The world’s first patient to receive a genetically modified pig kidney transplant died two months after surgery. Two years ago, the world’s first patient to receive a genetically modified pig heart transplant also died two months after surgery.
The world’s first patient to receive a genetically modified pig kidney transplant died two months after surgery. Two years ago, the world’s first patient to receive a genetically modified pig heart transplant also died two months after surgery. This poses a challenge to the survival period after xenotransplantation.
The world’s first patient to receive a pig kidney transplant is 62 year old Richard Slayman, who underwent a transplant surgery at Massachusetts General Hospital in March this year.
After Sleiman’s death, the transplant team at the hospital stated that there was no indication that transplantation was the cause of death. However, the specific cause of Sleiman’s death has not yet been announced.
Previously, surgeons at Massachusetts General Hospital had stated that they believed pig kidneys could work in the body for at least two years.
“The cause of death of patients still needs to be determined through specific pathological analysis, but the two patients who received pig heart transplantation did not survive for two months after the transplantation surgery. This indicates that xenotransplantation still faces many challenges before it truly enters clinical application,” said Zhu Tongyu, an organ transplant expert and vice president of Shanghai Medical College at Fudan University, to a reporter from First Financial News
The first patient to receive a xenograft heart transplant, David Bennett, died on March 8, 2022, exactly two months after his surgery. Bennett was infected with a virus from pigs, causing heart damage.
Zhu Tongyu believes that important issues that need to be addressed in xenotransplantation include exploring better immune tolerance induction strategies and paying attention to endogenous virus activation. “Regarding immune rejection, it seems that the problem of hyperacute (within 24 hours) rejection has been resolved, but the problem of acute rejection still exists,” he said.
Exploring the application of pig organs in living humans has been a significant breakthrough in the field of xenotransplantation in the past two years. Previously, most xenografts were performed on patients with brain death.
The organs of pigs are anatomically similar to those of humans. For over thirty years, pig heart valves have been used to repair human hearts. But transplanting the entire organ of a pig is still difficult because genetic differences can lead to human rejection of them, and pig organs may carry potential viruses, thereby harming human receptors.
The donor kidney for the first pig kidney transplant was provided by eGenesis, a company based in Cambridge, Massachusetts. It was obtained from a genetically edited pig, which knocked out genes that may be harmful to human receptors and added certain human genes to improve compatibility. The company also inactivated certain viruses inherent in pigs that may infect humans.
In March of this year, the urology team at Xijing Hospital in China transplanted the kidney of a donor pig into a brain dead recipient, using a gene edited pig provided by a domestic company, Sinovac.
Pan Dengke, founder and chairman of Zhongke Aoge Biotechnology Co., Ltd., predicts that in China, in the next two to three years, xenograft surgery may be carried out for critically ill patients who cannot wait for organ transplantation. “At the beginning, it will not be widely applied. Only patients who strictly meet the requirements can become the first patients to benefit from gene edited pig organs,” he said.
At present, global regulatory agencies still adopt an extremely cautious attitude towards the clinical application of xenotransplantation. The US FDA stated, “Xenotransplantation shows great hope, but there are also potential risks, and it is recommended that such transplantation be limited to patients with severe or life-threatening diseases without sufficient alternative options.”
Xenotransplantation experts believe that due to the severe shortage of human organ donors, to break the paradigm of “someone must die in order for someone to survive” in the field of organ transplantation, xenotransplantation is the most direct answer. In the future, animal organs can be regularly provided to patients, which is expected to save millions of lives.
Despite controversy, related xenograft surgeries are still ongoing. In April of this year, it was reported on the official website of the Langley Health Center at New York University that surgeons at the center performed the first combined surgery of a mechanical heart pump (LVAD) and a gene edited pig kidney transplant. The patient was Lisa Pisano, a woman from New Jersey, USA.
This surgery represents the fusion of multiple medical advancements, showcasing the possibilities and hopes of modern medicine. There have been no previous records of people using mechanical heart pumps receiving any type of organ transplantation.