Xenotransplantation - Nuffield Council on Bioethics

Animal-to-Human Transplants : the ethics of xenotransplantation
Table 1.1
One year and five year survival rates of
transplant recipients 1
Organ
Survival Rates
1 year 5 years
Kidney 84% 70%
Liver 62% 54%
Heart 73% 62%
1.4 Organ transplantation offers several benefits. For some conditions, such as advanced
heart failure, treatment with drugs or restorative surgery may not be possible and a
transplant will provide the only way of replacing a failed vital organ. Heart or liver
transplantation can offer many additional years of life for people who otherwise
might not survive, as the one year and five year survival rates for liver and heart
transplant recipients show (Table 1.1). Worldwide there are patients whose lives have
been considerably extended following transplantation: by 23 years after liver
transplants and 20 years after heart transplants.
1.5 Transplantation can not only increase the length of life, but also improve its quality.
Even where there is an alternative form of treatment, such as dialysis for end-stage
kidney failure, a transplant frequently offers a higher quality of life despite the
drawbacks of the continuous immunosuppressive regime most transplant recipients
require. Kidney transplant recipients are freed from the necessity of regular,
uncomfortable and time-consuming treatment and are restored to a level of health not
possible with dialysis. They are able to eat and drink freely, and to travel, in ways
that people on long-term dialysis often cannot. Patient support groups describe heart
transplant recipients who are able to climb hills, and undertake other activities, that
they would not have been able to manage before the operation. Some transplant
recipients participate in highly demanding sporting contests such as the Transplant
Games.
1.6 It should be noted that, contrary to some misperception, transplantation is not
particularly expensive. Estimates are very difficult to make, but it is possible to get
a rough idea of the relative costs of different treatments. A kidney transplant
operation costs in the region of £10,000. After that, the cost of immunosuppressive
drugs and other follow-up treatment is about £3,000 a year. In contrast, dialysis costs
about £18,000 a year if the patient is treated in hospital, and about £11,000 if the
patient is treated at home. Thus, kidney transplantation is a more cost-effective
1
Source: United Kingdom Transplant Support Service Authority (UKTSSA) publications: Renal Transplant
Audit 1984-1993; Liver Transplant Audit 1985-1992; Thoracic Organ Transplant Audit 1985-1992.
2