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Updated: Aug 26, 2025

A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
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Reevaluating the Ethical Issues in Porcine-to-Human Heart Xenotransplantation.

Henry Silverman, Patrick N Odonkor

    The Hastings Center Report
    |October 13, 2022
    PubMed
    Summary

    Porcine heart xenotransplantation offers a solution for organ shortages. Ethical considerations, including psychosocial support and informed consent, are crucial for future clinical trials in xenotransplantation.

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    Area of Science:

    • Transplantation Medicine
    • Bioethics
    • Surgical Innovation

    Background:

    • Limited availability of donor organs for heart allotransplantation.
    • Porcine heart xenotransplantation as a potential alternative for end-stage heart failure.
    • First-in-human porcine xenotransplantation at UMMC highlighted ethical considerations.

    Purpose of the Study:

    • To examine ethical issues guiding selection criteria for xenotransplantation trials.
    • To discuss risk-benefit balance and clinical equipoise in xenotransplantation.
    • To explore the role of psychosocial evaluations and informed consent in xenotransplantation.

    Main Methods:

    • Review of ethical considerations from a first-in-human porcine xenotransplantation.
    • Analysis of psychosocial evaluation's role in post-transplant compliance and equity.
    Keywords:
    bioethicsethicsinformed consentpig-to-human heart transplantpsychosocial criteriarisks and benefitsselection criteriaxenotransplantation

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  • Discussion of informed and voluntary consent requirements for xenotransplantation candidates.

    • Main Results:

    • Psychosocial criteria should identify patients needing support, not exclude them, based on reciprocity.
    • Balancing risks and benefits, and understanding clinical equipoise are essential.
    • Proper assessment of informed consent is critical for patient autonomy.

    Conclusions:

    • Ethical frameworks are vital for advancing porcine heart xenotransplantation.
    • Psychosocial support and equitable evaluation enhance patient care in xenotransplantation.
    • Ensuring informed and voluntary consent is paramount for ethical xenotransplantation practices.