Pig Kidney to Human Transplant

Xenotransplantation — that is, animal to human — organ transplants offer distant hope for ethically ending the long wait for a transplant. That hope came a big step closer recently as scientists were able to successfully attach a genetically modified pig kidney to the outside of a person who was brain dead and observed it function properly. From the MIT Technology Review story:

The pig had been genetically-engineered so that its organ was less likely to be rejected. The feat is a potentially huge milestone in the quest to one day use animal organs for human transplants, and shorten waiting lists.

The person used in the experiment was deceased, but the body still functioned with the use of medical technology:

The surgical team, from NYU Langone Health, attached the pig kidney to blood vessels outside the body of a brain-dead recipient, then observed it for two days. The family agreed to the experiment before the woman was to be taken off life support, the AP reported. The kidney functioned normally — filtering waste and producing urine — and didn’t show signs of rejection during the short observation period.

Was this ethical? If one accepts that brain death is dead — as I do — then, yes. After all, the deceased person’s organs could have been removed for transplantation. Thus, attaching an organ to the circulatory system was not causing any harm. Moreover, proper consent had been obtained from the family.

But could this be done ethically with a living patient? Not unless the hope was to save his or her life, it seems to me, and after the procedure was approved for human trials — which is still way down the road.

Is it ethical to use pigs in this way? Only animal-rights believes would say no. Human lives are more important than those of pigs. But animal rightists don’t believe that, and indeed, deny our right to use animals in any way for human benefit.

But animal rightists aside, I don’t see the issue. Moreover, pig-heart valves are already used in human patients without any ethical problem.

This experiment also doesn’t provide answers to a most important xenotransplantation safety concern, that is, whether transplanting pig organs into people could also pass a porcine virus for which we would have no resistance. That will be a very difficult problem to overcome because it can only be determined over extended time.

Some bioethicists have urged that we use cognitively disabled patients for such experiments who don’t need transplants, but to just observe them. No! That would be immoral because it would offer the experimented-upon person no chance of benefit.

These are difficult issues. We have to avoid crass utilitarianism as we strive to bring great human benefit to the clinical setting. But this is a hopeful step forward.

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