Creating Ethics Frameworks for Xenotransplant Implementation | NYU Langone Health

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Transplant Ethics & Policy Projects Creating Ethics Frameworks for Xenotransplant Implementation

Creating Ethics Frameworks for Xenotransplant Implementation

More than 100,000 people in the United States are waitlisted for a lifesaving organ transplant, and on average, 20 die each day because of inadequate organ supply. Among several emerging efforts to reduce this shortage is xenotransplantation—transplanting organs and tissues from nonhuman animals into humans. Research in this field has persisted with no promising advances in interspecies organ compatibility or improving immune suppression until very recently. CRISPR-based gene-editing technology has renewed excitement around xenotransplants, under the theory that these techniques—unprecedented in effectiveness and efficiency—could edit nonhuman organs to be more human compatible, thereby reducing human immune system responses.

Edited pig kidneys have been successfully grafted onto deceased humans who were mechanically supported, and the first edited pig heart was transplanted into a living human who was not a candidate for a standard heart transplant. If successful, xenotransplant has the potential to vastly reduce the organ shortage. However, several critical ethics considerations must be incorporated into both the testing of this form of transplant and the definition of xenotransplant success.

Through a grant funded by the Appelbaum Foundation, members of the Transplant Ethics and Policy research program at NYU Langone are developing practical ethics criteria for xenotransplant research. We are collaborating directly with leading researchers to determine how these criteria should be proactively incorporated into the next xenotransplant experimental designs.

Project Focus Areas

The three components of this project examine the following.

Human Recipient Considerations

We are developing ethically framed parameters for determining eligibility to be among the first xenotransplant recipients with attention to just and fair demographic representation. We are also creating specific standards for facilitating and obtaining informed consent to xenotransplant research.

Public Perceptions

We are studying public and patient perspectives regarding xenotransplants, with particular attention to different racial, ethnic, and religious groups, to inform education, research development, and policy.

Nonhuman Animal Use Considerations

We are reviewing the existing ethics justifications for sacrificing animals to extend human life and considering how these principles need to be updated in light of advancing xenotransplant research. This will inform practical guidance for animal care and use committees and research programs.

Project Faculty

Brendan Parent, JD
Principal Investigator
Director, Transplant Ethics and Policy Research, Division of Medical Ethics
Assistant Professor, Departments of Population Health and Surgery

Arthur L. Caplan, PhD
Co-Principal Investigator
Founding Head, Division of Medical Ethics
The Drs. William F. and Virginia Connolly Mitty Professor of Bioethics, Department of Population Health

Laura L. Kimberly, PhD
Co-Principal Investigator
Assistant Professor, Hansjörg Wyss Department of Plastic Surgery and Department of Population Health
Division of Medical Ethics

Tamar Schiff, MD
Co-Principal Investigator
Postdoctoral Fellow, Transplant Ethics and Policy Research, Division of Medical Ethics

Lena Milam
Program Coordinator, Transplant Ethics and Policy Research, Division of Medical Ethics

Working Group Members

Asma Alzaidy, MBBS, MBE
Instructor, Saudi Commission for Health Specialties
General Physician, Saudi Ministry of Health
Fellow, Misk Foundation

Moshe Cohn, MD, HEC-C
Faculty Affiliate, Division of Medical Ethics, NYU Grossman School of Medicine

Bruce E. Gelb, MD
Assistant Professor, Department of Surgery, NYU Grossman School of Medicine
Associate Medical Director, Comprehensive Transfer Center, NYU Langone Health

Daniel Hurst, PhD, ThM, MSc
Director of Medical Professionalism, Ethics, and Humanities
Assistant Professor, Department of Family Medicine, Rowan University School of Osteopathic Medicine

Samantha Klitenic, JD
Research Program Coordinator, Department of Surgery, Division of Transplantation, Johns Hopkins School of Medicine

Stephen R. Latham, JD, PhD
Director, Interdisciplinary Center for Bioethics, Yale University

Lisa Moses, VMD, DACVIM
Lecturer, Center for Bioethics, Harvard Medical School
Bioethics Scholar, Yale Interdisciplinary Center for Bioethics
Vertebrate Genomics Group, Broad Institute of MIT and Harvard

Rabbi Daniel Nevins
Head of School, Golda Och Academy
Transplant Ethics and Policy Research, Division of Medical Ethics, NYU Grossman School of Medicine

Luz Padilla, MD, MSPH
Director, Surgical Research for the Pediatric and Congenital Heart Center of Alabama
Assistant Professor, Departments of Cardiothoracic Surgery and Epidemiology, University of Alabama at Birmingham

Peter Reese, MD, MSCE
Professor, Renal Division, Perelman School of Medicine at the University of Pennsylvania

Sylvia Rosas, MD, MS
Director, Latino Kidney Clinic
Investigator and Staff Physician, Joslin Diabetes Center
Associate Professor, Harvard Medical School

Jeff Sebo, PhD
Director of the Animal Studies M.A. Program
Clinical Associate Professor of Environmental Studies
Affiliated Professor of Bioethics, Medical Ethics, and Philosophy

Laurie Sellars
MA Student and Course Assistant, NYU Animal Studies

Lesley Sharp, PhD
The Barbara Chamberlain and Helen Chamberlain Josefsberg ’30 Professor of Anthropology, Barnard College

Bonnie Venter, LLM
PhD Candidate/Research Associate, Centre for Health, Law, and Society, University of Bristol Law School

Anthony Watkins, MD, FACP
Surgical Director, Kidney Transplant Program, Tampa General Hospital

Amanda Zink, JD
Research Associate, Transplant Ethics and Policy Research, Division of Medical Ethics, NYU Grossman School of Medicine

Publications and Media

Sebo J. Against human exceptionalism. Aeon. May 5, 2022.

Sebo J. Op-ed: If we balk at killing pigs for organ donations, then we also should rethink killing them for food. Chicago Tribune. January 18, 2022.

Caplan A … Schiff T. Opinion: Here are some questions about the pig heart transplant that people actually should be asking. The Washington Post. January 14, 2022.

Molteni M. First transplant of a genetically altered pig heart into a person sparks ethics questions. Stat. January 10, 2022.

Reese PD and Parent B. Promoting safety, transparency, and quality in xenotransplantation. Ann Intern Med. 2022. DOI.

Padilla LA … Cooper DKC. Informed consent for potential recipients of pig kidney xenotransplantation in the United States. Transplantation. 2022. DOI.

Caplan A and Parent B. The ethics of saving lives through a new kind of organ transplant. New York Daily News. October 25, 2021.

Additional Information

Our program—the Division of Medical Ethics Transplant Ethics and Policy Research at NYU Langone—is independent from the NYU Langone Transplant Institute, both in leadership and in funding. This working group (Ethics of Xenotransplant) is funded by a grant from the Applebaum Foundation to NYU Langone’s Division of Medical Ethics, and has no direct affiliation with the NYU Langone Transplant Institute. We work collaboratively with clinical researchers at NYU Langone and other institutions leading xenotransplant research, but our projects and outputs are independent.