotransplantation is in no way worthy of that commitment. Instead, scientists should focus their research on creating a supply of human organs that can be replenished when needed. Stem cell research, for example, is one way that scientists are working to help solve this crisis. Rather than resulting to organs of different species that have been unable to survive in human bodies in experiments, scientists should hone in on the research that deals with solely the creation of human organs for the organ shortage crisis.

After analyzing the cost and time effectiveness of xenotransplantation along with the risk of transmissible diseases, considering the consent of both the animals and the humans involved in this transplantation method is important. Whether or not animals should be subject to breeding for purely the purpose of killing is a considerably sized debate that already takes place today. Animal rights activist groups along with some vegans and vegetarians believe that cattle, chickens and pigs are unfairly being raised for slaughter. Xenotransplantation raises the same questions pertaining to animal rights. According to an experiment concerning xenotransplantation from animal to animal, researchers described monkeys and baboons who were recipients of organs from another species dying after fits of vomiting and diarrhoea. These animals also suffered from violent spasms, bloody discharge, grinding teeth and uncontrollable, manic eye movements. (People for the Ethical Treatment of Animals UK, 2009). The terrible monstrosities that those animals were subject to should in no way be allowed to continue. Especially when these animals are being tortured for a cause that is yet to show any successful prospect in humans. Others would argue that the suffering of these experimental animals can be justified through the medicinal accomplishments that xenotransplantation would provide for so many humans in need.  However, there has been zero evidence through these years and years of experimentation that this method of transplantation could lead to any sort of effective solution to the organ crisis, especially when there are also ethical issues concerning the humans involved in any future clinical trials. The patients that would experience the transplantation would possibly not be the only ones that would have to provide their consent. According to a report done by the Hastings Center, “consent [must] be sought not only from the patient but also from his or her intimates and even—through some mechanism—from the general public itself. The ability for diseases to spread across borders makes xenotransplantation a truly global issue.” (Hanson, 2003). Where would it end? Exposing the public to transmissible diseases without their knowledge is unethical. Which means that whatever patient underwent the transplantation would either have to stay in a confined room with no human contact or find a way to get consent from basically every single human. Without that consent, any possible epidemic or pandemic that would break out would be at the fault of whatever research facility/company that put that experiment into place. The extensive amount of consent that would be needed from every human involved in transplantation would be too much for this method to be considered effective as a solution to the organ donation problem.

Although the research for xenotransplantation is still underway, there have been a few clinical trials pertaining to animal-to-animal transplantations. The majority of them, have been largely unsuccessful. A article written by PETA UK in 2009, one specific lab experimented with a modified pig's heart and attached the organ to vital arteries in the neck of a baboon. The scientists found that the animal’s heart swelled way beyond normal size and that there was a strange yellow fluid seeping from the pig’s heart. The baboon died 21 days later. A similar baboon was subject to limb spasms and paralysis and died of a stroke shortly after. This failure of a transplant should be concerning for many researchers trying to pursue this path of transplantation. There wasn’t even the slightest bit of success in this trial, which again raises the question as to whether or not xenotransplantation research is beneficial, if after all these years, trials are still considered ineffective. Dr. Thomas Starzl performed a few xenotransplantation surgeries of his own that included human patients. His trials were also unsuccessful, “in 1964, he carried out baboon kidney transplants in six patients with terminal renal disease for whom no living or deceased donor became available; graft survival was for 19-60 days” (Cooper, 2017). Those who would argue that human trials would provide different results than animal trials would be debunked by these very experiments. Although some of the transplantations provided success, it was very short lived. Organ transplantation is geared towards lengthening the lives of those who receive the organs. Therefore, Dr. Starzl’s experiments are nowhere close to achieving the level of success that they should in order for them to be considered an alternative to human-to-human organ transplantation.

If xenotransplantation took place, the patients receiving the organs would have to be monitored extensively for many years after the transplantation. Patients that participated in xenotransplantation would, “likely be more prone to illness and may need to have their intimate relations restricted to minimize risk of disease transmission. Intimates may have to be monitored as well” (Hanson, 2003). If those who signed up for this transplantation knew the extensive amount of research that they would be apart of afterwards, would they really believe that the money and time would be worth the outcome? They would have to live constantly under the watch of scientists and doctors, unable to live the free lives that they want to. Although there may be a point in time where a patient must choose between life or death, the xenotransplantation trials have shown that the animals tested on died horrible deaths. Of course, the same effects may not occur in humans, but is it really fair for patients to take this risk when they can be given much more peaceful deaths. The copious amounts of monitoring that patients would be suspect to largely outweighs the benefits of xenotransplantation for humans, especially when clinical trials including humans have continually failed.

Xenotransplantation is a research opportunity that would ultimately create more harm than good. The unknown transmittable diseases, sketchy ethics, failed trials, along with the cost and time commitments are all reasons as to why xenotransplantation should not be pursued. Currently, there are no ways to screen animals for diseases that are unknown to mankind, which provides a dangerous, lurking monster in the shape of a possible epidemic or pandemic. The animals that are currently being suspect to xenotransplantation trials suffer terrible deaths, where the experiments continually fail. The research behind more trials and the discovery of these currently unknown diseases would cost too much time and money for xenotransplantation research to be considered effective for the organ shortage crisis. Rather than use xenotransplantation, doctors and scientists should try to educate those who they interact with about the importance of being an organ donor and the falsities that so many people associate with that label. By doing so, doctors can bypass uncharted waters and continue to successfully provide patients with the organs that they need. As a society, even though we are in dire need of healthy organs, we should not have to result to dangerous and unprecedented methods such as xenotransplantation.

References

Berger & Lamont. (2000). Animal-to-Human Transplants Are Dangerous and Unethical, Plunging Headlong into Madness. Retrieved from go.galegroup.com

Cooper, David. K. (2017, March). Early clinical xenotransplantation experiences-an

interview with Thomas Starzl. Retrieved from ncbi.nlm.nih.gov

Hanson, Mark. J. (1999-2003, November). Xenotransplantation Is Dangerous

Xenotransplantation Protocol: Commentary. Retrieved from go.galegroup.com

Gale Opposing Viewpoints in Context. The Saturday Evening Post: Animal-to-Human Transplants Could Save Lives. (2000). Retrieved from go.galegroup.com

People For the Ethical Treatment of Animals UK. (2009). Xenotransplants: Killing Humans and Animals. Retrieved from go.galegroup.com

Sparks, Joel. (June, 2002). Timeline of Laws Related to the Protection of Human Subjects. Retrieved from history.nih.gov/about/timelines_laws_human.html

U.S Department of Health and Human Services. Organ Donation Statistics. (2019, January 16). Retrieved from organdonor.gov/