Dettmer 1 Brendan Dettmer Human Genetics and Ethics October 8, 2009 A Genetic and Ethical View on enotrans!

lantation "urrentl#, in the $nited %tates there are 11&,000 !eo!le that need or'an trans!lants( )%tatistics*( +hat number is risin' dail#( +here is an ob,ious need -or or'an donations in the $nited %tates( But at what !oint does a countr# loo. awa# -rom traditional human or'an donation, and start loo.in' to other means/ 0i'ht now such a means is bein' in,esti'ated and this means is called 1enotrans!lantation(

enotrans!lantation is the !rocess b# which an or'an -rom an animal is trans!lanted into a human bein'( 2ow, there are ob,ious !roblems with enotrans!lantation( +o start, how does one 'et a !i' or'an into a human without the ris. o- re3ection( +o hel! sol,e this scientists ha,e been ma.in' trans'enetic !i's( +hese !i's are lac.in' 'enes which ma.e al!ha41,5 Gal e!ito!es as well as modi-#in' !i's to e1!ress human com!lement re'ulator# !roteins, "D59, endothelial !rotein " rece!tor, heme o1#'enase 1, thrombomodulin, tissue -actor !athwa# inhibitor, and -inall# modulators o- the cellular immune s#stem( Al!ha4 1,5 Gal e!ito!es are !roteins that are naturall# -ound in !i' or'ans which will in humans tri''er h#!er acute re3ection, !re,entin' the trans!lant -rom bein' success-ul and harmin' the or'an reci!ient( )6l#miu. 209*( +he additional modi-ications hel! increase the trans!lant7s chances o- success( Besides biolo'ical issues with 1enotrans!lantation there are ob,ious ethical dilemmas brou'ht u! b# 1enotrans!lantation( %ince this is an issue that a--ects so man# li,es, it is crucial to loo. at this -rom an utilitarian ,iew!oint( B# wei'hin' the bene-its and downsides o- the e--ect

Dettmer 2 o- 1enotrans!lantation on !o!ulation that needs trans!lants, as well their -amilies8 the 'eneral !o!ulation8 the animal !o!ulation8 as well as the e--ect o- 1enotrans!lantation u!on cultures, it will be clear that the !ros o- these !rocedures will out wei'h the cons othis !rocedure( Howe,er, it is also ,ital -or humanit# to reco'ni9e the ris.s o1enotrans!lantation as it will become rele,ant in the -uture should this !rocedure become !o!ular medical !rocedure( +here are 11&,000 !eo!le in the $nited %tates alone that need trans!lants( )%tatistics*( :t is a -act that with human donors alone, the $nited %tates and rest o- the world will not ha,e enou'h or'ans -or e,er#one( )%alomon 1;*( +here-ore it is im!ortant to loo. at the bene-it o- 1enotrans!lantation( O,er a hundred thousand !eo!le would e,entuall# 'et the or'ans the# mi'ht need( Howe,er, there is also a considerable ris. that mi'ht e--ect the !o!ulation as a whole( :n 1enotrans!lantation there is a ris. o- a cross s!ecies in-ection( +his is when a disease -rom one s!ecies is trans-erred o,er to o,er to another( An e1am!le o- this in the !ast would be the A,ian <lu( )<o,a'ue*( +here is also the ris. o- re3ection( 0i'ht now, scientists ha,e tried to minimi9e this b# ma.in' the !i's dis!la# 'enes that e1!ress human com!lement re'ulator# !roteins( )6l#miu. 209*( +hese !roteins tric. the human bod# into thin.in' the !i' or'an is a human or'an( Also scientists ha,e been turnin' o-- 'enes which ma.e al!ha41, 5 Gal e!ito!es, which is reco'ni9ed b# the human bod# to be -orei'n( )6l#miu. 209*( =ith re'ards to the !o!ulation, 1enotrans!lantation has the !otential to sa,e thousands o- li,es which is cruciall# im!ortant( Howe,er, there are de-inite ris.s to the !rocedure( Disease is a !ossibilit#, which can im!act a lot o- our !o!ulation( But, with care-ul research and !ractice this ris. can be miti'ated( )<o,ar'ue*( 0e3ection is an issue, howe,er, e,en with

