Everything about Xenograft totally explained
Xenotransplantation (
xeno- from the
Greek meaning "foreign") is the
transplantation of living
cells,
tissues or
organs from one
species to another such as from pigs to humans (see
Medical grafting). Such cells, tissues or organs are called
xenografts or
xenotransplants. The term
allotransplantation refers to a same-species transplant.Human xenotransplantation offers a potential treatment for end-stage organ failure, a significant health problem in parts of the industrialized world. It also raises many novel medical, legal and ethical issues. A continuing concern is that pigs have different lifespans than humans and their tissues age at a different rate. Disease transmission (
xenozoonosis) and permanent alteration to the genetic code of animals are also a cause for concern.
Because there's a worldwide shortage of organs for clinical implantation, about 60% of patients awaiting replacement organs die on the waiting list. Recent advances in understanding the mechanisms of transplant organ rejection have brought science to a stage where it's reasonable to consider that organs from other species, probably pigs, may soon be engineered to minimize the risk of serious rejection and used as an alternative to human tissues, possibly ending organ shortages.
Other procedures, some of which are being carefully investigated in early clinical trials, aim to use cells or tissues from other species to treat life-threatening and debilitating illnesses such as
cancer,
diabetes,
liver failure and
Parkinson's disease. If
vitrification can be perfected it could allow for long-term storage of xenogenic cells, tissues and
organs so they'd be more readily available for transplant.
There are only a few published successful xenotransplant procedures. Some patients who were in need of liver transplants were able to use pig livers that were on a trolley by their bedside successfully until a proper donor liver was available.
Problems
Immune rejection remains the biggest challenge for xenotransplantation. The problem exists even for human to human transplants (known as
allotransplantation), but is more serious for transplants between different species. Nearly all
mammalian cells have
markers which enable the
immune system to recognise them as being foreign. The more different the genetic code between the donor organ and recipient, the greater the difference between a "self" marker and a "foreign" marker. Some companies are currently developing
transgenic animals such as pigs, that produce human markers to try and lessen the chance of rejection.
Cross-species transplants are more likely to produce host-vs-graft or graft-vs-host reactions than same-species transplants, because of the lack of
antigenic similarity. Organisms which have been
genetically engineered to reduce this difference have been produced but are not yet used to any significant degree in medical care.
A worrisome element of xenotransplantation is the potential for infectious disease to spread from the donor animal, which is called
xenozoonosis. One example is porcine
endogenous retroviruses (PERVs) which are viruses within pigs that pigs are immune to, but can infect isolated human cells in
cell culture. Some recipients of pig neural cell transplants have had to agree to never donate blood, take frequent blood tests and use safe sex methods for the rest of their lives due to the risk of spreading such viruses. However, the patients who have received these pig cell transplants have yet to show any PERV-type infection. The situation with other animals is currently unknown.
Acceptance
Xenografts have been a controversial procedure since they were first attempted. Many, including animal rights groups, strongly oppose killing animals in order to harvest their organs for human use. Legitimate medical concerns exist about possible
disease transfer between animals and humans, such as the porcine
endogenous retrovirus found in pig tissues. Religious beliefs, such as the
Jewish and
Muslim prohibition against eating pork, may also present concerns for some.
In general, however, the use of pig and cow tissue in humans has been met with little resistance. The tissue is harvested from agricultural animals that were already being butchered, which is less offensive to most people than the idea of raising a
primate (which due to its genetic similarity would produce more suitable organs for transplants to humans) solely as an organ donor. Similarly, while some individual Jews may not wish to receive a pig
valve based on their personal beliefs, the rabbinical view is that the use of pig valves in humans isn't a violation of
kashruth law. In fact, killing a pig in order to save a human life is a requirement in the
Jewish faith, under the laws of
pikuach nefesh.
In 2005, the
Australian
National Health and Medical Research Council declared a five-year moratorium on all animal-to-human transplantation, concluding that the risks of transmission of animal viruses to patients and the wider community have not yet been resolved .
Further Information
Get more info on 'Xenograft'.
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