
PCRM Asks FDA:
Ban Cross-Species Transplants
By Steven RaglandAnimal organs have been suggested as a possible, albeit remote,
solution to the shortage of transplantable human organs. However, in over three decades of
experimental transplants, no human recipient of an animal organ has survived.
In comments submitted to the Food and Drug Administration (FDA), PCRM is urging a ban
on all animal-to-human transplants (xenotransplants). The FDAs draft guidelines,
currently under consideration, are too weak to safeguard public health.
The shortage of human organs is a solvable problem. While most Americans support organ
donation, fewer than one in five has actually completed an organ donor card. By increasing
overall organ donation rates by just 17 percent, deaths from lack of donor organs can be
eliminated. In Washington, D.C. area hospitals alone in 1994, more than 200 patients who
died were suitable donors, but their organs went unharvested.1 Improved
tracking and harvesting of suitable organs can significantly diminish this shortfall.
Even more effective is to implement a policy of presumed consent. Under this system,
unless individuals specify otherwise, all suitable organs will be used upon a
persons death. When Belgium enacted such a law, organ availability jumped 140
percent.2
Another method is to allow people to choose to make an organ donation provision when
they renew their drivers licenses or file income tax forms.
We can also reduce the need for donor organs through prevention programs. At best, even
human-to-human transplants remain stop-gap measures, as most fail within five years, and,
depending on the organ, between 9 and 40 percent fail within a year of transplantation.3
Heart, lung, and liver disease are, in many cases, preventable through proper diet,
exercise, and avoiding the organ-damaging effects of smoking, certain medications, and
heavy use of alcohol. Undoubtedly, genetics and other uncontrollable factors do contribute
to organ disease, but rates can be greatly reduced through preventive efforts.
Even supporters of xenotransplantation concede that the risk of viral transmission is
real. Transmitting animal viruses into immunosuppressed patients could open a
Pandoras box of disease. Influenza, Marburg, and Ebola viruses are known to infect
humans and can cause catastrophic disease. One documented outbreak of Ebola in Zaire
involved more than 200 people and had an 88 percent fatality rate.4 Most newly
emerging human infectious diseases have been shown to come from other species.5-8
Many microorganisms do not cause disease in their natural hosts, but have serious
pathogenic potential when transmitted to another species. For example, simian
immunodeficiency virus (SIV) is found in nonhuman primates and is non-pathogenic in many
species.4 However, SIV is transmissible to humans, and it is widely believed
that Human Immunodeficiency Virus (HIV) is the result of a cross-species infection of a
simian retrovirus.9
In organ transplants, natural barriers such as skin, mucosal surfaces, and the
environment of the stomach are bypassed.5 Transplant patients who are
intentionally immunosuppressed to prevent rejection of grafted material are more likely to
contract diseases from host pathogens.
While some have hoped to reduce this risk by breeding germ-free animals for
xenotransplantation, it is impossible to screen for all pathogens, and simply not possible
to breed a completely germ-free animal.
Some experimenters have claimed that pig organs are less likely to harbor
disease-causing viruses. However, a retrovirus that can infect human cells was recently
discovered in pigs in the U.K.10 The virus is apparently present in all
domestic pigs, and one strain quickly invades human cells, permanently inhabiting the new
hosts system. As a result, British health officials are expected to withhold
approval of planned pig-to-human heart transplants.
Xenotransplants are risky and expensive. They are not treatments, but experiments that
have been universal failures. They do not serve the public health; rather, they put the
population at risk of unknown and potentially lethal viral outbreaks.
References
1. Washington Regional Transplant Consortium. 1995.
2. Roels L, Vanrenterghem Y, Waer M, Gruwez J, Michielsen P. Effect of a presumed consent
law on organ retrieval in Belgium. Transplant Proc 1990;22:2078-2079.
3. United Network for Organ Sharing. U.S. Transplants by Organ Donor and Type. 1996.
4. Institute of Medicine. Xenotransplantation: Science, Ethics, and Public Policy.
Washington, DC. National Academy Press, 1996.
5. Allen JS. Xenotransplantation at a Crossroads: Prevention Versus Progress. Nature Med
1996;2:1.
6. Hjelle B, et al. A Novel Hantavirus Associated with an Outbreak of Fatal Respiratory
Disease in the Southwestern United States: Evolutionary Relationships to Known
Hantaviruses. J Virol 1994;68:2:592-596.
7. Morse SS, Schluederberg A. Emerging Viruses: The Evolution of Viruses and Viral
Diseases. J Infect Dis 1990;162:1-7.
8. Murphy FA. New, Emerging, and Reemerging Infectious Diseases. Adv Virus Res
1994;4:1-52.
9. Desrosiers RC. A Finger on the Missing Link. Nature 1990;345:326.
10. Garrett L. Pig Virus Called Human Threat. New York Newsday. November 14, 1996. A37. |