A Cross-Species Solution to Organ Donation?

When thinking of genetically modified organisms, vast fields of corn and large confined animal feeding operations might come to mind. However, a recent development in medical technology has moved us one step closer to modifying animals for purposes other than agriculture. Xenotransplantation is the practice of transplanting cells, organs, or tissues across species. Previously, the largest obstacle to xenotransplantation was the potential infection of viruses between species. However, a new experiment successfully eradicated the threat of such viruses, opening the door a little wider in terms of pig-human transplantation.

Apart from its modernity, xenotransplantation has been resisted for ethical reasons. Is it ethical to harvest organs from another animal for human use? How could this technology challenge who and what we consider human? And is this technology truly controversial, or is it morally indistinguishable from other medical practices?

Though widespread organ donation programs have made life possible for those who would otherwise die, it is not a perfect solution. The push for xenotransplantation comes in large part to the unwavering demand for organs. Over 90 percent of Americans support organ donation, and the majority are registered organ donors. Despite these facts, about 22 people die every day waiting for an organ transplant. Many may believe that this is an unsolvable issue, considering the fact that major organ transplants require the death of the donor. However, organ donations don’t necessarily require one deceased person and one living person. Despite this, it is undeniable that the benefits of deceased organ donation greatly outweigh those of living. This is mostly due to the fact that one deceased organ donor can save up to 8 lives.

One way to solve organ demand is to approach organ donation as an opt-out system, instead of an opt-in one. France recently enacted this policy, and is expecting it to help save many more lives. However, an opt-out system does not come without ethical questions of its own, specifically about government boundaries and bodily autonomy. Additionally, even if everyone registered to be an organ donor, it is estimated that only about three in 1,000 people die in a way that makes them suitable for organ donation.

These issues seem unsolvable statistically, relying solely on human donation. Xenotransplantation has the potential to solve the organ availability issue. Because of their organ structure, pigs, specifically inbred miniature swine, appear to be the top candidates for human organ donation. Not only do supporters believe that xenotransplantation could save the lives of those who need organs, but they also theorize it could decrease black market organ sales. With a shorter or non-existent waitlist, unsafe and unlawful organ sales and transplants could be drastically reduced. Surplus organs could also lower the overall costs of transplants, thus making them available to everyone. And as Heather Zeigar of Quartz once put it, “Organ donation is inherently unfair.” Without a waiting list or high cost for organs, the inequity that currently exists in organ donation could be eliminated.

However, if access to organ transplants become readily available, couldn’t those without life-threatening conditions attempt to prolong their life by replacing their organs? One of the pros of xenotransplantation is the belief that it will dispel the black market for human organs. And this could be true if organs were reserved for those with life-threatening conditions. But what if a black market develops for those attempting to redesign their bodies? And what about the cost of these organs? Currently, organ donation is run by non-profit organizations, like the United Network for Organ Sharing. However, most entities developing and researching xenotransplantation are private corporations. Putting organ donation in the hands of such entities could have devastating consequences by not only failing to abolish the waitlist for organs, but prioritizing those in need by ability to pay.

Detractors might also argue that experimenting xenotransplantation is cruel and inhumane. Supporters of xeno might respond by pointing out that, without animal testing, we wouldn’t have made major medical advances that have saved human lives. Animal testing has been directly involved in the discovery and use of penicillin, insulin, and blood transfusion. And xenotransplantation might not just stop at organ donation, but could potentially save lives by preventing disease. The end goal of some scientists, like Luhan Yang, is not only to provide those in need with organs, but to immunize the organs to common human maladies. In an interview with Stat News, Yang wondered, “Could we make the human genome cancer-resistant? … Or make it virus-resistant? … There is a great opportunity that xeno can tell us what would happen in humans after dramatic genome engineering.”

The ethical implications of genetically modifying humans are vast and greatly debated in the bioethics field, as technology develops. And what about the pigs? Is a pig with a human heart growing inside of it human? Maybe not in the opinion of many, but what about a brain? Human identity and sentience are greatly tied to our concept our mind and brain, and growing one inside a pig could complicate exactly what we would consider makes us human.

Though scientists have moved one step closer to xenotransplantation, some do recognize the barriers, both technologically and ethically that still exist. Genetics professor Darren Griffin believes that “There are so many variables, including ethical issues, to resolve before xenotransplantation can take place.” We can only hope these ethical considerations are not overlooked.