Table 2.

Ethical domains of practical considerations in xenotransplantation

Ethical domains
Autonomy	Religious taboos against pigs	Racial and ethnic attitudes	Extent of informed consent	Trans-species infection; chimerism	Tracking infection risk	Stigma of having a pig kidney
Equity	Who will be in clinical trials	Who will be eligible for xenotransplant	Availability to groups excluded from transplant now	Insurance coverage public and private	Insurance coverage public and private	Number of kidneys needed per transplant
Utility	Oversight national, local; need for rules to conform	Cost of program infrastructure and transplants	Potential savings from xenotransplant over allotransplant	Return on investment to commercial entities involved	Concern for monopoly pricing if limited number of providers	Hyperacute rejection	Pig kidney response to human hormones
	Xenotransplant regulatory oversight	Approval of genetic changes	Need for more animal models before human trials	Allocation of pig kidneys	Tracking pig kidney success	Tracking infection risk
Justice	Violate the laws of nature; cruelty to animals	Lopsided distribution of healthcare spending	Diversion of money away from primary care	Who will be in clinical trials	Who will be eligible for xenotransplant	How to prevent hierarchy of kidneys and of recipients
	Availability to groups excluded from transplant now	Will government cover cost of immuno- suppression medications