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SPARE parts any takers?

by Raj Kishor Kha ware
THE recent unsuccessful case of pin heart transplantation by D R Baruah, an Assam-based doctor has created a furor in the field of bioethics which today is flummoxed over the question of organ transplant from one species to the other. While its critics fear the unknown dangers of this method, its defenders are optimistic that they can t>e anticipated and overcome.
Critics argue that there is always the remote possibility of a virus or any infectious agent lurking in a pig s kidney or a baboon’s liver which might infect the host, causing a vicious disease which may infect the entire humankind. Humans have been known to be suscep-I ible to a variety of animal viruses like the monkey pox virus, the herpes B virus from Macaques and viruses of porcine influenza and the swine vesicular disease.
Prions (infectious particle containing a protein) which cause degenerative brain diseases. are also capable of species-hopping. Although humans are resistant to animal pathogens, transplanting organs directly might create a difficult situation, particularly when patients are given immunosuppressive drugs to prevent graft rejection.
in its latest report, Animal-to-Human-Transplants: the Ethics of Transplantation. Nuffield council, an influential bioethics advisory group and independent watchdog in the UK concluded that the risk associated with the possible transmission of infectious diseases as a consequence of xenotransplantation (transplanting organs form one species onto another species) has not been
dealt adequately because it is unethical to conduct clinical trials involving human beings.
The council's report calls upon the UK government to immediately establish an advisory committee on xenotransplantation. to assess potential public health risks, define precautionary measures prior to human clinical trials and protect patients' interest.
I agree that spare parts surgery, using animal organs, challenges our notion of humanness and our sense of distinctness from other species. However, if one wishes to follow Nuffield council recommendations. how does one handle tfiat in 1994. 5.000 people in the UK were waiting for kidney transplants. while 320 were in need of biological heart? The 1996 figure is yet to come.
Certain viewpoints of the report seem exaggerated and overemphasised/High risk of disease transmission from primates persuaded the council to favour pigs over primates. The report pinpoints the lethal disease causing herpes B virus from macaque monkey draws attention to the similarities between simian and human immunodeficiency viruses. But what the council seems to have missed is the greater risk of disease transmission In human-to-human transplantatiop.
Earlier, the major source of insulin for diabetics was pig and cattle pancreas. Despite millions of diabetics taking several insulin injections dally, there were very few reported cases of bovine or porcine disease transmission. Insulin, of course, was a purified compound and not a living
preparation. However, it maybe recalled that purified proteins extracted from human sources have far worse record of disease transmission than does animal insulin.
The Nuffield council also raised the question of animal organs themselves being susceptible to animal diseases, especially in the case of transplanted lungs. The council report highlights the possibility of prion disease passing from species to species, but also states that such disease transmission may also occur due to transplantation or by eating infected things: bacon and ham should be avoided to keep pig prion at bay.
There are. however, many diseases which are virtually species specific and highly unlikely to cause any disease in humans ever. One may recall several animal pathogens which were beneficial to human beings. From Louis Pasteur who produced the first rabies virus to tlie modern producer of the influenza vaccine who are still cultivating attenuated virus in chicken eggs, experience indicates that growing viruses in cells of other species can make the infection agent less pathogenic, less fit for its being invasive, disease-causing role, and less likely, therefore, to affect humans.
So far. primate xenotransplantation exercises seem to have worked in a statistically acceptable way. If the trials demand several forms of pretransplantation and post-transplantation monitoring for both the source of animals and Satients. it can always be ful-lled. *
CSE/Down To Earth Features