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• W4205120952 abstract "In London, UK, last week, a press conference was held by the Department of Health to announce the findings of the Advisory Group on the Ethics of Xenotransplantation. The group's report was ready in August, at the height of the government's battle with the European Union over another animal-related health issue—culling cows to control bovine spongiform encephalopathy. Now, five months later, the government has taken the risk of releasing the report, and of gingerly supporting its findings. The report's recommendations are explained in our news pages (p 257). The advisory group's answer to the question posed to it is that no form of xenotransplantation is sufficiently safe for trials in patients to be allowed, not yet anyway. It is a time-honoured UK tradition that when a government is not sure which way to jump in tricky matters such as this, it sets up first an inquiry and then an interim regulator; this time it is the Xenotransplantation Interim Regulatory Authority, chaired, not by an expert on the safety of transplant procedures, but by a former archbishop who, 40 years ago, was a pharmacologist. Why, in view of the predictable shortfall between patients in need of transplants and human donors, were the ethical and other aspects of xenotransplantation in the UK not explored earlier? Xenotransplantation experiments began in earnest in the mid-1960s, but became more promising with the development of transgenic animals, in the UK by a commercial company, Imutran Ltd. Some sympathy for Imutran is inescapable; they have a product on which a great deal of money and effort has been invested and a queue of patients willing to try it out. Then the government steps in at the last minute and says they cannot go ahead. The group's reasons for advising against clinical trials include the risk of transmitting animal disease to human beings. That this is not an easily dismissible prospect is shown by the possibility that new variant Creutzfeldt-Jakob Disease resulted from a change in livestock-rearing practice—feeding the carcases of sheep to cattle—considered at the time (and for years afterwards) perfectly safe. Although individuals might consent to and even desire a xenotransplant, the risks of interspecies disease transmission must surely temper scientific curiosity with caution; the US Committee on Xenograft Transplantation agrees that this “must be considered a real threat”. Aspects of public health and the safety of patients apart, enthusiasts for xenotransplantation, be they scientists, doctors, or patients must be sure where they stand on the rights and wrongs of rearing animals as sources of donor organs. The UK advisory group finds it “ethically unacceptable to use primates as source animals for xenotransplantation… they would be exposed to too much suffering”. Transgenic pigs are acceptable sources providing “the pig neither suffers unduly nor ceases recognisably to be a pig”. The last proviso suggests the surreal prospect of the archbishop and his authority being called upon to decide when a transgenic pig is still a pig—and doing so in the setting of laboratory research as well as clinical application Man has exploited animals for many thousands of years, and the ethical limits to such exploitation have shifted according to dictates of religion and culture. Xenotransplantation with transgenic animals, though, involves an entirely new form of exploitation: manipulating the genes, not by selective breeding, but by insertion of genetic material from another species. Animals, including pigs, are specially bred for research purposes and have been used as a source of insulin and heart valves. People also readily accept the genetic manipulation of bacteria. Is xenotransplantation a quantum leap towards a human cyborg warranting a high-profile moratorium? Yes, provided that productive discussion and not further dithering is the objective." @default.
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• W4205120952 title "Have a Pig's heart?" @default.
• W4205120952 doi "https://doi.org/10.1016/s0140-6736(97)21004-4" @default.
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