Xenotransplantation -- Copyright -- Contents -- Executive Summary -- RECOMMENDATION 1 -- RECOMMENDATION 2 -- RECOMMENDATION 3 -- RECOMMENDATION 4 -- RECOMMENDATION 5 -- A NECESSARY CAVEAT -- 1 Setting the Stage -- INTRODUCTION -- STUDY PROCESS AND REPORT ORGANIZATION -- APPROACHING QUESTIONS OF OPPORTUNITIES AND RISKS -- The Potential Benefits of Xenotransplantation -- Providing Adequate Organ Supply -- Providing Cells and Tissues to Treat Disease -- Risk: Precedent and Uncertainty -- 2 Assessing the Science Base -- INTRODUCTION -- STAGES OF THE IMMUNE RESPONSE -- Progress in Molecular and Cellular Biology -- Mechanisms of Hyperacute Rejection -- Mechanisms of T-Cell-Mediated Rejection -- NOVEL THERAPEUTIC APPROACHES -- Limitations of Immunosuppression in Xenotransplantation -- Modification of the Source Animal -- Antibody Masking -- Transgenic Modification -- Gene Knockout -- Antisense RNA -- Modification of the Host -- Bone Marrow Chimerism -- Microchimerism -- Modification of the Graft: Encapsulation -- 3 Infectious Disease Risk to Public Health Posed by Xenografting -- ANIMAL INFECTIONS AND XENOTRANSPLANTATION -- BASIS FOR PUBLIC HEALTH CONCERN -- METHODS OF RISK EVALUATION -- DETECTION METHODS -- NEED FOR A REGISTRY -- SUMMARY -- 4 Ethics and Public Policy -- PATIENTS, ETHICS, AND SOCIETY -- Patients' Perspectives -- Informed Consent -- Justice and Fairness Issues: Organ Allocation and Research -- Social Acceptance of Xenotransplants -- Social Acceptance of Infectious Disease Risk -- VALUE AND USE OF ANIMALS -- Ethical Theory -- History of Social Responses to Xenotransplantation -- A Moderate Ethical Perspective of Xenotransplantation -- Application to Xenotransplantation -- ECONOMIC ISSUES REGARDING XENOTRANSPLANTS -- Aggregate Expenditures for Organ Transplantation -- Transplant Procedure Expenses -- Ethics and Public Policy.

Expenditures for Xenotransplantation -- Insurance Coverage -- Impact of Managed Care -- Justice, Fairness, and the Ability to Pay -- REVIEWING AND MONITORING XENOTRANSPLANTATION -- FDA Regulation of Xenotransplantation -- Current Regulatory Framework -- 5 Conclusions and Recommendations -- References -- A Workshop Agenda -- XENOGRAFT TRANSPLANTATION: SCIENCE, ETHICS, AND PUBLIC POLICY -- SPEAKERS AND PANELISTS -- B List of Participants -- WORKSHOP ON XENOGRAFT TRANSPLANTATION: SCIENCE, ETHICS, AND PUBLIC POLICY -- C Immunosuppression in Allotransplantation.