Xenotransfusion
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Xenotransfusion (from Greek '' xenos-'' ''strange'' or ''foreign''), a form of
xenotransplantation Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenograft ...
, was initially defined as the transfer of blood from one species into the
vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...
s of another. In most cases, it is a transfer of blood between a non-human animal and a human. However, further experimentation has been done between various non-human animal species. This procedure can be performed without affecting the health of the donor, as only about 10% of their
blood volume Blood volume (volemia) is the volume of blood (blood cells and plasma) in the circulatory system of any individual. Humans A typical adult has a blood volume of approximately 5 liters, with females and males having approximately the same blood ...
is used each time. Utilizing the unlimited blood supply from animal sources eliminates the risk of transmitting
infectious disease An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
s between humans. In 1658, Dom Robert des Gabets, a French monk, introduced the idea of xenotransfusion at a scientific society meeting. This society later afforded the
French Academy of Sciences The French Academy of Sciences (French: ''Académie des sciences'') is a learned society, founded in 1666 by Louis XIV at the suggestion of Jean-Baptiste Colbert, to encourage and protect the spirit of French scientific research. It was at ...
. Currently there are not any laws prohibiting the practice of xenotransfusion, but some ethical issues have been identified by the Ethics Committee of the International Xenotransplantation Association (IXA). For example, the IXA sets standards and regulations for those planning to orchestrate clinical xenotransplantation trials. The IXA has identified three major ethical areas that require adequate attention: favorable risk and benefit assessment supported by pre-clinical data, lack of alternative treatment for participants, and minimizing the risk of infection by ensuring the highest
biosafety Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health. These prevention mechanisms include conduction of regular reviews of the biosafety in laboratory settings, as well as strict guide ...
regulations are followed for selected animal donors. These are just a few examples of the ethics behind xenotransplantation.


History

Jean-Baptiste Denis, a French physician, and Paul Emmerez, a surgeon, performed the first documented xenotransfusion on June 15, 1667. The transfusion occurred between a lamb and a 15-year-old boy. Carotid artery blood from the lamb was introduced to a vein in the patient’s inner elbow, and the procedure ultimately resulted in a successful recovery. Denis and Emmerez performed multiple xenotransfusions together. On June 24, 1667, the duo performed a transfusion on a young Swedish nobleman. When they arrived, the patient had already lost his ability to speak and was practically unconscious. Shortly after the transfusion began, the patient was able to speak again. His health was improving until his condition grew progressively worse. A second transfusion took place, but it was unsuccessful, and the patient died. Richard Lower, an English physician, performed a similar procedure on November 23, 1667. He successfully transfused the blood of a lamb to a 22-year-old man. In both cases, the whole blood of the lamb was directly introduced into the vein of the patient. The direct introduction of blood was due to a lack of knowledge in preventative blood coagulation techniques at the time. After several xenotransfusion procedures, some successful some not, the
French Parliament The French Parliament (french: Parlement français) is the bicameral legislature of the French Republic, consisting of the Senate () and the National Assembly (). Each assembly conducts legislative sessions at separate locations in Paris ...
prohibited the practice of these transfusions in 1670. The
English Parliament The Parliament of England was the legislature of the Kingdom of England from the 13th century until 1707 when it was replaced by the Parliament of Great Britain. Parliament evolved from the great council of bishops and peers that advised t ...
, as well as the Pope, followed suit and prohibited the procedures shortly after.


Ethical arguments involving the pig for xenotransfusion

Xenotransfusion uses non-human animals to aid in the shortage of blood for
blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
in humans. Although there needs to be more study on the topic some scientists are already considering the idea to use Sus scrofa domesticus (pigs) for blood transfusion. To come up with this answer they tested many animals to see which one was the best candidate for
blood donation A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation (separation of whole blood components). Donation may be of whole bl ...
. As a result, pig red blood cells (pRBCs) showed more characteristics similar to that of a human. Starting with RBC diameters (pig 6 μm: human 7.2 μm) and RBC counts (pig 5.7 to 6.9 million/ll; human 4.2 to 6.2 million/ll) and, RBC average lifespan (86 vs. 120 days). Current evidence shows that pRBCs will function normally in humans due to a relation between porcine blood groups and human ABO group system. In addition, it is possible to produce pigs with type O blood and it is also possible to genetically modify the pig to make its blood more compatible with humans. Sus scrofa domesticus’s blood will be used to save lives and to increase blood quantity. The organism will be kept alive and no serious harm will be involved in XTF. It will be similar to how blood is removed from humans. Only 10% of the animal’s blood volume will be used each time, therefore, it is ethically acceptable to raise pigs for periodical blood collection as it does not damage the health of the animal. It will also be ethical to use pRBCs on humans since it will not cause a severe harm on human’s health. At the moment XTF is not a real necessity because a lot of people are willing to donate their blood and there is not a significant shortage on blood.


Veterinary xenotransfusion

Transfusion of canine blood into domestic cats was performed historically and continues to be performed in some countries. Xenotransfusions have been performed on birds, though the procedure is only done to stabilize a bird in shock, due to rejection by the recipient bird's antibodies. Xenotransfusion of bovine whole blood into domestic goats has been preliminarily investigated as a potential option for anemic goats.Smith JS, Viall AK, Breuer RM, Walton RA, Plummer PJ, Griffith RW and Kreuder AJ (2021) Preliminary Investigation of Bovine Whole Blood Xenotransfusion as a Therapeutic Modality for the Treatment of Anemia in Goats. Front. Vet. Sci. 8:637988. When comparing caprine-recipient bovine-donor cross matching a study found 11/15 caprine-bovine combinations compatible on both major and minor cross matching.{{Cite journal, doi = 10.3389/fvets.2021.637988, doi-access = free, title = Preliminary Investigation of Bovine Whole Blood Xenotransfusion as a Therapeutic Modality for the Treatment of Anemia in Goats, year = 2021, last1 = Smith, first1 = Joe S., last2 = Viall, first2 = Austin K., last3 = Breuer, first3 = Ryan M., last4 = Walton, first4 = Rebecca A., last5 = Plummer, first5 = Paul J., last6 = Griffith, first6 = Ronald W., last7 = Kreuder, first7 = Amanda J., journal = Frontiers in Veterinary Science, volume = 8, page = 637988, pmid = 33748213, pmc = 7969644


References

Animal physiology Transfusion medicine Organ transplantation Xenotransplantation Biology articles needing expert attention Biology articles needing attention