In the first treatment of its sort, Boston surgeons transplanted a kidney into a sick 62-year-old man from a genetically altered pig. If successful, hundreds of thousands of Americans with failed kidneys would have hope thanks to this development.
The early signs are encouraging.
The kidneys filter the blood of waste materials and extra fluid. Physicians at Massachusetts General Hospital, also known as Mass General, report that the patient’s condition is improving and that the new kidney started generating urine quickly after the surgery last weekend. He may soon be released from the hospital and is already moving about the hallways.
The individual undergoing the treatment is Black, and given the high incidence of end-stage kidney disease among Black patients, this procedure may hold particular relevance for him.
The insufficient access of minority patients to kidney transplants is a persistent issue in the field, which a novel kidney source “may solve,” according to Dr. Winfred Williams, associate chief of Mass General’s nephrology division and the patient’s primary kidney physician.
Dialysis “will become obsolete” if kidneys from genetically modified animals can be transplanted broadly, according to Dr. Leonardo V. Riella, Mass General’s medical director of kidney transplantation. Mass General Brigham, the hospital’s parent company, created the transplant program.
Dialysis, a process that removes toxins from the blood, is necessary for the over 800,000 Americans who suffer from renal failure. A waiting list of more than 100,000 people awaits the donation of a kidney from a living or deceased human donor. Black Americans are three times as likely as White Americans to have end-stage kidney disease.
Additionally, chronic kidney disease, which can result in organ failure, affects tens of millions of Americans.
An organ transplant is the gold standard of care, even though dialysis keeps patients alive. But because there is a severe organ shortage, thousands of patients pass away every year while waiting for a kidney. There are only 25,000 kidney transplants done annually.
The implantation of an animal’s organ into a human being, or xenotransplantation, has long been suggested as a viable remedy that may greatly increase the availability of kidneys. Experts point out that long-term rejection can happen even when donors are well-matched, and that the human immune system rejects alien tissue, which can lead to potentially fatal consequences.
Recent developments in science, including as cloning and gene editing, have brought xenotransplants closer to reality by enabling the modification of animal genes to increase organ compatibility and decrease the likelihood of immune system rejection.
The kidney was taken from a pig that the biotech company eGenesis had genetically altered to eliminate three genes that could have led to the organ’s rejection. Seven more human genes were added to improve human compatibility. In addition to inactivating the diseases, the business also carries retroviruses that can infect humans in pigs.
Surgeons at NYU Langone Health in New York transplanted a genetically engineered pig’s kidney onto a guy who was brain-dead in September 2021, and they saw it start to work and produce urine. Scientists from the University of Alabama in Birmingham reported shortly afterward that they had carried out a similar process with comparable outcomes.
Twice, heart transplants from genetically altered pigs have been performed by University of Maryland surgeons on individuals suffering from cardiac disease. Both patients had advanced disease, and although the organs were functional and the first did not seem to be rejected, they both passed away soon after.
(People who consent to these state-of-the-art experimental treatments are typically very unwell and have few choices; frequently, they are ineligible for other reasons or are too sick to be placed on the waiting list for a valuable human organ.)
Richard “Rick” Slayman, a supervisor in the state transportation department, had been receiving treatment at Mass General for more than ten years for his diabetes and hypertension. Slayman was a transplant patient in Boston.
Mr. Slayman’s kidneys failed, and he spent seven years on dialysis before he was finally given a human kidney in 2018. However, the donated kidney failed after five years, and additional problems, such as congestive heart failure, appeared, according to Dr. Williams.
(People who consent to these state-of-the-art experimental treatments are typically very unwell and have few choices; frequently, they are ineligible for other reasons or are too sick to be placed on the waiting list for a valuable human organ.)
Richard “Rick” Slayman, a supervisor in the state transportation department, had been receiving treatment at Mass General for more than ten years for his diabetes and hypertension. Slayman was a transplant patient in Boston.
Mr. Slayman’s kidneys failed, and he spent seven years on dialysis before he was finally given a human kidney in 2018. However, the donated kidney failed after five years, and additional problems, such as congestive heart failure, appeared, according to Dr. Williams.
Although Mr. Slayman had numerous concerns when Dr. Williams first suggested he consider obtaining a pig’s kidney, he ultimately made the decision to go ahead.
In a Mass General statement, he added, “I saw it not only as a way to help me, but a way to provide hope for thousands of people who need a transplant to survive.”
Mr. Slayman has been allowed to discontinue dialysis because his new kidney appears to be working thus far. In addition to producing pee, the new pig kidney also removes waste products like creatinine.
His physicians noted that other metrics are also getting better every day. Physicians will keep an eye out for any indications of organ rejection in Mr. Slayman.
“Using pigs as a source of spare parts is potentially lethal for animals, dangerous for human patients, and could spark the next pandemic,” the speaker stated. “It is not feasible to eradicate or even recognize every virus that pigs harbor. Researchers should put more effort into streamlining the organ donation process and spare the animals.
A group of surgeons, led by Dr. Tatsuo Kawai, head of Mass General’s Legorreta Center for Clinical Transplant Tolerance, and Dr. Nahel Elias, performed the four-hour procedure.
The operation was carried out in accordance with a Food and Drug Administration process known as a compassionate use provision, which is given to patients who potentially benefit from an authorized treatment but have a life-threatening ailment. The approach also made use of novel medications to inhibit the immune system and stop organ rejection.
About Mr. Slayman, Dr. Williams remarked, “He’s remarkably courageous to step forward.” Bravo to him. With this, he’s contributing greatly.
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