XENOTRANSPLANTATION:
PROS AND CONS
DOI:
https://doi.org/10.7443/problemata.v14i5.65980Keywords:
ethic, science, xenotransplantAbstract
This article aims to provide a broad view of the complexity of xenotransplantation, a technique that consists of using non-human animals as organ suppliers for humans. In this sense, it is intended to assist in the ethical analysis of the potential benefits of the technique, in light of the questions inherent to its research and possible implementation. On the one hand, xenotransplantation has the potential to solve the chronic shortage of human organs for transplantation, reducing deaths resulting from the lack of organs and the waiting lists. On the other hand, it raises several issues that must be widely analyzed and democratically debated by society, such as: the risk of xenozoonosis, the use of non-human animals, the limitation of the privacy of recipients of organs of animal origin, collection protocols of free and informed consent and the use of brain-dead patients in experiments. Thus, it is concluded that, even if clinical obstacles are overcome in the future and it is possible to successfully perform xenotransplantation of organs, it is essential to carefully evaluate the pros and cons before deciding on its continuity.
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References
ABOUBAKR, M. et al. Brain Death Criteria. Em: StatPearls [online]. Treasure Island (FL): StatPearls Publishing, 2022. E-book. Disponível em: http://www.ncbi.nlm.nih.gov/books/NBK545144/. Acesso em: 28 fev. 2023.
ADENA, R. Xenotransplante: avanços e desafios. Ciência Hoje. 28 fev. 2013. Disponível em: https://cienciahoje.org.br/xenotransplante-avancos-e-desafios/. Acesso em: 28 fev. 2023.
ANDERSON, M. Xenotransplantation: a bioethical evaluation. Journal of Medical Ethics, [online], v. 32, n. 4, p. 205–208, 2006. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565783/. Acesso em: 28 fev. 2023.
BUENO, V.; PESTANA, J. O. M. Revisão/Atualização em Transplante Renal: Xenotransplante. Jornal Brasileiro de Nefrologia, [online], v. 18, n. 3, p. 302–306, 1996. Disponível em: https://bjnephrology.org/wp-content/uploads/2019/12/jbn_v18n3-1.pdf. Acesso em: 28 fev. 2023.
COELHO, G. H. de F.; BONELLA, A. E. Doação de órgãos e tecidos humanos: a transplantação na Espanha e no Brasil. Revista Bioética, Brasília, v. 27, n. 3, p. 419–429, set. 2019. Disponível em: http://old.scielo.br/scielo.php?script=sci_abstract&pid=S1983-80422019000300419&lng=en&nrm=iso&tlng=pt. Acesso em: 28 fev. 2023.
COOPER, D. K. C. A brief history of cross-species organ transplantation. Proceedings (Baylor University. Medical Center), [online], v. 25, n. 1, p. 49–57, jan. 2012. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246856/. Acesso em: 28 fev. 2023.
DESCHAMPS, J.-Y. et al. History of xenotransplantation. Xenotransplantation, [online], v. 12, n. 2, p. 91–109, 2005. Disponível em: http://doi.wiley.com/10.1111/j.1399-3089.2004.00199.x. Acesso em: 28 fev. 2023.
DOOLDENIYA, M. D.; WARRENS, A. N. Xenotransplantation: where are we today?. Journal of the Royal Society of Medicine, [online], v. 96, n. 3, p. 111–117, 2003. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539416/. Acesso em: 28 fev. 2023.
FDA. Guidance For Industry: Public Health Issues Posed by the Use of Non-Human Primate Xenografts in Humans. Rockville, USA: U.S. Department of Health and Human Services; Food and Drug Administration; Center for Biologics Evaluation and Research, 1999. Disponível em: https://permanent.fdlp.gov/LPS113609/LPS113609/www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Xenotransplantation/ucm092866.pdf. Acesso em: 28 fev. 2023.
FDA. Guidance for Industry: Source Animal, Product, Preclinical, and Clinical Issues Concerning the Use of Xenotransplantation Products in Humans. Silver Spring, USA: U.S. Department of Health and Human Services; Food and Drug Administration; Center for Biologics Evaluation and Research, 2016. Disponível em: https://www.fda.gov/media/102126/download. Acesso em: 28 fev. 2023.
