The chief transplantologist at the Ministry of Health and the director of the Shumakov Center for Transplantology and Artificial Organs spoke about two patients who died following a transplant attempt using a genetically modified pig heart. They noted that those individuals might have been eligible for a conventional human heart transplant and questioned why a standard option was not pursued in either case. This observation was attributed to the authority of an academician and professor named Sergei Gauthier.
There is a background narrative in which the second patient, previously reported in the United States, received a pig heart due to tissue rejection issues, underscoring the ongoing debate about organ compatibility and immune responses in xenotransplantation.
Gauthier raised ethical questions about the decision-making process: why were these two patients chosen for a high-risk experimental procedure, and who authorized or oversaw that choice? He noted that clinicians had told the patients they did not qualify for conventional organ donation because their chances of surviving surgery were low. He described the situation as a matter of record-keeping as well as clinical judgment, emphasizing that the ethics committee and treating physicians must wrestle with such decisions rather than treat them as mere curiosities.
From the medical standpoint, the impossibility of relying on immunosuppressive therapy is generally viewed as a contraindication to transplantation. In many cases, particularly where cancer compromises immune function, attempting transplantation could worsen the patient’s condition by further weakening immune defenses. This consideration remains central to evaluating who might benefit from a transplant and who should pursue other life-sustaining strategies.
Gauthier acknowledged uncertainty about the fate of the second patient. He noted that in the United States, when heart failure becomes life-threatening, there is a wide array of resources to support cardiac function mechanically. This is not hypothetical; such technologies are routinely deployed to sustain circulation when a transplant is not immediately feasible. The critical question, he said, is why a patient might die from graft rejection after a pig heart is implanted instead of continuing to live with a left-ventricular support system, if the patient’s native circulation can be maintained in the short term.
The professor expressed the conviction that in countries with advanced healthcare systems, such as the United States, options exist to perform a heart transplant or to employ mechanical circulatory support when needed. He cautioned against abandoning exploration in this field, urging the medical community to pause and study these outcomes more deeply. By investigating why the genetic modification did not yield the anticipated results, researchers could learn valuable lessons without sacrificing human life in the pursuit of novelty. He suggested that other strategies to save lives should be pursued while scientists refine their approaches.
Ultimately, the conversation touches on the broader aim of improving organ survival after transplantation. The field continues to pursue safer, more effective methods for extending transplant viability and patient life, balancing ambition with patient safety and ethical accountability. [Attribution: Ministry of Health]