On the Way to Xenotransplantation

Surgeons in a New York hospital attempted to transplant a pig kidney into a human specimen, and the results are amazing. But they also raise important questions, too.

Maybe you know someone who desperately needed an organ transplant. You remember how long they waited, sick and suffering, while the doctors tried to find a match. Maybe that patient was you. Organs for transplantation are not easy to obtain, and scientists have been hard at work trying to change that. Now, things are looking hopeful.

The story was first published by The Associated Press (see link at end of article). The biotechnology company Revivicor, along with a few others, has been working to produce pigs with organs suitable for human transplantation. They engineered some pigs to lack a certain sugar that triggers the immune system to attack. The kidney of one of these pigs was then taken and connected to two large blood vessels outside a patient who was kept functioning via ventilation. The surgeons who transplanted the kidney observed it for two days, monitoring for an immune response. There was none, and the kidney functioned as expected.

“This is an important step forward in realizing the promise of xenotransplantation, which will save thousands of lives each year in the not-too-distant future,” said Martine Rothblatt, the CEO of United Therapeutics, the parent company of Revivicor.

Figure 1: In this September 2021 photo provided by NYU Langone Health, a surgical team at the hospital in New York examines a pig kidney attached to the body of a deceased recipient for any signs of rejection. From left are Drs. Zoe A. Stewart-Lewis, Robert A. Montgomery, Bonnie E. Lonze and Jeffrey Stern. The test was a step in the decades-long quest to one day use animal organs for life-saving transplants. (Joe Carrotta/NYU Langone Health via AP)

So why pigs? Well, pigs are similar to humans. Primates are even more so, but earlier animal-to-human organ transplant, or xenotransplantation, attempts with baboons had limited success and provoked uproar from the public over the ethics of using primates for experimental purposes. Thus scientists started using pigs, altering genes as needed to bridge the species gap. This is not so upsetting, as humans eat pig meat often (bacon, anyone?). Moreover, pig parts are used in other medical procedures, such as skin grafting and cornea replacements.

Figure 2: In this September 2021 photo provided by NYU Langone Health, a surgical team at the hospital in New York examines a pig kidney attached to the body of a deceased recipient for any signs of rejection. The test was a step in the decades-long quest to one day use animal organs for life-saving transplants. (Joe Carrotta/NYU Langone Health via AP)

After all, it's a lot easier to breed pigs than humans. As amazing as this xenotransplantation success was, however, it raises some important ethical concerns. For one, is it really right to be breeding animals for the sole purpose of organ harvesting? Exactly how would the organs be retrieved from the organism? While the organisms of Terra are ours in the sense that we are responsible for caring for them and keeping the biosphere healthy, they are not ours to abuse. Every pig has a life. It has hopes and fears, and may even fly in its dreams when it sleeps. It feels pain. It wants to live. It may even be self-aware. (Yes, pigs are smarter than you think.) But so do humans.

Figure 3: FILE - This undated photo provided by Revivicor in December 2020 shows a "GalSafe" pig which was genetically engineered to eliminate a sugar in pig cells, foreign to the human body, which causes immediate organ rejection. Scientists temporarily attached kidney from one of these pigs to a human body and watched it begin to work, a small step in the decades-long quest to one day use animal organs for life-saving transplants. (Revivicor via AP)

There is also the ethical concern of mixing up organisms such as in transplantation. This issue is almost never discussed, as human understanding of the nature of life itself and the living organism is still in its infancy. There is a reason the immune system attacks foreign organisms like bacteria and transplanted organ cells - they are not part of the organism which it defends. The immune system is responsible not only for protecting the organism from damage, but also for maintaining its integrity and identity as one organism. By replacing an organism's organ with another's, is the recipient really the same organism as it was pre-transplant? For major organ transplants such as heart and liver transplants, the organism is dead but for the functioning of another organism's part. Anecdotal and scientific evidence suggests that indeed much more happens with a successful transplant than mere chemistry (see here, here, and here). But organ transplants save lives, you contend. Perhaps, but what lives? If a person needs a foreign heart to function, are they really alive? They are not self-sustaining if they require a foreign source to keep them going - self-sustenance, or more precisely, self-creation, is the foundation of life. (I'm currently working on an article that explains what I mean - stay tuned!)

Don't get me wrong - I am not advocating for the end of organ transplants, at least not until a lot more is known about the fundamental nature of life. This procedure is a big step forward for medicine. I am just asking that we consider the nature of all lives involved, human and animal.

So comment below - What do you think of this amazing medical feat?

Source: https://apnews.com/article/animal-human-organ-transplants-d85675ea17379e93201fc16