Dettmer 5 human or'ans re3ection will alwa#s be an issue( )>latt*( A'ain with research, re3ection is also an issue that can be sol,ed in most cases( +here-ore in re'ards to the !o!ulation as a whole, 1enotrans!lantation has more !ositi,e conse?uences than ne'ati,e conse?uences( =hen loo.in' at 1enotrans!lantation on animal health there are 'oin' to be some ethical dilemmas( +o what e1tent as human bein's, should we allow animals to come to harm/ @ost !eo!le will a'ree that human li-e is worth more than an animal7s li-e( Howe,er, it is not ethical to mistreat animals and cause them needless !ain( )@clean*( <or 1enotrans!lantation, !i' or'ans are o-ten used( +he reason -or this is because !i' or'an si9es are com!arable to humans( Also, se,eral sur,e#s were done and the 'eneral !o!ulation !re-ers to not ha,e !rimate or'ans( )0eiss*( +his is because !rimates are our closet relati,es, and are more di--icult to raise( +hou'h !i's are used most -re?uentl# other animals ha,e been used in the !ast( +here ha,e been trans!lantation o- baboon7s li,er to human sub3ects, but usuall# !i's are !re-erred( )0ossi*( One o- the lar'est !oints that is -ocused a'ainst 1enotrans!lantation is the treatment and .illin' o- the animals( <rom this !oint, one should !oint their attention to the -ood industr#( Hundreds o- !i's are raised to be .illed -or their meat, and #et it still ha!!ens( =h#/ >i's !ro,ide humans with -ood( )Daar*( Ai.ewise, with 1enotrans!lantation the !i's will !la# a ,ital role in !ro,idin' humans with much needed or'ans( As -or their ethical treatment, the standards -or care o- these !i's are e1tremel# hi'h( +hese !i's ha,e to be well cared -or, and treated humanel#( +he or'an that is trans!orted must be health#, and the standards -or the or'an to be trans!orted are ,er# hi'h( )>latt*( =hile the animals are still bein' .illed, the# are bein' treated humanel# and much better than the# would i- the# were bein' used solel# -or -ood( +his means the !i' 'ets the !ositi,e conse?uence o- ha,in' a 'ood li-e

Dettmer & but o- course the e,entual ne'ati,e conse?uence o- death, while humanit# 'ets much needed or'ans -or trans!lantation( >i's are the most !o!ular choice -or 1enotrans!lantation( =hile this ma# lead to some -uture biolo'ical !roblems, there are also cultural issues to ta.e into consideration( %ome reli'ions such as :slam do not thin. o- a !i' as a clean animal( +here-ore a !erson with :slamic -aith ma# not want a !i'7s heart in their bod#( )@cAean*( =hile this brin's issues with 1enotrans!lantation, there are still other o!tions a,ailable( +here are other animals that are bein' research on, thou'h the -ocus is on !i's( Also a !erson can still wait on the human trans!lant list( )Aechler ;0;*( enotrans!lantation will also e,entuall# lead to the end o- an inhumane ille'al acti,it#( Blac. mar.et or'ans ha,e been !re,alent in countries such as "hina, which ha,e been s!awned to hel! ma.e u! -or America7s or'an shorta'e( )=oan*( +hese acti,ities 'reatl# harm humans and the res!ect -or human li-e( Death row !risoners in "hina ha,e had their or'ans har,ested a-ter death and sold on the blac. mar.et( :n some cases innocent !erson7s or'ans are ta.en( =ith 1enotrans!lantation, the demand o- or'ans will 'o down, and with it ille'al actions bein' made in des!eration( :n conclusion, 1enotrans!lantation can hel! humanit# more than hinder it( +here are !ositi,e and ne'ati,e conse?uences to this( enotrans!lantation will hel! sa,e man#

li,es -or those waitin' on the or'an trans!lantation wait list, as well as those who are ha,in' their or'ans har,ested ille'all# in the blac. mar.et( +here is some ris.s( +here is the ris. -or cross s!ecies in-ections and or'an re3ection( %ome cultures will not want 1enotrans!lants and there is the un-ortunate cost o- animal li-e( Howe,er, most o- the ne'ati,es are s!eculati,e, while the !ositi,es are de-inite(

Dettmer B

Biblio'ra!h# Alle#ne, 0ichard( CAnimal to Human Or'an +rans!lants "ome "loser A-ter G@ >i' Brea.throu'h(C Animal to Human Organ Transplants Come Closer after GM Pig Breakthrough( +he +ele'ra!h, 05 Dune 2009( =eb( 2E %e!t( 2012( Fhtt!GHHwww(tele'ra!h(co(u.HscienceHscience4newsHB&29E0EHAnimal4to4human4 or'an4trans!lants4come4closer4a-ter4G@4!i'4brea.throu'h(htmlI( "obianchi, A(, %( Jonta, @( E( Bernardo, @( A( A,an9ini, @( De @artino, A( >ietrabissa, <( Aocatelli, >( Dioni'i, and @( Alessiani( C:solation And E1 Vi,o E1!ansion OBone @arrow4Deri,ed >orcine @esench#mal %tromal "ellsG >otential <or A!!lication :n An E1!erimental @odel O- %olid Or'an +rans!lantation :n Aar'e Animals(C Transplantation 90 )2010*G 10&2( >rint( "osta, "ristina, and 0a-ael @ane9( Xenotransplantation: Methods and Protocols( 2ew Kor.G Humana, 2012( >rint( Daar, A(%( CEthics o- enotrans!lantationG Animal :ssues, "onsent, and Ai.el# +rans-ormation o- +rans!lant Ethics(C World ournal of !urger" 21(9 )199E*G 9EB482( >rint( Daar, A( %( C%cience @useum( Brou'ht to Ai-eG E1!lorin' the Histor# o- @edicine(C Animal#human Transplants( %cience @useum, n(d( =eb( 2E %e!t( 2012( Fhtt!GHHwww(sciencemuseum(or'(u.Hbrou'httoli-eHtechni?uesHanimalhumantrans! lants(as!1I( <o,ar'ue, %ara( Xenotransplantation and $isk: $egulating a %e&eloping Biotechnolog"( "ambrid'eG "ambrid'e $>, 2012( >rint(

