TRANSPLANTS: Non-Vital Procedures Raise Ethical Hackles

      Sunday's New York Times profiled a new breed of "non-vital" transplants -- hands, knees, larynxes, nerves and muscles -- that are inspiring researchers to "stretch their imaginations" even as ethicists caution against subjecting patients to a lifelong dependence on antirejection drugs. The Times reports that leading surgeons "envision a future where they can put new faces on burn patients; give a woman new breasts, or even a uterus; transplant penises; and reconstruct jaws and neck tissues." But others are not sure that the regimen of antirejection drugs, which carry risks of infection, diabetes and cancer, is worth the risk. McGill University's Dr. Rolin Daniel, who pioneered research in primate hand transplants, said, "The issue here is: Are you ever justified to put a patient's life at risk on an ongoing basis with immunosuppression just to justify a quality of life transplant?" Washington University cosmetic surgeon Dr. Susan Mackinnon called recent highly publicized hand transplants "dangerous and irresponsible," saying, "All it's going to do is save a limb, it's not going to save a life."

Thymus and HIV/AIDS
      One hot area of research centers on thymus gland transplants as a means of rejuvenating the immune systems of HIV/AIDS patients "in whom the new drug cocktails fail." Medical researchers hypothesize that AIDS patients may suffer from damaged thymus glands, organs responsible for regulating the immune system. Dr. Andre Nahmias of Emory University said he is "convinced that up to 15% of adults have HIV that hits the thymus and kills off the cells, and that leaves nothing else but a thymus transplant to replace them" (Altman, New York Times, 5/2).