Xenotransplantation is a very useful surgical method to be used nowadays which is “the transplantation of living cells, tissues or organs from one species to another species such as from pigs to humans.” (http://en.wikipedia.org/wiki/Xenotransplantation). The transplantation can be between the same species (human to human) or different species (animal to human) which causes more problems.
Biological Concepts and Processes
There are some steps before a recipient can carry out xenotransplantation. Firstly, there has to be a donated organ that will less likely to cause rejection inside the recipient’s body which is the hardest part. The organ has to be checked carefully. Then the recipient can carry out organ transplantation. After the surgery there are some things that the recipient needs to be careful with. Many people desperately need more organs, therefore that is why xenotransplantation has developed between the same species and different species.
1. Transplant surgery
Transplant surgery is defined as “the surgical removal of an organ(s), tissue, or blood products from a donor and surgically placing or infusing them into a recipient.” (http://www.surgeryencyclopedia.com/St-Wr/Transplant-Surgery.html). The purpose of transplant surgery is to give a chance to recipients who do not have any other ways to cure the diseases, because they are at the very last stage for their organ diseases. Unfortunately, not all the recipients can have a transplant surgery as there are some limitations. They depend on how old the recipient is, whether it is going to work or not and the stage of the disease. “Transplant surgery is not recommended for patients who have liver, lung, or kidney problems; poor leg circulation; cancer; or chronic infections.” (http://www.surgeryencyclopedia.com/St-Wr/Transplant-Surgery.html).
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2. Immunosuppressant drugs
When xenotransplantation from pig to human takes place at a recipient’s body, of course the body rejects the transplanted organ. As the immune system of the body does not accept the transplanted organ, it can have an effect on the transplanted organ. This happens most of the times, and therefore the immuno-suppressant drugs are very useful and highly required for the rejection of the body.
Immunosuppressant drugs are defined as anti-rejection drugs which are helpful for the protection of the body from rejecting the transplanted organ. Some examples of these drugs that are currently used are cyclosporins, azathioporins and corticosteroids. “Immunosuppressant drugs greatly decrease the risks of rejection, protecting the new organ and preserving its function.” (http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/immunosuppressant_drugs.jsp). The immunosuppressant drugs block the immune system of the body which gives a less possibility that they will react with the transplanted organ. These drugs also help other diseases such as skin disorders and other diseases (e.g. psoriasis, rheumatoid arthritis, Crohn’s disease and patch hair loss). Some major side effects of the use of immunosuppressant drugs are increasing the risk of infection and cancer. Some minor side effects are the loss of appetite, vomiting, shaking and increased hair growth.
3. Patient recovery
For inpatient recovery, after the transplant surgery, the transplant recipient is expected to stay in the hospital for about 3-4 weeks. Straight after the surgery the recipient is moved to an intensive care unit (ICU) as the recipient needs to be closely observed. As the recipient feels more stable and comfortable, then the recipient can stay in a normal hospital room. “The IV in the patient’s arm, the urinary catheter, and a dressing over the incision remain in place for several days.” (http://www.surgeryencyclopedia.com/St-Wr/Transplant-Surgery.html).
There are some important equipment required for the patient which are a chest tube to get rid of excess fluids, “A breathing aid called an incentive spirometer is used to help keep the patient’s lungs clear and active after surgery.” (http://www.surgeryencyclopedia.com/St-Wr/Transplant-Surgery.html), and also a PCA (patient-controlled anesthesia). PCA is a helpful equipment for the patients which carries the medications into the IV for pain.
In order to minimize the risks of organ rejection and infection, the patient is expected to take the immunosuppressive medications and also the number of visitors is limited. “The patient will be given intravenous antibiotic, antiviral and antifungal medications, as well as blood and platelet transfusions to help fight off infection and prevent excessive bleeding.” (http://www.surgeryencyclopedia.com/St-Wr/Transplant-Surgery.html).
Some tests are required, especially blood test, because it contains the information on the recipient’s kidney and liver function. After the recipient has been treated well enough to leave the hospital (outpatient recovery), the patient will need to have some visits. There are some things that the patient needs to be aware of which are keep taking medications and precautions (for preventing infection), contact the patient’s own doctor if the patient feels that something is not right and lastly, not trying to play rough sports.
