Reevaluating the Ethical Issues in Porcine-to-Human Heart Xenotransplantation

A major limiting factor with heart allotransplantation remains the availability of organs from deceased donors. Porcine heart xenotransplantation could serve as an alternative source of organs for patients with terminal heart failure. A first-in-human porcine xenotransplantation that occurred in Jan...

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Bibliographic Details
Authors: Silverman, Henry (Author) ; Odonkor, Patrick N. (Author)
Format: Electronic Article
Language:English
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Published: Wiley 2022
In: The Hastings Center report
Year: 2022, Volume: 52, Issue: 5, Pages: 32-42
Further subjects:B risks and benefits
B Informed Consent
B Ethics
B Bioethics
B xenotransplantation
B selection criteria
B pig-to-human heart transplant
B psychosocial criteria
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Summary:A major limiting factor with heart allotransplantation remains the availability of organs from deceased donors. Porcine heart xenotransplantation could serve as an alternative source of organs for patients with terminal heart failure. A first-in-human porcine xenotransplantation that occurred in January 2022 at the University of Maryland Medical Center provided an opportunity to examine several ethical issues to guide selection criteria for future xenotransplantation clinical trials. In this article, the authors, who are clinicians at UMMC, discuss the appropriate balancing of risks and benefits and the significance, if any, of clinical equipoise. The authors also review the alleged role of the psychosocial evaluation in identifying patients at an elevated risk of posttransplant noncompliance, and they consider how the evaluation's implementation might enhance inequities among diverse populations. The authors argue that, based on the principle of reciprocity, psychosocial criteria should be used, not to exclude patients, but instead to identify patients who need additional support. Finally, the authors discuss the requirements for and the proper assessment of informed and voluntary consent from patients being considered for xenotransplantation.
ISSN:1552-146X
Contains:Enthalten in: Hastings Center, The Hastings Center report
Persistent identifiers:DOI: 10.1002/hast.1419