For the first time in history, surgeons in the US have successfully transplanted a pig’s kidney into a human without triggering an immune response of rejection by the patient as it had been genetically modified. This is exciting news, which could revolutionize the solution for the shortage of human organs needed for urgent transplants.
The two hour long operation took place at NYU Langone Health in New York City. Here the patient’s family consented to the experiment on the patient who was brain dead and required a life support machine, with no possibility for recovery.
The transplanted kidney was kept outside of the patient’s body so that it could be accessed, and connected to blood vessels to see if it could continue to function normally. Surgeon Dr. Robert Montgomery who led the study commented that the kidney and its function, “looked pretty normal, and made the amount of urine that you would expect” from a transplanted human kidney. The creatinine level also looked normal which was a good indicator of healthy kidney function after the transplant and showed no signs of rejection.
Dr. Montgomery who has received a heart transplant himself highlighted the urgent need for more organs as waiting lists for transplants grow to outnumber the supply. He also acknowledged the controversy of his work, “”I certainly understand the concern and what I would say is that currently about 40% of patients who are waiting for a transplant die before they receive one. We use pigs as a source of food; we use pigs for medicinal uses – for valves, for medication. I think it’s not that different.”
Dr. Montgomery’s team believed that knocking out the pig gene for a carbohydrate that triggers rejection called alpha-gal could prevent the rejection response in humans. United Therapeutics Corp’s Revivor unit developed the genetically modified pig, which is known as, ‘GalSafe’, which was approved by the FDA in 2020. Its original use was to create a food source for those with a meat allergy. If used as a medical device it will require a difficult type of FDA approval. It could potentially open up clinical trials for patients with kidney failure.
The idea of using animal organs in humans is not a new idea but it is the first time it has been successful as the most advanced experiment of its kind done to date and especially in humans. Pig hearts are already used in humans but organ transplants have not been done before.
Although this experiment has been hugely successful, it does raise questions on ethics and the reflective question that if we can do this procedure does it mean that we should? There is still a long way to go, and many conversations to be had before this kind of transplantation becomes the norm, and it would need to be approved by the FDA. Until then, the emphasis on encouraging everyone to consider organ donation continues.