Commentary | Published:

Uncertainty in xenotransplantation: Individual benefit versus collective risk

Nature Medicinevolume 4pages141144 (1998) | Download Citation

Subjects

Xenotransplantation continues to present daunting scientific hurdles but there is now a genuine prospect for clinical application. There are also significant and unknown risks. We call for a moratorium on all human xenotransplantation and offer a strategy for balancing the ethical, medical, scientific and societal demands of xenotransplantation prior to human clinical trials.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    Bach, F.H., Turman, M.A., Vercellotti, G.M., Platt, J.L., & Dalmasso, A.P. Accommodation: a working paradigm for progressing toward clinical discordant xenografting. Transplantation Proceedings 23, 205–207 (1991).

  2. 2

    Bach, F.H., Winkler, H., Ferran, C., Hancock, W.W., & Robson, S.C. Delayed xenograft rejection. Immunology Today 17, 379–384 (1996).

  3. 3

    Bach, F.H., et al. Accommodation of vascularized xenografts: expression of “protective genes” by donor endothelial cells in a host Th2 cytokine environment. Nature Medicine 3, 196–204 (1997).

  4. 4

    Cooper, D.K., et al. Specific intravenous carbohydrate therapy. A new concept in inhibiting antibody-mediated rejection—experience with ABO-incompatible cardiac allografting in the baboon. Transplantation 56, 769–777 (1993).

  5. 5

    Dalmasso, A.P., Vercellotti, G.M., Platt, J.L., & Bach, F.H. Inhibition of complement-mediated endothelial cell cytotoxicity by decay-accelerating factor. Potential for prevention of xenograft hyperacute rejection. Transplantation 52, 530–533 (1991).

  6. 6

    Dalmasso, A.J., & Bach, F.H. Expression of human regulators of complement activation on pig endothelial cells. Xeno 4, 55–57 (1996).

  7. 7

    Sachs, D.H., Sykes, M., Greenstein, J.L., & Cosimi, A.B. Tolerance and Xenograft Survival. Nature Medicine 1, 969 (1995).

  8. 8

    Platt, J.L. . Xenotransplantation: recent progress and current perspectives. Current Opinion in Immunology 8, 721–728 (1996).

  9. 9

    Deacon, T. . et al. Histological evidence of fetal pig neural cell survival after transplantation into a patient with Parkinson's disease. Nature Med. 3, 350–353 (1997).

  10. 10

    Animal Tissue to Humans: A Report of the Advisory Group on the Ethics of Xenotransplantation, London (1996).

  11. 11

    Animal-to-Human Transplants: The Ethics of Xenotransplantation., London, (1996).

  12. 12

    Draft Public Health Service Guideline in Infectious Disease Issues in Xenotransplantation, (1996).

  13. 13

    Xenotransplantation: Science, Ethics and Public Policy. Institute of Medicine, Washington, D.C. (1996).

  14. 14

    Understanding Risk: Informing Decisions in a Democratic Society (eds. Stern, P.C., and Fineberg, H.V.) Washington, D.C. (1996).

  15. 15

    Berg, P., Baltimore, D., Brenner, S., Roblin, R.O., & Singer, M.F. Summary statement of the Asilomar conference on recombinant DNA molecules. Proceedings of the National Academy of Sciences of the United States of America 72, 1981–1984 (1975).

  16. 16

    Berg, P., Baltimore, D., Brenner, S., Roblin, R.O.r., and Singer, M.F. Asilomar conference on recombinant DNA molecules. Science 188, 991–994 (1975).

  17. 17

    Fishman, J.A. . Miniature swine as organ donors for man: Strategies for prevention of xenotransplant-associated infections. Xenotransplantation 1, 47–57 (1994).

  18. 18

    Fishman, J.A. . Xenosis and xenotransplantation: addressing the infectious risks posed by an emerging technology. Kidney International - Supplement 58, S41–S45 (1997).

  19. 19

    Chapman, L.E. . et al. Xenotransplantation and xenogeneic infections. N.E.M. 333, 1498–1501 (1995).

  20. 20

    Patience, C., Takeuchi, Y., & Weiss, R.A. Infection of human cells by an endogenous retrovirus of pigs [see comments]. Nature Med. 3, 282–286 (1997).

  21. 21

    Daar, A.S. Ethic of Xenotransplantation - Animal Issues, Consent, and Likely Transformation of Transplant Ethics. World J. Surgery 21 (9), 975–982 (1997).

Download references

Author information

Author notes

    • H.V. Fineberg

    Present address: Harvard University, Cambridge, MA, 02138, USA

Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, 99 Brookline Avenue, Boston, MA, 02215, USA

    • F.H. Bach
    • , L. Forrow
    •  & S.C. Robson
  2. Massachusetts General Hospital, Harvard Medical School

    • J.A. Fishman
  3. Department of Philosophy, Tufts University

    • N. Daniels
  4. Harvard School of Public Health

    • J. Proimos
    • , B. Anderson
    •  & H.V. Fineberg
  5. Brigham and Women's Hospital, Harvard Medical School

    • C.B. Carpenter

Authors

  1. Search for F.H. Bach in:

  2. Search for J.A. Fishman in:

  3. Search for N. Daniels in:

  4. Search for J. Proimos in:

  5. Search for B. Anderson in:

  6. Search for C.B. Carpenter in:

  7. Search for L. Forrow in:

  8. Search for S.C. Robson in:

  9. Search for H.V. Fineberg in:

About this article

Publication history

Issue Date

DOI

https://doi.org/10.1038/nm0298-141

Further reading