Sir

As a clinician involved in clinical allotransplantation and experimental xenotransplantation (heart-lung and lung), I should like to comment on your attitude to xenotransplantation1.

The European Union has provided a ECU1.5 million (US$1.6 million) grant (1997-2000) to establish a working group of several non-UK countries to address different topics of xenotransplantation. The unique aspect of this group is that it is composed of a physician, researchers (in biochemistry, immunology, genetics and virology), a sociologist, philosophers and so on.

Although heterogeneous, this group has a unique question in mind: is xenotransplantation of clinical benefit for a human being? Although you have published quite a lot on this subject, as far as I know none of the authors has been at the bedside of a patient. They cannot feel the frustration of patients who die while waiting for an organ nor the wonderful sensation of being able once more to breathe or to move without effort. What about the parents seeking a therapeutic solution for children with terminal diseases? As a clinician, is it really ethical for me to have no solution or should I be more concerned with infection and social arguments?

In the laboratory in which I work, we have recently used the nude mouse to host a human trachea derived from human embryonic cells. After several months, we transplanted up to 10 cm3 of human trachea into piglets to test whether the process might be used in human babies as an alternative to their death. All the experiments were successful (without immunosuppression, human grafts were not rejected). Do I have the right to propose this technique to the parents? I think I do and we are in the process of asking for permission to do it.

I believe that people dealing with xenotransplantation should give more thought to the patient rather than to ways of raising funds for research that may never be applied in clinical practice because it is too complicated. Have such researchers any idea what a child looks like after several years of immunosuppression treatment?

The time has come for clinicians rather than basic researchers to give their opinions on clinical xenotransplantation.