On January 12, 57-year-old American patient David Bennett became the first person in the world to receive a heart transplant from a genetically modified pig. Doctors decided Bennett was too ill to be eligible for a human heart transplant. But on Friday doctors transplanted the heart of a genetically modified pig into Bennett after a seven-hour experimental operation. After 3 days, he was doing well.
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The procedure has been hailed as a medical breakthrough that could shorten the time patients wait for transplanted organs and change the lives of patients around the world. But some have questioned whether the practice is ethical.
They believe that this treatment method has potential ethical issues in terms of patient safety and animal rights.
So how controversial is organ transplanting from pigs?
medical risk
This is an experimental procedure, and the patient has to take huge risks. Even well-matched human donor organs can be rejected after transplantation, and transplanting animal organs can be more dangerous.
For decades, doctors have tried to use animal organs for so-called “xenotransplantation.”
In 1984, a California medical team tried to use a baboon heart to save the life of a little girl, but she died 21 days after surgery.
Although the treatment is very dangerous, some medical ethicists say that if patients are aware of the risks, they should still proceed.
“You can never be sure if someone will die soon after treatment, but you can’t help but take the risk,” said Julian Savulescu, a professor of practical ethics at Oxford University.
“As long as I understand all the risks, I think people should be able to agree to these radical experiments,” he added.
It’s important to give patients all options available, including extracorporeal heart support or human organ transplants, Saulescu said.
The doctor who operated on Bennett said the surgery was justified because the patient himself had no other options for treatment, and without surgery he would have died.
Saulescu stressed that before any surgery, surgery must go through “very rigorous tissue and animal testing” to ensure safety.
Bennett’s organ transplant was not part of a clinical trial, and the drug he was taking had not been tested on other primates.
But Christine Lau, a doctor at the University of Maryland School of Medicine who was involved in planning the operation, said there were no shortcuts in preparing for the operation.
“We’ve been experimenting with primates in the lab for decades, trying to get to the point where it’s safe to give animal organs to human patients,” she said.
animal rights
Bennett’s surgery also reignited the debate over the use of pig organs for human transplants, which many animal rights groups have opposed.
One of them condemned the surgery as “immoral, dangerous and a huge waste of resources”.
“Animals are not ransacked tool sheds, but intelligent, complex creatures,” the group said.
Scientists have modified 10 genes in donor pigs used for heart transplants to avoid rejection. Activists say modifying the animal’s genes adds to the mistake.
A spokesman for the UK animal rights group said they opposed genetic modification or xenotransplantation of animals “under any circumstances”.
“Animals have the right to live their own lives without all the pain and trauma that comes with modifying their genes,” the group said. “They are just killed and their organs harvested.”
Some activists are also concerned about the unknown long-term effects of modifying the gene on pig health.
Katrien Devolder, a bioethics researcher at Oxford University, said we should only use genetically modified pigs as donors for organ transplants if we can “ensure they are not harmed unnecessarily”. body.
“Using pigs to produce meat is more problematic than using them to save lives, and certainly not a reason to ignore animal welfare,” she said.
Faith issues
Another conundrum may arise for patients who, because of their beliefs, have difficulty receiving animal organs.
Pigs were chosen as organ transplant donors because pigs have organs similar in size to humans and are relatively easy to breed and raise.
But what impact does this choice have on Jewish or Muslim patients?
Moshe Freedman, a senior rabbi in London who is a member of the UK Department of Health‘s Ethics and Ethics Advisory Group (MEAG), said that while Judaism prohibits Jews from keeping or eating pigs, accepting pig hearts “doesn’t violate the kosher diet in any way. Law”.
“Since Judaism is primarily concerned with protecting human life, Jewish patients will be obliged to receive animal organ transplants if this approach provides the greatest chance of survival and the best quality of life in the future,” Friedman said in an interview.
For Islam, animal material is also allowed if it saves a person’s life.
Egypt’s central authority, which issues religious rulings, said it would allow pig heart valves if there were “fears of loss of life, worsening or continuation of the disease”.
Saulescu said that even if someone refuses to transplant animal organs for various reasons, they should not wait for human organs to donate organs.
“Some people might say that once you have the opportunity to get an organ and give it up, you should get back in line; others will say, you should have the same rights as other patients.” “These are situations that we have to reconcile. .” (Chen Chen)
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