FISHER, L. M. Down on the Farm, a Donor; Breeding Pigs That Can Provide Organs for Humans. The New York Times, New York, USA, 5 jan. 1996. Business. Disponível em: https://www.nytimes.com/1996/01/05/business/down-on-the-farm-a-donor-breeding-pigs-that-can-provide-organs-for-humans.html. Acesso em: 28 fev. 2023.
GARCIA, C. D.; PEREIRA, J. D.; GARCIA, V. D. (Org.). Doação e transplante de órgãos e tecidos. São Paulo: Segmento Farma, 2015. E-book. Disponível em: http://www.adote.org.br/assets/files/LivroDoacaOrgaosTecidos.pdf. Acesso em: 28 fev. 2023.
GREEA. Declaração de Montreal sobre a Exploração Animal. [online] Montreal, 1 out. 2022. Disponível em: https://greea.ca/en/declaracao-de-montreal-sobre-a-exploracao-animal/. Acesso em: 28 fev. 2023.
GRINSTEIN, J. Playing God with Pork. Xenotransplantation could save lives and money - but is it ethical? [online], 19 mai. 2022. Disponível em: https://neo.life/2022/05/playing-god-with-pork/. Acesso em: 28 fev. 2023.
HAMMER, C. Physiological obstacles after xenotransplantation. Annals of the New York Academy of Sciences, [online], v. 862, p. 19–27, 1998. Disponível em: https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1998.tb09113.x Acesso em: 28 fev. 2023.
HORTA, O. O que é o especismo?. Ethic@ - An international Journal for Moral Philosophy, Florianópolis, v. 21, n. 1, p. 162–193, 2022. Disponível em: https://periodicos.ufsc.br/index.php/ethic/article/view/80645. Acesso em: 28 fev. 2023.
ISRANI, A. K. et al. OPTN/SRTR 2016 Annual Data Report: Deceased Organ Donation. American Journal of Transplantation, [online], v. 18, n. Suppl 1, p. 434–463, 2018. Disponível em: https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.14563. Acesso em: 28 fev. 2023.
JOHNSON, L. S. M. Existing Ethical Tensions in Xenotransplantation. Em: Cambridge Quarterly of Healthcare Ethics, [online], v. 31, n. 3, p. 355-367, jul. 2022. Disponível em: https://www.cambridge.org/core/journals/cambridge-quarterly-of-healthcare-ethics/article/abs/existing-ethical-tensions-in-xenotransplantation/1639750599DBE6E0D4A8E435FED06BC7. Acesso em: 28 fev. 2023.
LAPID, N. Two pig heart transplants succeed in brain-dead recipients. Reuters, [online], 12 jul. 2022. Healthcare & Pharmaceuticals. Disponível em: https://www.reuters.com/business/healthcare-pharmaceuticals/two-pig-heart-transplants-succeed-brain-dead-recipients-2022-07-12/. Acesso em: 28 fev. 2023.
LOW, P. et al. The Cambridge Declaration on Consciousness in Non-Human Animals. Cambridge, Reino Unido: Francis Crick Memorial Conference on Consciousness in Human and non-Human Animals, 2012. Disponível em: http://fcmconference.org/. Acesso em: 28 fev. 2023.
MHANNA, R.; HASAN, A. Introduction to Tissue Engineering. Em: HASAN, A. (Ed.) Tissue Engineering For Artificial Organs: Regenerative Medicine, Smart Diagnostics and Personalized Medicine, v. 2 [online]: John Wiley & Sons, abr. 2017. p. 1–34. E-book. Disponível em: https://onlinelibrary.wiley.com/doi/abs/10.1002/9783527689934.ch1. Acesso em: 28 fev. 2023.
