The dilemma of xenotransplantation.

To the Editor: I read with considerable interest Robert E. Michler’s commentary on xenotransplantation (1). From my point of view, that of a basic virologist, the dilemma is not to know in what “foreseeable future, clinical xenotransplantation may achieve its targeted goal of extended graft survival,” but what deadly emerging infectious disease, most probably viral in nature, would arise in a recipient of a baboon or chimpanzee heart. While we face the terrific threat of AIDS, which clearly emerged from Africa and non-human primates 40 to 50 years ago, we are preparing a new infectious “Chernobyl.” Monkeys and apes harbor approximately 50 simian viruses; some of them pose a serious threat to humans, especially the heavily immunosuppressed. Recently, an outbreak of encephalitis related to a new type of reovirus (2) occurred among baboons from a colony used in human organ transplants. Moreover, once unknown or unrecognized simian viruses, like HIV, may be efficient invaders of the entire earth’s population. Xenotransplantation does not simply pose an ethical problem; it concerns the survival of the human species, an endangered species if transplant practitioners continue their course. Ronald Montalero, a virologist, was right when he said “unknown viruses were always a major concern in xenotransplants” (2). A moratorium on these procedures seems the best solution until all simian pathogens are identified and the risks they pose to humans are clearly established.