A recent peer-reviewed research letter published in The Lancet by members of PIRU presents key findings from the first representative sample survey carried out in the UK to understand public attitudes and views on xenotransplantation - transplanting living cells, tissue or organs from genetically modified animals, currently most likely from pigs, to humans.

More than 3,000 people responded to the survey covering questions on ethical considerations, concerns, willingness and acceptance of xenotransplantation. Although animal organs are not available yet in the UK, advances in gene-editing technology as well a handful of cases of genetically modified pig-to-human transplants in the United States indicate that this could become an option in the future for patients waiting for human transplants.

The survey findings show that most people in the UK would broadly support the idea of transplant patients receiving organs from genetically-modified pigs in the future. Two thirds of people were supportive, with 19% saying it should definitely be allowed and 46% saying it should probably be allowed. In contrast, 24% stated it should probably not be allowed and 11% of respondents saying it should definitely not be allowed.

However, there are marked differences in levels of support for the introduction of xenotransplantation between ethnic groups, genders, and religious groups. Higher levels of support were reported by men, and those identifying as ethnically White, as well as younger age groups, and those over 60, compared to those aged 40 to 59.

Significantly lower support for the transplantation of pig organs was found among Muslims when compared to those reporting no religion, Christians and other religious groups.

Dr Mustafa Al-Haboubi, Assistant Professor at LSHTM, and lead author of the paper, said:

“This is clearly an issue which sparks different views. Many people want to know more about it, and reliable and clear information must be made available as the technology progresses. This research is just the start, but it should help to inform policymakers and regulatory authorities in their future planning.”

The highest level of support was found among those who had registered their wish to donate organs through the NHS Organ Donor Register. Levels of support moreover increased after completing the questionnaire which included basic information on xenotransplantation, with the proportion of those unsupportive falling by five percent once more information had been provided.

The main reason given by respondents in support of xenotransplantation was to save lives which otherwise would have been lost. Most respondents based their support for xenotransplantation on two conditions: rigorous regulation to ensure animal welfare, and guarantees that animals would be disease-free.

Professor Nicholas Mays, Professor of Health Policy at LSHTM, senior author on the paper, added:

“While this could be a potentially lifesaving innovation in a world where there are not enough donated organs to meet demand, the responses suggest there needs to be rigorous regulation and management to ensure progress happens safely and responsibly. Patients and families, as well as the wider public, need continued support to understand the limitations and implications of a new technology such as this.”

The key reasons for not being in support included mainly animal welfare concerns, such as apprehension about genetically modifying animals, keeping them in sterile conditions indoors and keeping them solely to provide organs for human transplantation.

The survey was commissioned by the Department of Health and Social Care via the National Institute for Health and Care Research (NIHR) to support the work of its Implementation Steering Group for Organ Utilisation (ISOU) Expert Sub-group on Xenotransplantation.