What Is Xenotransplantation?

Ethical debates frequently occur today because of advances in society, technology, science, and many other areas. These arguments are comprised of many people due to the diversity of their interpretations of ethics in these areas. Ethics can be defined as "a system of moral, scruples, principles or values that in itself defines what is right or good behavior" (Shankarkumar, 317). The issue involving xenotransplantation, the sharing of organs between different species, has become a controversial subject with disagreements focusing on the ethical perspectives of the surgery. In order to comprehend the numerous ethical arguments surrounding xenotransplantation, the following three parties must be viewed: physicians, both for and against the surgery, and society.

Xenotransplantation is defined as "transplanting cells, tissues or whole organs from one species into another" (Baker, 643). These transplantations involve organs such as the heart, kidneys, and many others. Today, pigs have quickly become the donor species due to their anatomical and economical advantages. Pigs grow and reproduce very rapidly, creating a large litter, increasing the number of subjects for donation. Also, their organs and blood vessels are similar in size to those of humans, making their use more practical than that of an anatomically larger species (Baker, 643).

The concept of xenotransplantation has been attempted many times throughout history. In 1682, doctors repaired the skull of an injured Russian nobleman using bone from the skull of a dog. The patient died soon after the surgery due to the unsanitary conditions of the procedure (Shankarkumar, 318). Next, in 1905, a French surgeon transplanted pieces of a rabbit's kidney into a sixteen-year-old boy. The reason for this surgery being the boy was suffering from the final stage of kidney failure. He died two weeks after the surgery had taken place (Shankarkumar, 318).

The first attempts of xenotrantransplantation in the U.S. did not occur until the 1960's. During this time, scientists tried to transplant baboon and chimpanzee organs to humans. These transplants failed due to rejection by the human immune system (Baker, 643). The most well known xenotransplantation attempt, known as Baby Fae, occurred in 1985 at the Coma Linda University Medical Center in California. During this surgery, Dr. Leonard Bailey completed the first human neonatal cardiac xenotransplantation by placing the heart of a baboon into an infant. Fae, the infant, suffered from hypo-plastic left heart syndrome, or simply an incomplete heart. The heart functioned for twenty days until stopping, killing Baby Fae (Clark, 1085). This attempt raised difficult ethical and policy issues, which have not yet been answered.

Recently, the low numbers of human donor organs and short term mechanical "organ" replacements have given cause for research on animal sources. For example, scientists at the University of California at San Francisco Medical Center have attempted to graft baboon bone marrow into an AIDS patient. Also, testing of pig fetal tissue transplants is now underway for the use of treating Parkinson's disease (Baker, 643).

In the last 25 years, each case of xenotransplantation performed has failed. Overcoming the human immune system rejection is the most difficult complication of xenotransplantation. "The success of xenotransplantation may ultimately depend upon the ability to induce long-term tolerance to foreign tissue antigens" (Trzepac, DiMartini, 292). Guidelines, created by the Federal Government, which govern xenotransplantation, make it unaffordable for small laboratories to complete research and further advance new

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development of the surgery (Baker, 643).

Many physicians today feel xenotransplantation is not a rational solution for patients in need of organ and tissue transplants. Their views are centered on the welfare of the patient. According to these physicians, there are many unknowns regarding the procedures after-effects, meaning it is not completely predictable. There is little research on how infectious agents in animals will affect humans, or a way of understanding the psychological effect on the patients and their effects on and of society.

Physicians against this surgery feel there is a great risk of disease and harm to the patient. Rejections of engrafts, tissues and organs from animals, is usually much quicker and more violent than rejections of all graft, tissues and organs from humans (Clark, 1082). Also, infection stands to be the greatest risk of xenotransplantation. Diseased animals could possibly spread infectious organisms to humans through surgery, leading to zoo noses, cross-species diseases (Clark, 1088). Today, many antibiotics are less effective against diseases due to mutant resistant strains of these infectious organisms (Ferzli, 2001). Infections can also spread through sexual activity involving a patient of xenotransplantation. In this case, precautions need to be taken to make sure no bodily fluids are transmitted (Clark, 1098). This and constant medical attention, involving tests and treatment, create the necessity of lifetime monitoring of the patients.

Another unknown of xenotransplantation is the psychological issue, which the patients might endure. Having an animal as part of oneself may induce emotions no one can understand. There is also a very high possibility of depression and other emotional

complications to the patient.

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One of the most pertinent indefinite aspects of the surgery is the effect of the patient on and of society. With the possibility of the transplant recipient spreading disease to the public, some physicians feel it is not ethical for one person to affect the human population (Ferzli, 2001). This could lead to an epidemic, with diseases like AIDS, having been traced to animal origin (Shankarkumar, 314), serving as support. On the other hand, society's effects on the xenotransplant recipients may not be predictable. If the procedure is not morally accepted, than the recipients may not be morally accepted, further damaging them psychologically.

According to this group of physicians, the legal aspects of the surgery involve ethical concern. In the case of liability, very few doctors would want to be held liable for patients undergoing xenotransplantation, due to the possibility of infection and widespread public harm; in other words, taking responsibility for the unknown. Also,