Pig kidney transplants in a human – Last Wednesday, the pioneering recipient of a genetically modified pig kidney transplant, Richard “Rick” Slayman, 62, was discharged from Massachusetts General Hospital (MGH) in Boston, Massachusetts. Slayman, who had been grappling with end-stage kidney disease, bid farewell to dialysis following the groundbreaking procedure conducted at MGH, the largest teaching hospital affiliated with Harvard Medical School.
Slayman’s medical journey began with an end-stage renal disease diagnosis, rendering his kidneys incapable of autonomous function. From 2011 until 2018, he relied on dialysis until receiving his first kidney transplant from a human donor at MGH. However, approximately five years later, signs of kidney failure emerged, prompting Slayman to resume dialysis in May 2023. Complications ensued, typical among dialysis patients, necessitating frequent hospital visits for interventions such as de-clotting and surgical revisions, significantly impacting his quality of life.
The genetically modified pig kidney, sourced from eGenesis, a biotechnology firm in Cambridge, Massachusetts, specializing in human-compatible engineered organs, offered a solution. Through genetic editing, eGenesis eliminated harmful pig DNA from the donor organ while incorporating human DNA to enhance compatibility with the recipient’s body.
Remarkably, just two weeks after the four-hour procedure on March 16, Slayman was deemed fit to return home. In a statement released by MGH on April 3, Slayman expressed profound gratitude, labeling his departure from the hospital with “one of the cleanest bills of health” in a long time as one of the happiest moments of his life.
The recent procedure exemplifies “xenotransplantation,” which involves transplanting organs from one species to another.
The transplant received approval from the Food and Drug Administration (FDA) under a single Expanded Access Protocol, also known as “compassionate use,” offering experimental treatment to patients facing life-threatening illnesses.
Expressing gratitude, Slayman remarked, “I want to thank anyone who has seen my story and sent well wishes, especially patients waiting for a kidney transplant. Today marks a new beginning not just for me, but for them, as well.”
This development holds significant importance
As stated by MGH in a press release, “The procedure marks a major milestone in the quest to provide more readily available organs to patients.”
The success of the procedure shines a beacon of hope amidst the organ shortage crisis in the United States and globally. Presently, over 103,000 people in the US are awaiting organ transplants, with data from the Organ Procurement and Transplantation Network revealing that 17 individuals die daily while awaiting transplantation.
“I am firmly convinced that xenotransplantation represents a promising solution to the organ shortage crisis,” emphasized Leonardo V Riella, the medical director for kidney transplantation at MGH, overseeing Slayman’s procedure.
David Klassen, the chief medical officer of the United Network for Organ Sharing (UNOS), echoed similar sentiments, stating that this advancement could begin to bridge “the gap between the need for organ transplantation and the number of organs available for transplantation.”
Could organ transplants between species become commonplace? More research is needed before such transplants from pigs or other animals become widely accessible.
In January 2022:
David Bennett received a gene-edited pig heart, which initially seemed to function in his body. Unfortunately, Bennett passed away in March 2022, with the exact cause of death undisclosed.
In September 2023, Lawrence Faucette became the second person in the US to receive a genetically modified pig heart. However, he also passed away six weeks later. The University of Maryland Medical Center, where the transplant took place, reported signs of rejection in Faucette’s body.
Despite these setbacks, in the same month, surgeons at New York University Langone Health found success with a gene-edited pig kidney transplant in a brain-dead human body.
UNOS’s chief medical officer, Klassen, emphasized that organ rejection is a common risk in all transplants. Signs of rejection are typically addressed by adjusting transplant medications.
Klassen noted that recent xenotransplants have demonstrated scientists’ ability to mitigate the immediate rejection risk with genetically modified pig organs. However, he highlighted that extensive research and clinical trials involving large numbers of patients are necessary before such procedures can become widely available.
While this advancement builds on decades of medical research, there is still much groundwork to cover, including studying long-term outcomes and conducting comprehensive clinical trials.
