Xenotransplantation: A potential solution to the critical organ donor shortage

The success of allotransplantation as a treatment for end-stage organ failu re has resulted in the need for an increasing number of organ donors. Attem pts to meet this need include the use of organs from living related and unr elated donors, financial or other incentives for the donor family, and even the reuse of transplanted organs. Despite these initiatives, the supply of organs for transplantation still falls far short of the demand, as evidenc ed by longer waiting times for transplantation and decreasing transplantati on rates. Even if Canada were able to increase its organ donor rate to that of Spain (40 to 50/million), where organ donation is governed by 'presumed consent' legislation, this would not alleviate the problem of donor shorta ge. Interest in xenotransplantation stems from the need to overcome this in creasingly severe shortage of human organs. Indeed, some argue that xenotra nsplantation is the only potential way of addressing this shortage. As immu nological barriers to xenotransplantation are better understood, those hurd les are being addressed through genetic engineering of donor animals and th e development of new drug therapies. However, before xenotransplantation ca n be fully implemented, both the scientific/medical communities and the gen eral public must seriously consider and attempt to resolve the many complex ethical, social and economic issues that it presents.