Poland explores xenotransplantation to overcome organ transplant shortages [Advocacy Lab Content]

At the latest meeting of the Polish Transplant Council, experts discussed the necessity of establishing a team to thoroughly analyse the risks associated with the introduction of xenotransplantation.

Xenotransplantation, the transplantation of organs between species, represents one of the most fascinating and controversial directions in transplant research.

“We want xenotransplantation to be one of the points in the National Program for the Development of Transplant Medicine,” the National Consultant for Clinical Transplantology, Prof. Grąt, who initiated the meeting, told Euractiv.

The future of xenotransplantation

In light of the increasing demand for transplantable organs and the dramatic shortage of available ones, scientists must explore new solutions. One potential solution is the transplantation of organs from animals.

Pigs are among the best candidates for organ donors.

Pig organs are anatomically similar to human organs, and pigs carry few diseases that can be transmitted to humans, making them safer than primates. Additionally, pigs are relatively easy and economical to breed – they have short gestation periods, large litters, and mature quickly.

For now, xenotransplantations are still viewed as an experimental therapy used only for patients who have no other treatment options.

For instance, in 2022, the world’s first successful transplantation of a pig heart was performed on a 57-year-old American man who was not eligible for a human heart transplant.

Unfortunately, the patient died two months after the surgery. It was later found that the pig’s heart was infected with porcine cytomegalovirus, which might have contributed to the patient’s death.

In March 2024, surgeons in Boston successfully transplanted a kidney from a genetically modified pig into a human for the first time. The patient with the transplanted kidney lived for two months. The doctors stated that his death was unrelated to the organ transplant.

“I believe we are still far from the point where this solution could replace transplants from deceased or living donors,” Prof. Grąt told Euractiv. “However, in certain clinical situations, it might be a partial answer to the enormous organ shortage,” he added.

Xenotransplantation controversies

It is essential to remember that despite the immense hope associated with xenotransplantation, more research is needed to ensure this new technology becomes entirely safe and effective. One of the primary challenges in transplantation is the risk of organ rejection.

“In my opinion, the greatest risk in life-saving organ transplants is that the transplanted organ may fail to function. Xenotransplantation can only be considered once we are confident that the transplanted organs will function over the long term,” Prof. Grąt explained to Euractiv.

Despite its promise of saving the lives of patients awaiting transplants, xenotransplantation also raises significant ethical controversies. These include the ethics of breeding and using animals solely for the purpose of harvesting their organs, issues related to the dignity of both humans and animals and concerns regarding the “unnaturalness” of the process.

The greatest controversy, however, stems from the risk of transmitting unknown animal viruses, which could potentially lead to new pandemics.

“Accurately determining the risk of zoonotic disease transmission during transplantation is extremely difficult. Experimental models do not fully represent the actual risk of disease transmission. Real data will only come from patients who undergo such transplants,” Prof. Grąt highlighted.

Establishing guidelines

It is also crucial to develop national guidelines for xenotransplantation, even if its integration into standard medical procedures is still several years away.

“We must act now to avoid being left behind when the technology becomes widely available,” said Prof. Grąt. “To this end, we intend to assemble a team of experts from various fields, including clinical transplantology and surgery, to effectively assess the risks associated with xenotransplants and their potential impact on society,” he added.

Prof. Grąt emphasises that regardless of the direction transplantology takes, it is crucial to combat all forms of misinformation and pseudoscientific theories that can mislead the public, particularly in the context of obtaining organs from deceased donors.

“There are no medical controversies in the procedure of identifying potential donors. However, it is important for people to be informed that decisions regarding organ donation are made after the donor’s death, and these organs can save many lives,” he stressed.

Education, spreading knowledge, and raising public awareness are long-term goals that can bring about real change.

A good example is Spain. “In this country, a widespread media and social campaign contributed to achieving the highest number of deceased organ donors in Europe,” notes Prof. Grąt.

[By Paulina Mozolewska, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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