Dettmer ; 6l#miu., 2i.olai, Bernhard Ai'ner, Gott-ried Brem, and Ec.hard =ol-( CGenetic @odi-ication o- >i's as Or'an Donors -or enotrans!lantation(C Molecular $eproduction and %e&elopment )2009*G 209421( >rint( Aechler, 0obert :(, @e'an %#.es, An'us =( +homson, and Aaurence A( +ur.a( COr'an +rans!lantationLhow @uch o- the >romise Has Been 0eali9ed/C 'ature Medicine 11(; )200B*G ;0B415( >rint( @cAean, %heila, and Aaura =illiamson( Xenotransplantation: (a) and *thics( Aldershot, Hants, En'landG Ash'ate, 200B( >rint( C2ational Health and @edical 0esearch "ouncil(C Animal to Human Transplantation $esearch +Xenotransplantation,( 2H@0", 11 Dul# 2011( =eb( 2E %e!t( 2012( Fhtt!GHHwww(nhmrc('o,(auHhealth4ethicsHethical4issuesHanimal4human4 trans!lantation4research41enotrans!lantationI( >almer, Do#( CAnimal4to4Human +rans!lantsG As Dan'erous as 2uclear <ission/C Animal to Human Transplants( Doctors And Aaw#ers <or 0es!onsible @edicine, n(d( =eb( 2E %e!t( 2012( Fhtt!GHHwww(dlrm(or'HresourcesHtrans!lants(htmI( >latt, D( A( C:mmunobiolo'# o- enotrans!lantation(C Transplant -nternational 15(0 )2000*G %E4%10( >rint( >latt, De--re# A( Xenotransplantation: Basic $esearch and Clinical Applications( +otowa, 2DG Humana, 2002( >rint( 0eiss, @ichael( CEthics o- enotrans!lantation M Biotech Aearnin' Hub(C *thics of Xenotransplantation . Biotech (earning Hu/( 2(!(, n(d( =eb( 09 Oct( 2012( Fhtt!GHHwww(biotechlearn(or'(n9HthemesHbioethicsHethicsNo-N1enotrans!lantationI (

Dettmer E 0ossi, Aisa( C<irst Baboon to Human Ai,er +rans!lant(C 0irst Ba/oon to Human (i&er Transplant( enotrans!lantation, 2& A!r( 2005( =eb( 2E %e!t( 2012( Fhtt!GHHwww(1enotrans!lant(ineu(or'H1enotransHnewsH19920;29(htmI( %alomon, Daniel 0(, and "arol#n A( =ilson( Xenotransplantation( BerlinG %!rin'er, 2005( >rint( %tadlbauer, V(, >( %tie'ler, %( @Oller, @( %chwei'er, @( %ereini'', 6(H( +scheliessni'', and =( <reidl( CAttitude toward enotrans!lantation o- >atients >rior and a-ter Human Or'an +rans!lantation(C Clinical Transplantation )2010*G n( !a'( >rint( C%tatistics(C !tatistics . %onatelife1net( Donate Ai-e America, n(d( =eb( 08 Oct( 2012( Fhtt!GHHdonateli-e(netHunderstandin'4donationHstatisticsHI( %tarl9, +(, A( Demetris, 2( @urase, A( +homson, @( +rucco, and "( 0icordi( CDonor "ell "himerism >ermitted b# :mmunosu!!ressi,e Dru'sG A 2ew View o- Or'an +rans!lantation(C -mmunolog" Toda" 1&(; )1995*G 52;452( >rint( =oan, %unn#( CBu# @e a >ound o- <leshG "hinaPs %ale o- Death 0ow Or'ans on the Blac. @ar.et and =hat Americans "an Aearn -rom :t(C !anta Clara (a) $e&ie) &E(2 )200E*G n( !a'( >rint(