Start Page / Reports / Xenotransplantation – renal transplantation example

Xenotransplantation – renal transplantation example

Report type: Alert
Published: 1999-03-26  Revised: 2001-12-10
Contact person: Jan Liliemark  E-mail: liliemark@sbu.se

Findings by SBU Alert

This is a translation of version 1, published on March 26, 1999. The latest version of this report is not available in English.

Many patients who have suffered organ damage from disease can now be helped by organ transplantation. However, the number of transplants is limited by access to donor organs. One way to remedy the shortage in organs would be to use animal organs, ie, xenotransplantation. Advancements in genetic technology have created new opportunities for xenotransplantation. An analytical model has been developed to illustrate the future economic impact of xenotransplantation of kidneys from genetically engineered pigs. Nevertheless, considerable uncertainty remains as to the future costs for research & development and clinical services.

Knowledge concerning the risks of this technology is incomplete. Likewise, no* reliable evidence is available concerning short-term and long-term patient benefits. The method is associated with substantial ethical consequences that must be illuminated and debated.

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Professor Carl-Gustav Groth, Department of Transplantation Surgery, Huddinge Hospital. Referee has been Professor Nils H Persson, Vascular and Renal Diseases, MAS University Hospital, Malmö.

The complete report is available in Swedish only.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

  1. Zaidi A, Schmoeckel M, Bratti F, Waterworth P, Tolan M, Cozzi E, Chavez G, Langford G, Thiru S, Wallwork J, White D, Friend P. Life-supporting pig-to-primate renal xenotransplantation using genetically modified donors. Transplantation 1998;65:1584-90.
  2. Patience C, Takeuchi Y, Weiss RA. Infection of human cells by an endogenous retrovirus of pigs. Nature Medicine 1997;3:282-286.
  3. Heneine W, Tibell A, Switzer M, Sandstrom P, Vazquez Rosales G, Mathews A, Korsgren O, Chapman LE, Folks TM, Groth CG. No evidence of infection with porcine endogenous retrovirus in recipients of porcine islet-cell xenografts. Lancet 1998;352:695-698.
  4. Patience C, Patton GS, Takeuchi Y, et al. No evidence of pig DNA or retroviral infection in patients with short-term extra-corporeal connection to pig kidneys. Lancet 1998;352:699-701.
  5. Coghlan A. So far, so good. New Scientist 1998;159:4.
  6. Sennfält K. Ekonomiska aspekter på xenotransplantation av njurar. ArbetsPM 2, SBU 1998.
  7. Persson A. Att överskrida gränser. Om xenotransplantation, risker, värderingar, och människouppfattning. Vest 1998;11:31.
  8. Groth CG, Korsgren O, Tibell A, Tollemar J, Möller E, Bolinder J, Östman J, Reinholt FP, Hellerström C, Andersson A. Transplantation of porcine fetal pancreas to diabetic patients. Lancet 1994;344:1402-04.
  9. Breimer M, Björck E, Svalander CT et al. Extracorporeal ("ex vivo") connection of pig kidneys to humans I: clinical data and studies of platelet destruction. Xenotransplantation 1996;3:328-329.