Canada should not proceed with clinical trials involving the transplantation of live animal organs, tissue or cells into human patients because “critical issues” must be resolved, a Canadian Public Health Association (CPHA) report states.
“Canadians appreciate that we need to solve the organ shortage that leaves thousands dying on waiting lists every year,” said Dr. Heather Ross, cochair of a CPHA-appointed group that consulted Canadians last year and released its report in January. “[The majority of those] consulted … believe that too little is known about the potential risks of crossing the species barrier.”
This uneasiness underlies the key recommendations presented to then Health Minister Allan Rock. Ross, director of the Cardiac Transplant Program at the University Health Network, Toronto General Hospital, said the report does not close the door on animal-to-human transplants but calls for more research into potential risks.
It recommends that Health Canada:
· consider alternatives, such as disease prevention, expansion of the human donor pool, development of mechanical substitutes and pursuit of stem cell research;
· continue pre-clinical research that does not involve humans but will provide more information about the viability of xenotransplantation;
· develop rules on all aspects of clinical trials involving xenotransplantation.
At 6 public forums held by the committee, panellists discussed xenotransplantation with experts. Prior to the forums many participants held a positive view about it, but after discussing the risks the majority concluded that Canada should not proceed, with 34% saying no and 19% saying no with qualifications; 46% said yes with qualifications.
The CPHA also commissioned a telephone survey of 1519 Canadian adults, and 70% were not very or not at all knowledgeable about xenotransplantation. Of this number, however, 65% supported clinical trials.
“It's clear that opinions change with information and discussion,” said Robert Van Tongerloo of the Canadian Federation of Humane Societies, a cochair of the consultation group. “Meaningful public consideration will happen only if a concerted effort is made to inform Canadians.”
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Steven Wharry
CMAJ
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