Proponents of xenotransplantation hope that it will provide organs to fill the gap between the demand for and supply of organs for transplant. The scientific obstacles to transplanting animal organs into humans are daunting, as are the moral, political, and policy issues. Among them are concerns about animal rights and welfare, patient acceptance and informed consent, and broader public health issues, such as the cost-efficient deployment of scarce resources and the risk of disease in third parties. The latter is, in my view, the most immediately urgent issue. Pigs, the current animal of choice, carry many bacterial and viral pathogens, and it is currently impossible to assess the risk of disease to human populations. Because of this risk, a moratorium on xenotransplantation is necessary to protect public health; it is also questionable whether the technology, if successful, would be the most cost-effective way to promote health.