Health
First successful kidney transplant from gene-edited pig brings hope
BOSTON – Massachusetts General Hospital announced that it has successfully transplanted a genetically modified pig kidney into a human. This is the first case of a person surviving after receiving an organ transplant from another species.
Richard “Rick” Suleiman of Weymouth, Massachusetts, is recovering well from the four-hour surgery he underwent on March 16, doctors announced Wednesday. On Tuesday, he managed to walk 20 laps around the hospital's transplant unit. The Massachusetts Department of Transportation systems administrator was scheduled to be discharged from the hospital within the next few days.
A personal statement released by doctors and the hospital said Suleiman had very limited medical options and agreed to the surgery as “a way to offer hope to the thousands of people who need a transplant to survive.” That's what it means.
is more than 100,000 people are on national organ transplant listbut The number of transplants is less than half It is held every year. People who need more organs don't make it onto the list at all, either because they're not suitable transplant candidates or because they die first.
That's why researchers have been working for decades to find ways to use pig organs instead of human organs.
But certain sugars present on the outside of all pig cells instantly alert the human immune system that the pig parts don't belong. In very early attempts at cross-species transplants in the middle of the last century, when a person's immune system rejected an organ, the organ turned black almost immediately.
But in Suleiman's case, when surgeon Tatsuo Kawai connected the human and pig's blood vessels and ureters, the pig's kidney immediately turned pink. Urine came out rapidly.
“It really was the most beautiful urine I've ever seen,” Kawai told a room of reporters and Massachusetts staffers gathered in a room Wednesday, to thunderous applause.
Why use pig organs?
Pig organs are suitable for transplantation. This is because pig organs are about the right size for humans, are relatively biologically similar, and are already bred for food by billions of people, so sacrificing pigs for their organs doesn't make sense. This is because there are fewer ethical concerns than when using primates.
Rejection remains a major concern, both for pig organs and for any organ transplanted from one organism to another.
Dr. Jolene Madsen, director of the MGH Transplant Center, said three major advances have enabled researchers at the hospital to overcome “formidable” barriers to transplantation. One is a pig that has been genetically modified to be more compatible with humans, and the second is an improved version. By providing sufficient evidence through drug regimens and animal-to-animal transplantation to reduce the risk of rejection, researchers and patients can feel confident in testing in humans.
General, Massachusetts, was the site of the first human-to-human organ transplant in 1954, when an identical twin donated a kidney to his younger brother. Dr. Paul Russell, who launched the hospital's transplant program in 1963 and lent his name to the museum where Wednesday's press conference was held, sat in the front row at age 99 and, as Madsen said, “once imagined.'' “I couldn't even do it,” I asked about the progress. that.
Mike Curtis, CEO of EGenesis, a biotechnology company that breeds and raises gene-edited pigs, said the pig that donated life and kidneys to Suleiman was raised on an undisclosed farm in the Midwest, and is undergoing surgery. He was flown to Boston for transplant.
Curtis said the cloned pigs used in Suleiman's transplant had 69 gene edits, compared to pigs in other transplant experiments that have had between three and 10 gene edits.
Three genes were removed or “knocked out” to reduce the risk of immediate rejection after transplantation. Seven additional human genes were added to reduce the chance of subsequent rejection, and 59 genes associated with endogenous pig retroviruses were deleted to eliminate the possibility of the virus jumping from pigs to humans. Activated.
Monkeys with the same gene-edited pig kidneys lived for two years.
Why was a transplant necessary?
Suleiman had had type 2 diabetes for 30 years and was on dialysis for seven years before receiving his first kidney transplant from a deceased donor in 2018, said nephrologist Dr. Winfred Williams.
Williams said that even before the transplant, his veins had been clotting, blocking blood flow and making dialysis difficult.
After five years, the new organ began to fail. It was removed and he was put on dialysis again.
He underwent 30 to 40 surgeries and radiation treatments to keep his veins open, but dialysis still wasn't working. “I witnessed patients becoming depressed and depressed,” Williams said. “At one point he said to me… 'I can't do this anymore.' He started considering unusual measures.”
That's when he began considering Suleiman as a candidate for pig transplant surgery.
Since this is Suleiman's first time, it is unclear how long his kidneys will continue to function normally. Kawai said, “We are aiming for two years or more, but we still need to be careful.''
Two patients received gene-edited pig hearts at the University of Maryland Medical Center. one person survived Approximately 2 months in 2022. the other almost 6 weeks In 2023.
Williams said Suleiman's physical condition before the surgery was in much better shape than both heart patients, so he expected a much better outcome.
What will the future hold?
Dialysis, which occurs three times a week for three hours each, was never intended to be a lifelong solution, but it is now a “last resort” for 600,000 Americans. said Dr. Leonardo Riera, Massachusetts Kidney Transplant Medical Director. general.
“Imagine a different story, where a healthy young kidney is available for transplant,” Leila says. “Today, we offer a glimmer of hope to many of these patients.”
Pig kidneys could offer an opportunity, especially for older patients, doctors said, as they commonly struggle with dialysis. Less than a quarter of most people survive five years after being placed on the transplant list.
It's not clear how much it will cost to transplant the pigs. Because it was , the cost of the new surgery was “huge,” Williams said. Transplants are usually cheaper than dialysis. “Once it becomes commonplace, its cost structure will go down.”
Researchers need to test pig kidneys and other organs in more patients at multiple sites before the Food and Drug Administration considers approval for routine use.
Karen Weintraub can be reached at [email protected].
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