Who deserves a pig heart?

By Johannes Kögel and Georg Marckmann. Ethical criteria are essential for determining which patients should receive a pig heart transplant. These criteria—medical need, capacity to benefit, and patient choice—are designed to ensure a pathway to clinical trials that balances short-term outcomes with the long-term success of the therapy. Xenotransplantation, the transplantation of organs across species […]

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Should AI allocate livers for transplant?

By Max Drezga-Kleiminger, Joanna Demaree-Cotton, Julian Koplin, Julian Savulescu, and Dominic Wilkinson. The field of artificial intelligence (AI) is moving rapidly. In the (recent) past, we could hide behind the knowledge that much of the ethical discourse around AI was in hypothetical terms – we were discussing what we should do in case technology progressed […]

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Pig hearts and paediatrics: how children will require distinctive ethical approaches when xenotransplantation becomes a reality

By Anthony Merlocco Due to the ongoing struggle to obtain organs for those in need, and the resulting morbidity and mortality while awaiting organs, renewed efforts to study transplantation between species, or xenotransplantation (XTx), have emerged. Gene editing has been used to enhance human graft survival or to make animal organs better suited for a […]

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David Bennett and the first porcine xenotransplantation

By Christopher Gyngell and Julian Savulescu. At 57, David Bennett was dying. He had a decades long history of heart disease. Prior treatments, including surgery, had proved ineffective. In November 2021, he was diagnosed with uncontrollable arrhythmia and was admitted to the University of Maryland Medical Centre. Despite the best efforts of clinicians, his condition […]

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Split liver transplantation: Is saving more lives always the ethical option?

By Tae Wan Kim, John Roberts, Alan Strudler, and Sridhar Tayur. In 2016, the Organ Procurement and Transplant Network (OPTN) and United Network for Organ Sharing (UNOS) posed an increasingly consequential question: Should a large liver always be split if medically safe? During a split liver transplantation (SLT), a whole human liver is divided into […]

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Prize, Not a Price: How the right reward could solve the problem of kidney failure

By Aksel Braanen Sterri. Worldwide 1.2 million people are dying from kidney failure each year. The best treatment for kidney failure is a kidney transplant from a living donor, but too few people are willing to donate. In the paper, Prize, Not a Price: Reframing Rewards for Kidney Donors, I defend a way to meet […]

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Ensuring equity in vascularized composite allotransplantation

By Laura L. Kimberly, Elie P. Ramly, and Eduardo D. Rodriguez Vascularized composite allotransplantation (VCA) can be considered the innovative cousin of solid organ transplantation. VCA is the transplantation of multiple tissues, such as skin, muscle, nerve, and bone as a functional unit. This includes facial, upper and lower extremity, uterine, penile and abdominal wall […]

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