The Mystery of Xenotransplantation for Social Sciences

Xenotransplantation is a fascinating subject – for obvious reasons, as it involves transplanting organs or other body parts across species boundaries (in practice: transplanting pig organs into humans). The social sciences have shown considerable interest in this topic, exploring its implications for various facets of human life. These include the consequences for patients’ self-understanding and identity, human-animal relationships, regulatory and feasibility considerations, moral and religious attitudes, the conceptualization of organs as gifts, the bioeconomy, biopolitics in biotechnology governance, and the implications for global justice. As a group of social researchers on xenotransplantation, we touch on these themes in a recently published position paper (Kögel et al., 2024).

However, what continues to captivate social scientists is the deeper mystery xenotransplantation presents. This mystery – which remains unsolved until xenotransplantation becomes sufficiently established to allow for empirical study[1] – lies in what it will reveal about us as social beings (beings driven to understand ourselves and constantly seek to refine that understanding).

Engaging with the social boundaries of what defines the human experience can expose our blind spots and offer fresh insights. One such boundary lies at the threshold between the living and the dead, exemplified by humans declared brain-dead (now also used as experimental models in xenotransplantation trials). These are individuals considered dead by medical-scientific standards but who, to bereaved family members, remain visibly alive—their bodies warm, their breathing sustained. This paradox reveals how we rely on third parties to meaningfully define dyadic social interactions, especially in boundary cases of life and death.[2]

Another frontier is the intersection of humans and technology. Through technological integration, we have expanded our understanding of agency – recognizing it as more distributed than previously assumed. Technology also prompts us to reconsider the social construction of reality, including the nature-culture divide and our concepts of (dis)ability. The integration of technology into human physiology – as in the case of cyborgs – most starkly illustrates these shifts.

Xenotransplantation covers the boundary between humans and animals – or between human animals and non-human animals, to emphasize the point of differentiation. While both hybrids (human-machine and human-animal)[3] confront us with issues of embodiment, their impacts on subjectivity differ significantly (see Haddow 2021). Technological components can often be incorporated into the body without fundamentally challenging one’s sense of self. Material parts simply lack the social histories that “stick” to organic materials. In contrast, fleshy components retain the traces of their organic origins and, with them, their associations and histories.

This distinction might explain why people tend to prefer technological solutions over receiving xenografts (Haddow 2021). The non-sentient nature of technology makes it easier to embrace as part of one’s body. Animals, however, occupy a different moral and symbolic realm. The meat production industry, for example, relies on dissociating meat products from the sentient beings they originate from to enable consumption with minimal moral discomfort. Similarly, in xenotransplantation, the patient may never see the transplanted body part or its source. Yet, unlike consumed meat, a transplanted organ remains part of the patient indefinitely, carrying its origin with it.

Studies with recipients of xenoislets – insulin-producing cells derived from animals that are transplanted into humans to treat diabetes – provide a glimpse into the recipients’ identity negotiations that might arise in the future of xenotransplantation (Lundin 2002). These recipients grappled with questions of self and foreignness, highlighting the profound psychological and social dimensions of such medical interventions.

Currently, xenotransplantation stands at a critical juncture. It is poised between experimental promise and clinical practice, awaiting validation as a viable alternative to human organ grafts. Until it matures to a stage that enables comprehensive social research with actual xenotransplantation patients, the “sticky” aspects of hybridity – the fleshy, particularly living organic, components with origins that stick to them – will remain shrouded in mystery.[4] For now, these unresolved questions sustain the social sciences’ enduring fascination with xenotransplantation and its implications for understanding the human condition.

Footnotes

[1] To date, there have been two heart xenotransplantations using genetically modified pigs (in 2022 and 2023), with patient survival times of six and eight weeks, respectively. In 2024, three kidney xenotransplantations were performed (one supplemented by a thymus gland). While two patients did not survive beyond two months, the patient who received a transplant last November is still alive. The fourth kidney xenotransplantation was performed at the beginning of this year.

While all these transplantations have taken place in the U.S., there was also a liver xenotransplantation in China last year; however, no long-term outcome data on the patient has been reported.

These xenotransplantations were conducted as so-called compassionate use cases, meaning they were individual treatments requiring special permits. Recently, the first human clinical trial on kidney xenotransplantation received approval and is expected to commence later this year in the U.S. (see: https://www.nature.com/articles/d41586-025-00368-w).

[2] Based on her study of severely neurologically impaired patients, Gesa Lindemann (2006) convincingly argues that social relations must always be understood as triadic. In dyadic relations, social expectations can be negotiated endlessly. Thus, a third party is required to determine whether social expectations and interpretations are legitimate, for example, whether the signs exhibited by neurologically impaired patients can be interpreted in a meaningful way.

[3] On a biological level, a hybrid refers to an organism with a mixed genome, in which all cells share the same DNA. In contrast, a chimera is an organism that contains cells with distinct genomes, such as a human who has received an organ transplant from a pig. Therefore, a transplant recipient would be considered a chimera.

[4] In the event that no such issues (of incorporating animal parts) arise, we will be left with the question of what it means for humans (and society) when they no longer distinguish themselves from (non-human) animals.

References

Haddow, G. 2021. Embodiment and Everyday Cyborgs: Technologies That Alter Subjectivity. Manchester: Manchester University Press.

Kögel, J., Cook, P., Brown, N., Clare, A., Glick, M., Hansson, K., Idvall, M., Lundin, S., Michael, M., a Rogvi, S., Sharp, L. 2024. “Engineering Organs, Hopes and Hybridity: Considerations on the social potentialities of xenotransplantation.” Medical Humanities doi.org/10.1136/medhum-2024-013061

Lindemann, G. 2006. “The Emergence Function and the Constitutive Function of the Third Actor”. Zeitschrift für Soziologie 35(2): 82-101.

Lundin, S. 2002. “Creating Identity with Biotechnology: The Xenotransplanted Body as the Norm.” Public Understanding of Science 11 (4): 333–45.