Ethical Considerations in Islet Xenotransplantation

For the management of type 1 diabetes, islet xenotransplantation has emerged as a potential alternative to lifelong insulin therapy or islet allotransplantation. However, this progress raises significant ethical questions that warrant further exploration. This article will examine the ethical landscape of islet xenotransplantation, highlighting points of convergence and distinction with solid organ xenotransplantation. We focus on four key areas: (i) animal welfare, including the ethical implications of sourcing large numbers of pigs per recipient; (ii) pediatric considerations, given the lifelong impact of early interventions, and the increasing prevalence and burden of pediatric diabetes; (iii) informed consent and obligations for long-term monitoring including sample retention; and (iv) strategies for inclusive public and patient engagement to build trust and transparency.