Human need and demand
What humans really need and demand for xenotransplantation, is to get many healthy organs. There are a lot of people who desperately need the organ transplantation. People usually donate organs straight after the accident which occurs only when their family agrees to donate. Organs are also donated by some people who know that they will die soon and have some healthy organs.
Therefore, the number of donated organs is too small compared to the number of people who desperately need xenotransplantation. “19 January 2007, nearly 95000 patients were waiting for an organ transplant.” It is very hard to find the most suitable organ for the recipient. For example, even though there are some organs available for a recipient, the recipient needs to find the organ that will not cause rejection.
Therefore it takes a lot of time which is why so many people on the waiting list wait for a long time and die. In fact, humans need organs from animals, especially pigs as their size of the organs are quite similar to humans. “They breed relatively quickly with large litters, so a large number of life-saving organs could potentially be generated quickly when necessary.” ((http://www.eurotransplant.nl/?id=xeno).
This increases not only the number of available organs but also gives a much greater possibility for recipients to find the suitable organs. “Demand for organ transplantation will continue to increase as improved technical skills and anti-rejection medication make transplantation a realistic option for groups of people previously considered too vulnerable.” (http://www.eurotransplant.nl/?id=xeno).
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Implications of Xenotransplantation
The major problem caused by xenotransplantation from one species to different species is the rejection, such as from pigs to humans. Rejection occurs because the human’s body’s immune system does not accept the new foreign organ. Therefore there is a chance that the immune system will be against the organ, causing many problems. To decrease this risk, scientists tried something new. “For example, altering the recipient’s immune system and immune cells so that there is no immune response to the foreign transplant or interrupting communications so that no immune response is initiated.” (http://www.hc-sc.gc.ca/sr-sr/biotech/about-apropos/xeno_e.html). “Rejection occurs in three different stages, namely hyperacute, delayed xenotraft rejection and cellular rejection.” (Robert, B., & Mark, F., & Paul, H. (2000).
Farm animals in research. The University of Adelaide.). There are many information on hyperacute rejection being currently researched. The hyperacute rejection is the act of destroying the organ occurring really quickly in the body. There are many animal viruses known from xenotransplantation which might kill humans when transplanted. For pigs, there are 25 diseases (e.g. Porcine Endogenous Retroviruses, paramyxovirus, Nipah) that can have an impact on human’s health. It is not yet found how to screen for diseases, therefore it makes it even more risky to transplant organs from pigs to humans.
Xenotransplantation causes some social concerns. One of the concerns has an impact on recipients who got infected from the animal viruses, because it is difficult to treat and cure as it needs a lot of money. The reason why it is a major concern is that still there is not a resolved solution for this. Once the recipients get infected, they are going to be ill which also affects the recipients’ families and friends.
The recipients get ill, as their body is against foreign organs. Therefore, the transplantation from animal to human involves injections of animal matter which is also one of the causes of the recipients getting very ill. Other concerns include the feelings of recipients about carrying a pig’s organ inside their body. Some recipients will be depressed as they think that they have lost their own identity. The recipients will also have difficulties to “accept some of the precautions that may need to be taken to limit the transmission of infectious agents.” (http://www.xeno.cpha.ca/english/viewpnt/issues/ethical/page1.htm).
Major ethical concerns relating to xenotransplantation arises as it involves the use of animals. There is a group of people who think that xenotransplantation is a lack of morality for the religious reasons. There are three examples of groups who are against xenotrasnplatnation. Firstly the religion which is against xenotransplantation is the Buddhist religion. One of the most important teachings for them is to protect the animals. There also is another group which is against xenotransplantation, because they think that xenotransplantation is not natural (incomplete).
Last group is “opposed to initiating animal to human xenograft research on the grounds that benefits do not justify the economic costs and that xenotransplantation will produce additional inequities into a healthcare system that is already over-stretched.” (Robert, B., & Mark, F., & Paul, H. (2000). Farm animals in research. The University of Adelaide.). One ethical concern is that some recipients will have psychological concerns as the organ transplantation is from animal to human. Some recipients will find it really hard to accept the fact that they have an animal’s organ inside their body. Other ethical concerns are the “voluntary consent of individuals, respect for the individual’s autonomy, issues surrounding risk communication and issues relating to equity.” (http://uq.edu.au/oppe/PDFS/Xenotransplantation.pdf).
