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Current controversy
Update on the ethical, legal and technical challenges of translating xenotransplantation
  1. Rebecca Thom1,
  2. David Ayares2,
  3. David K C Cooper3,
  4. John Dark4,
  5. Sara Fovargue5,
  6. Marie Fox6,
  7. Michael Gusmano7,
  8. Jayme Locke8,
  9. Chris McGregor9,
  10. Brendan Parent10,
  11. Rommel Ravanan11,
  12. David Shaw12,
  13. Anthony Dorling1,13,
  14. Antonia J Cronin1,13
  1. 1 Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals NHS Trust, London, UK
  2. 2 Revivicor Inc, Blacksburg, Virginia, USA
  3. 3 Centre for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
  4. 4 Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, Newcastle upon Tyne, UK
  5. 5 School of Law, The University of Sheffield, Sheffield, UK
  6. 6 School of Law and Social Justice at the University of Liverpool, Liverpool, Merseyside, UK
  7. 7 Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
  8. 8 Division of Transplantation, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
  9. 9 Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
  10. 10 Medical Ethics, New York University School of Medicine, New York, New York, USA
  11. 11 Southmead Hospital, Bristol, UK
  12. 12 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
  13. 13 Centre for Nephrology, Urology and Transplantation, King's College, London, UK
  1. Correspondence to Dr Antonia J Cronin, Centre for Nephrology, Urology and Transplantation, King's College, London, UK; antonia.cronin{at}kcl.ac.uk

Abstract

This manuscript reports on a landmark symposium on the ethical, legal and technical challenges of xenotransplantation in the UK. King’s College London, with endorsement from the British Transplantation Society (BTS), and the European Society of Organ Transplantation (ESOT), brought together a group of experts in xenotransplantation science, ethics and law to discuss the ethical, regulatory and technical challenges surrounding translating xenotransplantation into the clinical setting. The symposium was the first of its kind in the UK for 20 years. This paper summarises the content of the expert lectures showcasing the progress which has been made in xenotransplantation including—the history of xenotransplantation, advances in gene edited animals and progress towards clinical xenotransplantation. We then set out the ethical and legal issues still to be resolved. Finally, we report the themes of the roundtable discussion highlighting areas of consensus and controversy. While the detail of the legal discussion was directed towards the UK, the principles and summary reported here are intended to be applicable to any jurisdiction seeking to implement clinical xenotransplantation.

  • Ethics
  • Tissue and Organ Procurement
  • Legislation
  • Policy

Data availability statement

Data are available in a public, open access repository.

https://doi.org/10.1136/jme-2023-109298

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    Data availability statement

    Data are available in a public, open access repository.

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    Footnotes

    • X @SFovargue, @parent_brendan

    • Contributors RT: first author, original draft, and writing, review and editing. AD: Chair of symposium, conceptualisation, reviewed and edited manuscript. AJC: Chair of symposium, conceptualisation, reviewed and edited manuscript. DKCC: Presenter at symposium, reviewed and edited manuscript. DA: presenter at symposium. JL: presenter at symposium, reviewed and edited manuscript. BP: presenter at symposium, reviewed and edited manuscript. MG: presenter at symposium, reviewed and edited manuscript. JD: participated in roundtable discussion. CM: participated in roundtable discussion. SF: participated in roundtable discussion, reviewed and edited manuscript. MF: participated in roundtable discussion, reviewed and edited manuscript. RR: participated in roundtable discussion. DS: participated in roundtable discussion. RT and AJC: guarantors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests David Ayares is the chief scientific officer of Revivicor, Inc. David Cooper Consultant to eGenesis Bio, Cambridge, MA, USA. Jayme Locke receives grant salary support from Lung Biotechnology PBC, a subsidiary of United Therapeutics.

    • Patient and public involvement statement The viewpoint of this manuscript is not of one individual and does not reflect the opinions of these commercial organisations.

    • Provenance and peer review Not commissioned; externally peer reviewed.