Preserving Humanity in the Brave New World of Cardiac Xenotransplantation

Abstract: In a short period of time, the ability to successfully transplant genetically-modified animal organs into human bodies has gone from science fiction to reality, signaling a revolution that could save countless lives, but which evokes important questions about how humans relate to other life forms and generates new ethical complexities along the entire translational journey from clinical trials to implementation and population health outcomes. These issues are particularly weighty in the context of cardiac xenotransplantation; whether this novel therapy is ultimately a blessing or a curse will depend on how cardiac xenotransplantation is studied, offered, utilized and managed. How will investigators balance inclusion and protection of vulnerable populations as clinical trials begin? What constitutes adequate informed consent for patients and their families? How will access to porcine hearts complicate decisions around heart failure and end-of-life care, or alter allocation strategies for human organs? Will xenotransplantation reduce or exacerbate disparities for disadvantaged and marginalized patients? This diverse multidisciplinary panel, composed of a physician-bioethicist, a philosopher, a medical student and clinical research coordinator, and a heart transplant recipient and child life professional, will provide an overview of ethical concerns related to xenotransplantation research, medical decision-making, health equity, and holistic patient- and family-centered care, framed by the 2024 ASBH conference theme, “What does it mean to be human?”