Ethical Issues on the Frontier of Organ Replacement

Transplants are evolving to include external organs such as eyes, hands and faces. there are many ethical issues these so called vascularized composite allografts (VCAs) raise including who donates, managing surgery, acceptable appearance, getting sound consent, impacts on family, restoration of function, and dangerous side effects. For some artificial prosthetics may be a choice that is preferred over transplant. Costs are a huge issue as well. Consider eye transplants;

Of all the five senses losing sight is the one that individuals fear the most. Worldwide blindness has afflicted tens of millions of people each year. Historically, this has inspired researchers and doctors to try whole eye transplants (WET). A human cadaveric donor WET was attempted in 1969 at Methodist Hospital in Houston. The cornea, lens, and iris were transplanted but failed to restore vision (Bourne et al. 2017). The immediate future of eye transplantation both single and dual is likely to be very limited. Despite the remarkable technical achievement of an NYULangone team (Laspro et al. 2024), transplant experts and ophthalmology researchers know of a number of huge challenges that continue to make successful eye transplants ethically difficult.