This 3-day international conference was organized to review the ethical, scientific and regulatory issues surrounding xenotransplantation. Meech Lake is a beautiful wooded retreat near Ottawa made famous by the infamous Meech Lake Accord, whose failure to achieve consensus was viewed by many as the most divisive event in recent Canadian history. 

The genesis of the meeting was a visit to Ottawa in November 1998 by Dr. Fritz Bach, a researcher from Harvard Medical School. Dr. Bach was well known for his opposition to clinical trials of xenotransplantation and has been calling for a moratorium (broadcast debate). At that visit to Ottawa, Dr. Bach spoke to two government departments, Health Canada and Industry Canada. Dr Elizabeth McGregor, a Senior Biotechnology Advisor with Industry Canada was present at the lecture and, along with Dr. Bach, became a champion within Industry Canada for the creation of an international conference whose mandate would be the development of global standards for the ethics and regulation of xenotransplantation.

Industry Canada agreed to sponsor this conference, and to fund a 2-year fellowship for Dr. McGregor to work with Dr. Bach at Harvard to pursue issues relating to xenotransplantation.

The attendees included representatives from bioethics, Canadian and foreign governments, medical research, social sciences, veterinary research, Council of Europe, Organization for Economic Cooperation and Development, foundations, biotech industry, medical publishing, and economics. The co-chairs of the meeting were Dr. Farkhonda Hassan of the American University in Cairo and Dr. Strachan Donnelley, of the Hastings Center in Garrison, NY. 

The meeting was dominated by intense and often productive dialogue generally galvanized by brief presentations from the attendees. While the topics were wide ranging, there were a few noteworthy points of consensus for those of us who hope to see early clinical trials of encapsulated islet xenografts.

In terms of conference management, this was one of the best organized conferences I have ever been to. The availability of material, resources, food, and transportation was extraordinary. Dr. McGregor had drafted a group of young volunteers to assume responsibility for all aspects of organizing this impressive event. My own opinion is that they beat the professional conference organizers hands-down. Congratulations!

The Bottom Line...

There was so much discussed at this conference that I cannot do it justice by highlighting a few salient outcomes. However, from our admittedly narrow perspective of allowing small, well-regulated clinical trials of encapsulated islet xenografts to proceed, there were some noteworthy events:

• By the end of the meeting, there was a strong consensus that encapsulated islet xenografts should proceed as the first trial of xenotransplantation. Moving ahead in this endeavour was a major action item identified by the group and the test case for the ethical debate. I had several opportunities to present the data from the recent FDA xenotransplantation subcommittee meeting in which there was once again no evidence of zoonotic infection from pig xenografts and the FDA's clear statement of support for porcine cellular xenografts.

 
• Dr. Karl-Friedrich Bopp, of the Health and Social Policy Division of the Council of Europe presented the now-famous call for a moratorium on xenotransplantation in Europe. Dr. Bopp went on, however, to explain how the council used the term moratorium as a means of getting the attention of the national European governments. He explained that the Council of Europe is an advisory body only, and it often takes very strong language to get on the radar screen of European governments. He said that the real goal is to establish a working committee that can develop uniform guidelines for all of Europe, and not to impose a moratorium.

 
• There was strong consensus that the public should be involved in these issues. The disaster of public rejection of genetically modified foods was cited time and again. This was seen as an example of public hostility in the face of high-handed industry initiatives in which people were never consulted, even though there is no evidence or reasonable expectation of harm. 

The next step is very dependent on funding. Dr. Donnelley of the Hastings Center thought there was a possibility that he could obtain funding from foundations to support the ongoing work by his institute and the other participants. I am not certain that Industry Canada will continue to sponsor this mission, as ethics and regulation of medical advances is the normal venue of Health Canada. 

From a personal perspective, I had an opportunity to meet some extraordinary people involved in veterinary science, social science, medical research, biotech industry, government, publishing, and ethics. These connections will persist and will enrich the process ahead of us.