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Doctors announced Thursday that they have transplanted a genetically modified kidney from a pig into a living human for the first time.
The four-hour operation took place Saturday at Massachusetts General Hospital, the first hospital to perform a kidney transplant in 1954.
The patient, 62-year-old Rick Slaman of the Massachusetts Department of Transportation, who was diagnosed with end-stage kidney disease, is recovering well and is expected to be released from the hospital soon.
Doctors said Thursday they thought the new kidney could last for years, but acknowledged there are many unknowns involved in animal-to-human transmission.
In a written statement, the hospital said Sleiman had been a patient in the hospital's transplant program for 11 years. In 2018, after living with diabetes and high blood pressure for many years, he received a kidney from a human donor. Five years later, that kidney began to show signs of failure. He resumed dialysis in 2023.
When he was diagnosed with kidney disease at the end of last year, the doctors suggested that he try a pig kidney.
“I did it not only to help me, but to give hope to thousands of people who need a transplant to survive,” Sleiman said in a statement.
Doctors who were not involved in the case said that the operation represents a high level of medical care.
“After years of work and collaboration, it's a really big step forward and a great time to see this come to fruition,” said Dr. Parsia Vagefi, chief of transplant surgery at UT Southwestern Medical Center in Dallas.
Dr. Tatsuo, a surgeon and director of the Lagoreta Clinical Transplant Tolerance Center, said the pig organ is similar to a human kidney.
When they connected his veins to Slyman and put him in, he immediately “turned pink” and started making urine, Kawai said. The 15-member transplant team burst into applause in the operating room.
“It really was the most beautiful kidney I've ever seen,” Kawai said at a news briefing Thursday in an emotional news briefing for doctors, some of whom have worked on the study for their entire careers.
A doctor choked up as he thanked his patient, colleagues and biotech partners. A fellow doctor put his hand on his shoulder and said, “You did it.”
The demand for organs far exceeds the number available. Every day in the US, 17 people die waiting for an organ, and a kidney is the organ in shortest supply. According to the Organ Procurement and Transplantation Network, about 27,000 kidneys will be transplanted by 2023, but about 89,000 people are on the waiting list for these organs.
Experts say xenotransplants – transplanting animal organs into humans – are crucial to solving the organ shortage.
“Addressing one of the most intractable problems in our field, disparities in access to kidney transplants for minority patients, could be a major breakthrough,” said Dr. Winfred Williams, co-chair of the Department of Nephrology. In Mass. Gen., in News Summary.
This is the third transplant of a pig organ into a living human. The first two hearts were transplanted into living people who had exhausted other transplant options. The organs are transplanted under special laws that permit experimental treatment in a compassionate way for people in particularly difficult situations. Both patients died weeks after receiving their organs.
Researchers at Mass General Brigham said that although the latest progress is important, more research is needed — especially a large study conducted at multiple hospitals — to better understand how effective pig kidney transplants are.
“Our hope is that dialysis will become obsolete,” said Dr. Leonardo Riela, MD, director of kidney transplant medicine at Mass General. “Respiratory dialysis becomes like a ventilator for a sick patient. You use it for a while, and if they're healthy enough, they can get a more permanent solution, which could be a human transplant or a xenotransplant.”
Williams said Slimman had been his patient for more than a decade before the procedure.
He said the xenotransplant meant a lot to Slayman, who had “a lot of trouble” on dialysis. Arterial disease, diabetes and high blood pressure mean that the blood vessels that feed the dialysis machine often become clogged, complicating treatment.
Slayman needed more and more interventions to get rid of the claws. It is estimated that he performed 30 to 40 procedures to solve the problems.
“At one point, he told me he thought he couldn't go on. He literally said: 'I don't think I can go on like this. I don't want to go on like this,' Williams said.
At that point, Williams said, he began researching unconventional options and settled on the idea of using pig organs for Slyman.
The organ comes from a pig that has been genetically modified by the eGenesis Bio company to make it more human-like. Other companies are working to make pig tissues and organs suitable for xenotransplantation.
Taking blood and skin from animals and using them in human experiments It started in the 1600s With blood and skin.
Researchers said that the goal of transplanting pig kidneys into humans began to be pursued in the 1960s.
He pointed out that although pig kidneys are similar to human kidneys, it is not easy to know how to protect the human immune system.
Dr. Joren Madsen, director of the Mass Total Transplant Center, said: “The human immune system reacts to a pig organ with a surprisingly stronger response than to a human organ.
According to Madsen, if you give a person the same drugs used to prevent the rejection of other organs and try it with a pig kidney, this transplant will reject after minutes and turn black. Minutes.”
There are three key developments that ultimately made xenotransplantation a reality, Madsen said.
First, Igenesis was able to use CRISPR-Cas9 technology to make 69 precise edits to the pig's DNA — cutting things out in some areas, inserting things in others — to prevent the human body from recognizing the pig's kidney as foreign and rejecting it. They. They knocked out three genes for sugars expressed on pig cells that can be recognized and attacked by human antibodies. They have also used gene editing to eliminate porcine retroviruses that reactivate and infect humans.
The second: pharmaceutical companies have been able to develop special monoclonal antibodies specifically designed to prevent rejection of pig organs.
Finally, Madsen was able to test pig organs in non-human animal models to develop the best protocols for translating the technology to humans.
“This successful procedure heralds a new era of medicine where we can overcome the barriers to organ transplantation and realize our vision that no patient will die waiting for an organ.” News release.
“We are humbled by the courage and generosity of this patient, who was a true pioneer, making a breakthrough in science and transplant medicine possible,” he said.