The first patient to receive a kidney transplant from a genetically engineered pig is doing well and was discharged from hospital on Wednesday, just two weeks after the groundbreaking surgery.
Scientists say the transplant and its promising results represent a remarkable moment in medicine, perhaps ushering in an era of xenotransplantation.
Two previous organ transplants from genetically modified pigs failed. Both patients received heart transplants and died several weeks later. One patient had signs that his immune system had rejected the organ, which was always a risk.
But doctors at Massachusetts General Hospital say the kidneys transplanted into Richard Suleiman, 62, are able to produce urine, remove waste from the blood, balance body fluids and perform other important functions. It is said that it is fulfilling its purpose.
In a statement released by the hospital, he said: “This moment – to be able to leave the hospital today in the best health I have had in a long time – is something I wish I had been in for years. “It was a moment when I realized that.” “Now it has become a reality.”
He said he had received “exceptional care” and thanked the doctors, nurses and well-wishers who had helped, including kidney patients awaiting organ donation.
“Today is a new beginning not only for me but also for them,” Suleiman said.
The procedure brings the possibility of xenotransplantation, or the transplantation of organs from animals to humans, much closer to reality, said David, chief medical officer of the United Network for Organ Sharing, which manages the country’s organ transplant system.・Dr. Klassen said.
“There’s still a lot of work to do, but I think the potential of this technology to benefit many patients will be realized, which has been a question mark over the field,” Dr. Klassen said.
Dr. Klassen noted that it is still unclear whether Mr. Suleiman’s body will ultimately reject the transplanted organ. And there are other hurdles. Before xenotransplantation becomes widely available, successful surgery must be replicated in large numbers of patients and studied in clinical trials.
There are “difficult” logistical challenges if these transplants are to be scaled up and incorporated into health systems, starting with ensuring an adequate supply of organs from genetically modified animals, he said.
Of course, cost can be a major stumbling block. “Can we really realistically try this as a health care system?” Dr. Klassen said. “I need to think about that.”
Treating kidney disease already costs a lot of money. end stage kidney disease, When an organ malfunctions, 1 percent of Medicare beneficiaries affected However, it accounts for 7% of Medicare spending, according to the National Kidney Foundation.
However, the medical potential of pig-to-human transplantation is enormous.
Left with few options, Suleiman chose an experimental approach. Blood vessel problems made dialysis difficult for him, and he waited a long time for a kidney donation.
The kidney that was transplanted into Suleiman came from a pig that had been genetically engineered by the biotechnology company EGenesis. The company’s scientists removed three genes that could cause organ rejection and inserted seven human genes to increase compatibility, allowing pigs to carry the virus to potentially infect humans. Measures were taken to inactivate the retrovirus.
More than 550,000 Americans require dialysis due to kidney failure, and more than 100,000 are waiting to receive a kidney transplant from a human donor.
Additionally, tens of millions of Americans have chronic kidney disease, which can lead to organ failure. Black Americans, Hispanic Americans, and Native Americans have the highest rates of end-stage kidney disease. Black patients generally have worse symptoms and have less access to donated kidneys than white patients.
Although dialysis keeps people alive, the treatment of choice for many patients is a kidney transplant, which dramatically improves their quality of life. However, only 25,000 kidney transplants are performed each year, and thousands of patients die each year while waiting for a human organ due to a donor shortage.
Xenotransplantation has been discussed as a potential solution for decades.
The challenge with any organ transplant is that the human immune system is susceptible to attacking the foreign tissue, causing life-threatening complications in the recipient. Patients receiving organ transplants usually must take drugs designed to suppress the immune system’s response and preserve the organ.
Suleiman showed signs of rejection eight days after the surgery, said Dr. Leonardo V. Riera, chief kidney transplant physician at Massachusetts General Hospital. (The hospital’s parent organization, Mass General Brigham, developed the transplant program.)
This rejection reaction was of a type called cellular rejection reaction. The most common form of acute graft rejection. It can occur at any time, but especially within the first year after an organ transplant. Up to 25 percent of organ recipients experience cellular rejection within their first three months.
Dr. Riera said that although Mr. Suleiman experienced rejection earlier than usual, the rejection was not unexpected. Doctors managed to reverse the rejection by using steroids and other drugs to suppress the immune response.
“The first week was a roller coaster,” Dr. Riera said. Encouragingly, Suleiman added that the patient will respond to treatment in the same way as patients receiving organs from human donors.
Suleiman is taking several types of immunosuppressants and will continue to be closely monitored, including blood and urine tests three times a week and doctor visits twice a week.
His doctors do not want Suleiman to return to work at the state Department of Transportation for at least six weeks. Suleiman also has to take precautions to avoid infections due to drugs that suppress his immune system.
“Ultimately, we want patients to get back to doing the things they enjoy to improve their quality of life,” Dr. Riera said. “I want to avoid restrictions.”
By Wednesday, Suleiman was clearly ready to go home, Dr. Riera said.
“When we first came in, he had a lot of anxiety and anxiety about what was going to happen,” Dr. Riera said. “But when we visited him this morning at 7 a.m., he had a big smile on his face and you could tell he had a plan in place.”
