CMDA's The Point

Xenotransplantation: What’s New and Should We Be Concerned?

April 9, 2024

by Christian Medical & Dental Associations®

Christine Toevs, MD, FACS, FCCM, MA (Ethics) and Robert Cranston, MD, FAAN, MSHA, MA (Ethics)


In the last month, a patient with kidney failure was discharged from the hospital, off dialysis, with a new kidney—from a genetically modified pig. What an incredible accomplishment. The application of CRISPR technology to xenotransplantation expands the possibilities and options for organ transplantation. The benefits include increased organ supply, decreased issues regarding allocation of a scarce resource, decreased reliance on organs from patients through either Death by Neurological Criteria or Donation after Circulatory Death (DCD) and potentially decreased reliance on living related/unrelated organ donation. Given the current ethical issues about regarding “brain death,” DCD and some of the technologies used to procure these organs, xenotransplantation could eliminate or reduce these concerns.


Xenotransplantation in the modern era started in the 1960s with chimpanzee/baboon heart and lung transplantation. The patients receiving these organs survived a variable amount of time, and the transplants were often “proof of concept” technologies. Animal organs were also used as a bridge to human organ transplantation. Despite advances in immunosuppression, xenotransplantation remained unsuccessful except for short periods of time, due to rejection issues and cross-species incompatibility. CRISPR and genetic modification of pigs seems to have changed the game and revived xenotransplantation as a viable alternative to human organ transplant. Although just in the beginning stages, and with much work and research to be done, we may have found a solution to some of the ethical issues listed above.


However, xenotransplantation now creates its own ethical issues. If this technology is successful, everyone on the waiting list for organ transplantation will want an organ yesterday. How will we deal with demand, prioritization of patients and resource allocation, given a limited supply of genetically modified animal organs, ICUs, transplant surgeons, operating rooms, etc.? Immunosuppression, and the complications there-in, will remain problematic. Who will supply and raise the animals? Who will address quality control and oversee issues related to animal farming and organ procurement? What about patients who do not want an animal organ? How will we address the cost of xenotransplantation? Will the offset of patients no longer requiring dialysis cover the cost of transplantation? And as always, there is the “law of unintended consequences” and issues we have not yet begun to identify or address.


Genetically modified animals for transplantation likely will change current treatment and human-to-human transplant. Although it may “solve” one set of ethical issues, xenotransplantation will also create a new set of ethical issues. We need to be mindful and aware of what seems to be an incredible technology, which may not be as perfect as we hope. As one transplant expert says, “We don’t know what we don’t know.” Good intentions don’t eliminate unintended consequences.

Christian Medical & Dental Associations®

About Christian Medical & Dental Associations®

The Christian Medical & Dental Associations® (CMDA) is made up of the Christian Medical Association (CMA) and the Christian Dental Association (CDA). CMDA provides resources, networking opportunities, education and a public voice for Christian healthcare professionals and students. Founded in 1931, CMDA provides programs and services supporting its mission to "change hearts in healthcare" with a current membership of over 13,000 healthcare professionals. CMDA promotes positions and addresses policies on healthcare issues; conducts overseas medical education and evangelism projects; coordinates a network of Christian healthcare professionals for fellowship and professional growth; sponsors student ministries in medical dental, PA, and other healthcare training schools; distributes educational and inspirational resources; hosts marriage and family conferences; provides developing world missionary healthcare professionals with continuing education resources; and conducts academic exchange programs overseas. By being the "hands of Jesus" to needy people, CMDA seeks to fulfill His Great Commandment (Matthew 22:39; 25:36) and His Great Commission (Matthew 28:19). The Christian Medical & Dental Associations® is a 501(c)3 and is governed by a Board of Trustees and House of Delegates. Policies of CMDA are interpreted and applied by the Board of Trustees, which also establishes the guidelines for the executive director and his staff. An elected House of Delegates assists the board with recommendations on courses of action. The House of Delegates is composed of graduate, student, resident and missionary members who are elected for three-year terms by district and meets annually at the CMDA National Convention. Approximately 75 employees currently make up the staff of CMDA in the national office and U.S. field offices.

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