Xenotransplantation is a technology that is not so expensive to have. Xenotransplantation is very risky, because there could be many problems caused by xenotransplantation. The transplantation from human to human (“approximately, $300.000 per operation”) (http://www.crt-online.org/wrong.html) is less expensive than the transplantation from pig to human (“$25.000 to $100.000 to test just on pig for the presence of known bacteria and virus”). (http://www.crt-online.org/wrong.html) It is not the transplantation that is expensive, there are some extra money needed for other things, such as immunosuppressant drugs. The best condition for pigs to grow with less disease is the free germ conditions which takes a lot of time and a lot of money.
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Xenotransplantation has the impact on the human environment as xenotransplantation causes many animal viruses to humans which leads to health problems. Therefore to reduce the number of diseases for pigs, it is a good idea to raise them an incubator when they are born and they will be grown individually without other pigs which means that they will not get any other diseases from other pigs. The relationship between human and environment is very important. Health Human service’ action has affected the relationship because xenotransplantation causes many kinds of animal viruses that people can get from xenotransplantation between different species.
Also, there will be more animal viruses occurring inside the person’s body that are not found yet. The transplantation between different species requires a lot of animals. Increased in the number of pig organs, there will be more health problems as pigs pass human diseases (e.g. meningitis, salmonella, chlamydia, giardia, cryptosporidiosis, brucella, worms and influenza). “HHS also failed to address the environmental and health impacts caused by the disposal of numerous remains of genetically modified animals.” (http://www.crt-online.org/wrong.html) “Surveys find animal waste is degrading 1,785 bodies of water in 39 states. Pesticides, insecticides and antibiotics which are commonly used in agriculture may also contribute to soil and ground water contamination and consequently, harm human health.”
There are many different opinions of xenotransplantation. Campaign for Responsible Transplantation is a group which is against xenotransplantation. They believe that “xenotransplantation is a “significant” action because it is highly controversial and poses unique and unknown health effects to the xenograft recipient and the general public.” (http://www.crt-online.org/wrong.html). It is all known that currently there are animal viruses caused from the organ transplantation from pig to human. Therefore that is why I strongly think that there should be more researches.
Some people think that there is a big loss of pigs and also a lot of money wasted on research, but if there is a way to transplant pig organs into humans, it saves an uncountable number of people’s lives. There are a lot of people on the waiting list, waiting for an organ that is the most suitable for the recipient. If pig organs can be transplanted into humans, then there is a greater chance that the recipient will find the organ more quickly.
As the number of donated organs increases, the more people will have organ transplantation. “Others have strong moral convictions against using animals for any purpose, no matter how humans might benefit.” (http://www.xeno.cpha.ca/english/viewpnt/issues/ethical/page1.htm). I disagree with them, because the number of people dying on the waiting list is a lot. I think that both animals and humans are very important, however, humans worth more than animals. If xenotransplantation from pig to human becomes possible, there are many beneficial things that we can get from it, for example, there will not be a big loss of families and friends and intelligent people and so on.
Evaluation of Resources
I got a lot of information on xenotransplantation from variety of sources; web sites, books, encyclopedia, articles and documents. Xenotransplantation is a technology that is still developing, as the transplantation between animal to human (e.g. pig to human) does not have many successful cases. Therefore, there are still a lot of researches on xenotransplantation between different species. This was good because most of the sources I got from were between 2000 and 2008 which means that most of them were current. Some web sites did not have enough information, so I had to spend a lot of time looking for more details. Transplantation from human to human had more information than from pig to human.
There needs to be a lot more researches that have to be done. Some web sites had some really good information, so I did not have to find other web sites while some web sites were updated by random people. I could not use those web sites updated by random people, because mostly they had their own opinions and had wrong information. For the implications I found the web sites useful that had groups that are against xenotransplantation.
They had their own opinions as well as many well known concerns. As I was researching information on xenotransplantation, my opinion became stronger. Most of the sources were balanced of viewpoints. It was really good to know what other people or groups think about xenotransplantation, because I thought that most people would not be against xenotransplantation. But there were many groups and people against xenotransplantation such as Campaign for Responsible Transplantation.
Robert, B., & Mark, F., & Paul, H. (2000). Farm animals in research. The University of Adelaide.