Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
The Associated Press - 18 Dec 95; 50 Rockefeller Plaza, New York, NY 10020.
The question of whether animal transplants would foster new diseases among humans isn't just academic, according to Dr. Louisa Chapman, an epidemiologist with the Centers for Disease Control who is working on the guidelines.
More than 150 diseases can be transmitted from animals to humans, including rabies, and some become deadlier in humans. Some researchers believe the deadly 1918-19 flu pandemic was caused by a virus that spread from pig to humans, and AIDS is believed to have jumped fom monkeys to man.
The issue came to a head this year when the Food and Drug Administration delayed the baboon-to-human transplant until it determined the experiment's safety. San Francisco AIDS patient Jeff Getty received the baboon bone marrow cells on Thursday.
"This is a new world of infection possibilities," Chapman said, adding that the biggest concern is another pandemic like AIDS.
"It probably won't happen, but it would be an event that could have a tremendously adverse public health impact," she said.
The CDC decided to develop guidelines because of the growing belief among scientists that animal-to-human transplants -- called xenotransplants -- might one day help to solve the nation's critical organ shortage.
That day is not near -- researchers have yet to overcome the rejection of animal tissue by a human patient's immune system -- but the CDC and the FDA want to be prepared.
"Without question this is something that requires federal oversight and guidelines, primarily because of the public health implications," said Dr. Steven Deeks of the University of California, San Francisco, who is the lead clinician for Getty. "There's a large risk to the recipient, and although the risks to the public are negligible, there are unknowns."
Other xenotransplant experts say the government has no reason to intervene, and they accuse the CDC and FDA of exaggerating the danger.
The danger in using non-primates, such as pigs, is remote, said Dr. Mark Hardy of the Columbia-Presbyterian Medical Center. For one thing, these animals are raised in carefully controlled environments, he argued.
However, he agreed that guidelines concerning primates such as baboons and monkeys -- which are more closely related to humans -- are important. "We need to be concerned about that," he said.
The guidelines, which are in the final stages and will soon be published for public comment, set goals for transplant centers. They will be asked to uphold levels of expertise and safety, select animals to minimize the risk of infection, monitor patients after an operation to detect infection, and collect data on transplant recipients to determine if the government's public health concerns are valid.
The guidelines won't be law, but most centers are expected to follow them.
Copyright 1995/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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Copyright © 1995 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.
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