• Ethics
• Transplantation
• Palliative Care

Cardiac xenotransplantation has an experimental status with great potential to become an alternative treatment for patients who are ineligible or waiting for a transplant. In this commentary, I discuss the first three multi-criteria approaches to patient selection presented by the authors to identify a primary target group of patients who could benefit from this therapy.

The first criterion concerns adult patients with end-stage organ failure who have a high ‘medical need’ for xenotransplantation as an alternative treatment option. The authors limit their argument to patients for whom ventricular assist devices and artificial hearts are contraindicated and who have no chance of being placed on the transplant list due to comorbidities, acute decompensation or complex congenital heart disease (CHD).1 These patients could be considered for xenotransplantation. However, given the high risk of failure of this experimental treatment and the excessive burden on the patient’s health, the procedure is permitted only in extremely rare situations such as those of Bennett (2022) or Faucette (2023)2 discussed …