What Is Xenotransplantation?
Pig Organs in Human Transplants
Historically, xenotransplant, or the transplantation of organs from other species to humans, has failed due to incompatibility and rejection. Recently, an American patient became the first to receive a genetically modified pig heart transplant. The donor pig had undergone deletion of certain pig genes and addition of human genes to make its heart less likely to be recognized as foreign by the human recipient. David Bennett Sr. lived 45 days before apparently dying of a pig virus that hitched a ride on his new heart.
Time will tell how well this technology will work, but several moral questions arise:
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Have we examined the ethical questions about creating human-pig genetic hybrids?
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What is the quality of life of the human-pig chimera that has been created solely for eventual sacrifice for its organs?
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What risk will the transplant recipient face of becoming ill from endogenous pig viruses, especially as he/she will need anti-rejection drugs and be immunodeficient for the rest of his or her life?
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Is there a risk of these human-animal hybrid organs introducing animal infections (zoonotic disease) into the human population?
What If It Works?
If we decide it is ethical to create human-animal hybrids to exploit them for their organs, AND the pig-human chimera is as comfortable as any other lab animal, AND animal viruses are not going to be an infectious disease issue (a lot to assume), this new technology MAY be acceptable. Certainly, it would be preferable to the homicide of vulnerable people (as with donation after 'brain death' or 'circulatory death') who are actually alive at the time of their organ harvests.
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Professor Sheila Jasanoff wrote this about xenotransplantation in 2018:​
"What can be done imperceptibly segues into what should be done. The study of nature becomes, for scientists’ purposes, its own most pressing justification, just as it was in Doctor Moreau's remorseless, curiosity-driven world.
Have the human subjects of xenotransplantation elicited a more cautious or empathetic response? Early U.S. efforts to develop guidance for xenotransplantation suggest otherwise. The 2001 Public Health Service Guidelines for transplants into humans from nonhuman animal sources characterized the human subject as a 'xenotransplantation product recipient.' That designation reduced the treated patient to one-dimensional status, as the carrier of a novel, potentially infectious, biomedical product. Stripped of other attributes of personhood, 'xenotransplantation product recipients' were to be subjected to long-term, even lifelong, surveillance while incurring heavy obligations to inform close contacts, submit to regular monitoring, and make health records and physical movements publicly available. The price of rescue from deadly organ failure, in other words, was to become in many respects a social outcast, a permanent object of scientific and medical oversight."
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In August, 2023 two 'brain dead' men were used as test subjects when researchers at the University of Alabama and the NYU Langone Transplant Institute surgically implanted genetically modified pig kidneys into their abdomens. (A similar surgery had been performed the previous year, but the kidney did not function successfully.) This time around, one helpless 'brain dead' man has been kept alive like a lab rat for over a month as doctors study how long the xenotransplanted kidney will function. (Parenthetically, the fact that these 'brain dead' patients are deemed so physiologically stable that they can be used as xenograft hosts reveals that they are actually still alive.)
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It is hard to imagine that an experiment of this nature would receive consent from not only the family, but also the institutional review boards and ethics committees of these respective hospitals. When the President's Council on Bioethics wrote their white paper on death determination in 2008, they morally justified the declaration of death by neurologic criteria ('brain death') on the basis that continuing to ventilate and support these people violated the respect due to the 'dead'. Clearly, that respect has now gone out the window in the never-ending quest for more transplantable organs. ​​
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See Dr. Klessig's article about a brain dead man being implanted with a genetically-altered pig lung here. This story points out the staggering amount of Orwellian double-speak surrounding brain death.
