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March 4, 2009

Current Status of Xenotransplantation

Author Affiliations

Author Affiliations: Department of Surgery, Baltimore Veterans Affairs Medical Center, and Division of Cardiac Surgery, University of Maryland, Baltimore.

JAMA. 2009;301(9):967-969. doi:10.1001/jama.2009.237

Transplantation improves quality of life and saves tens of thousands of lives each year. However, the supply of human organs and tissues is insufficient to treat all patients who qualify for kidney, liver, islet cell, pancreas, heart, or lung transplantation. These considerations provide a powerful impetus motivating early clinical introduction of cross-species or xenotransplantation.

Pigs have been developed as a potential xenograft source species based on various physiological and logistical considerations.1 Use of nonhuman primates is not feasible for a number of reasons, ethical concerns prominent among them, and because the risk of a nonhuman primate virus causing epidemic human disease is not acceptable.2 Recently, a clinical islet xenograft trial involving 8 patients with diabetes and using porcine pancreatic cells has obtained provisional approval by New Zealand regulatory authorities.3 This Commentary discusses scientific benchmarks and ethical predicates necessary before clinical xenotransplant trials.