MONTGOMERY, R. A. et al. Results of Two Cases of Pig-to-Human Kidney Xenotransplantation. New England Journal of Medicine, [online], v. 386, n. 20, p. 1889–1898, 2022. Disponível em: https://www.nejm.org/doi/10.1056/NEJMoa2120238. Acesso em: 28 fev. 2023.
MOURA, L. C.; SILVA, V. S. e (Org.). Manual do Núcleo de Captação de órgãos: iniciando uma Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplantes (CIHDOTT). Barueri, SP: Minha Editora, 2014.
NUFFIELD COUNCIL ON BIOETHICS. Animal-to-Human Transplant: the ethics of xenotransplantation. London: Nuffield Council on Bioethics, 1996.
OLAKANMI, O.; PURDY, L. Xenotransplantation: For and Against. Philosophy Now, [online], n. 55, 2006. Disponível em: https://philosophynow.org/issues/55/Xenotransplantation_For_and_Against. Acesso em: 28 fev. 2023.
PALMER, M. Problemas morais em medicina. Curso prático. Tradução: Barbara Theoto Lambert. 1. ed. São Paulo, SP: Edições Loyola, 2002.
PATEL, P. The Path to Printed Body Parts. ACS Central Science, [online], v. 2, n. 9, p. 581–583, set. 2016. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5043457/. Acesso em: 28 fev. 2023.
PATIENCE, C.; TAKEUCHI, Y.; WEISS, R. A. Infection of human cells by an endogenous retrovirus of pigs. Nature Medicine, [online], v. 3, n. 3, p. 282–286, 1997. Disponível em: https://doi.org/10.1038/nm0397-282 Acesso em: 28 fev. 2023.
RABIN, R. C. In a First, Surgeons Attached a Pig Kidney to a Human, and It Worked. The New York Times, New York, USA, 20 out. 2021. Health. Disponível em: https://www.nytimes.com/2021/10/19/health/kidney-transplant-pig-human.html. Acesso em: 28 fev. 2023.
RAMOS, A. Xenotransplantação – considerações éticas. Revista Lusófona de Ciência e Medicina Veterinária, [online], v. 1, p. 1–4, 2007. Disponível em: https://revistas.ulusofona.pt/index.php/rlcmv/article/view/1096. Acesso em: 28 fev. 2023.
REGAN, T. Jaulas Vazias: encarando o desafio dos direitos animais. Porto Alegre: Lugano, 2006.
SCHUURMAN, H.-J. Regulatory aspects of clinical xenotransplantation. International Journal of Surgery, [online], v. 23, n. Part B, p. 312–321, nov. 2015. Disponível em: https://www.sciencedirect.com/science/article/pii/S174391911501239X. Acesso em: 28 fev. 2023.
SMETANKA, C.; COOPER, D. K. C. The ethics debate in relation to xenotransplantation. Revue Scientifique Et Technique (International Office of Epizootics), [online], v. 24, n. 1, p. 335–342, 2005. Disponível em: https://doc.oie.int/dyn/portal/digidoc.xhtml?statelessToken=uDarDpdS0xHOnr5eZncbIjt1gAKr4JXcIQ6VlbTCnn4=&actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless. Acesso em: 28 fev. 2023.
STILES, S. Pig Heart Successfully Transplanted to Man. Medscape [online], jan. 2022. Disponível em: http://www.medscape.com/viewarticle/966367. Acesso em: 28 fev. 2023.
VARELLA, D. Transplantes entre animais e humanos deixaram de parecer ficção científica. Folha de São Paulo, São Paulo, 14 dez. 2022. Opinião. Disponível em: https://www1.folha.uol.com.br/colunas/drauziovarella/2022/12/transplantes-entre-animais-e-humanos-deixaram-de-parecer-ficcao-cientifica.shtml. Acesso em: 28 fev. 2023.
WESTPHAL, G. A. et al. Diretrizes para avaliação e validação do potencial doador de órgãos em morte encefálica. Revista Brasileira de Terapia Intensiva, São Paulo, v. 28, n. 3, p. 220–255, 2016. Disponível em: http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0103-507X2016000300220&lng=en&nrm=iso&tlng=pt. Acesso em: 28 fev. 2023.
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