Imagine a giant football stadium, swarming with fans. Every single seat is filled up, and there are even people standing on the field and in the isles, just to be in that stadium. Now add 20,000 more people. That’s how many people were waiting for organ transplants in 2022.
Over 100,000 US patients each year are on a life-or-death organ transplant waiting list, but only around 40,000 transplants occur annually. For a majority of patients on that list, the wait for an organ is excruciating and can have a deadly toll, but the gap between the number of organ donors and the number of recipients is remaining relatively steady. When people are 16 and getting their driver's license, we can’t force them to check the ‘organ donor’ box. So, if we can’t increase the amount of donors, how can we fix this?
While we can’t increase the amount of human donors, we might be able to increase the amount of animal donors. Scientists have been experimenting with xenotransplantation, the transplantation of animal organs or tissue into a human. Within the past two years, there have been significant advances in this field including the first successful genetically modified pig heart transplant in 2022, at the University of Maryland School of Medicine, and the first successful pig kidney transplant in 2023, at NYU Langone. These are the first successful transplants in humans and with each new surgery, we continue to discover more and more about the human physiological response to animal organs.
While these transplants are promising, many physicians and patients are concerned with the ethical dilemma of xenotransplantation. Firstly, many patients may be resistant to receiving an animal organ as it conflicts with their personal religious beliefs. In Judaism and Islam, for example, pigs – or swine – are viewed as inferior and unclean beings. To have the organ of an animal that your religion forbids you from associating with can be mentally challenging. Even in patients who are not religious, the idea of having another animal’s organ inside of you is mentally tolling, especially with the stigma surrounding it. It’s hard to explain to someone who is not familiar with xenotransplantation treatment that you have a pig heart; to some people, it just seems gross. It may be hard for the patient to justify having that organ for themselves if people around them are not accepting of it.
Furthermore, the actual harvesting of pig organs is questionable morally and efficiency-wise. From birth, pigs are genetically modified in order to alleviate the human immune response from rejecting the foreign tissue. The caveat is that the pigs must be raised in a completely sterile lab and constantly undergo medical procedures until they are ready to be used for harvesting. The pigs – who are neurologically advanced animals – are not mentally stimulated, which raises concerns. Also, the entire process is costly and inefficient as a singular pig has to be raised in very specific conditions, so optimizing this procedure will take time.
Even if we develop an efficient way to harvest organs, it will still cost an exorbitant amount, leading to questions of who is prioritized for animal organs versus human organs. The financial costs of xenotransplantation often make it inaccessible for lower income families to obtain treatment immediately. This forces families to accept steep financial penalties if they choose to have the transplant rather than remaining on machinery such as a ventilator or dialysis machine as substitutes for failing organs.
However, if all of these ethical considerations are taken into consideration prior to xenotransplantation becoming a mainstream treatment option, then it will greatly benefit the medical community. So many lives will be saved because of this upcoming technology. It is only a matter of time before it becomes medically feasible.
Edited by: Sanjana Anand
Graphic Designed by: Shanzeh Sheikh
Citations
Ebner, K., Ostheimer, J., & Sautermeister, J. (2020). The role of religious beliefs for the acceptance of Xenotransplantation. exploring dimensions of xenotransplantation in the field of hospital chaplaincy. Xenotransplantation, 27(4). https://doi.org/10.1111/xen.12579
Grosse H. W. (2003). Xenotransplantation aus christlich-ethischer Sicht [Xenotransplantation from a Christian-ethical perspective]. ALTEX, 20(4), 259–269.
Rollin B. E. (2020). Ethical and Societal Issues Occasioned by Xenotransplantation. Animals : an open access journal from MDPI, 10(9), 1695. https://doi.org/10.3390/ani10091695
Two-month study of pig kidney xenotransplantation gives new hope to the future of the organ supply. NYU Langone News. (n.d.). https://nyulangone.org/news/two-month-study-pig-kidney-xenotransplantation-gives-new-hope-future-organ-supply
Health Resources and Services Administration. (n.d.). Organ Donation Statistics. Learn About Donation. https://www.organdonor.gov/learn/organ-donation-statistics
Science Learning Hub. (n.d.). Xenotransplantation – timeline. Xenotransplantation Timeline. https://www.sciencelearn.org.nz/resources/2125-xenotransplantation-timeline
Rabin, R. C. (2021, October 19). In a first, surgeons attached a pig kidney to a human, and it worked. New York Times. Retrieved from https://www.nytimes.com/2021/10/19/health/kidney-transplant-pig-human.html.