Surgical Advancements Enhance Performance of Genetically Modified Pig Kidney Transplants

Surgeons from Birmingham and New York City recently unveiled significant progress in the field of organ transplantation. Their breakthrough involves using genetically modified pig organs to prevent rejection in human recipients.

Researchers at the University of Alabama in Birmingham conducted a peer-reviewed study, demonstrating that modified pig kidneys successfully performed essential life-sustaining functions in a brain-dead patient for an entire week. Meanwhile, surgeons at NYU Langone Health achieved an impressive feat: a genetically modified pig kidney remained functional in a brain-dead patient on a ventilator for an unprecedented 32-day period. Notably, this represents the longest duration observed in such experiments.

Dr. Robert Montgomery, the director of the NYU Langone Transplant Institute, noted that the patient exhibited no signs of organ rejection. However, it's important to highlight that this groundbreaking research has yet to be officially published in a scientific journal.

Addressing the Significance: Tackling the issue of inadequate donor organ supply.

This research represents a groundbreaking scientific endeavor aimed at creating an alternative reservoir of transplant organs to aid individuals in the United States grappling with failed kidneys, hearts, and other organ deficiencies.

Among the most pressing demand is for kidneys, as over 800,000 Americans suffer from kidney failure, with a staggering 100,000 individuals awaiting a transplant. While kidney dialysis can sustain patients, organ transplantation remains the preferred and superior treatment.

Despite this, the shortage of human donor organs has restricted the annual kidney transplant count to fewer than 25,000, leading to unfortunate fatalities among thousands on the waiting list.

Dr. Jayme Locke, lead author of the newly published report and Director of U.A.B.'s Comprehensive Transplant Institute, emphasizes the misconception surrounding dialysis as an adequate solution and highlights the mortality rate associated with it.

Groundbreaking Discovery: Pig kidneys show promise as a solution.

The previous year witnessed several studies illustrating that pig kidneys transplanted into brain-dead individuals exhibited urine production for short periods. However, the U.A.B. study distinguishes itself by demonstrating that these pig organs also effectively filter creatinine, a muscle contraction byproduct that necessitates removal from the bloodstream.

Dr. Locke underscores the groundbreaking aspect of their research, asserting that pig kidneys can indeed clear sufficient creatinine to sustain adult human functions. Their findings were recently published in JAMA Surgery.

Crucial Functions of the Kidney: Beyond urine production.

The kidney serves a multitude of vital roles, including fluid equilibrium, blood pressure regulation, and pH level control. Dr. Locke stresses that to ensure life-sustaining kidney performance, urine production alone is insufficient.

Historical Context: The potential of animal organs to alleviate shortages.

The concept of xenotransplantation—implanting animal organs into humans—has long captured the interest of medical practitioners. Recent advancements in genetic engineering and cloning have accelerated progress in this realm.

In 2021, NYU Langone Health reported a successful kidney attachment from a genetically modified pig to a brain-dead recipient on a ventilator. Subsequently, the University of Maryland transplanted a genetically modified pig heart into a 57-year-old heart failure patient.

In a significant stride, Dr. Locke and her colleagues achieved a landmark accomplishment last year by transplanting genetically modified pig kidneys into a brain-dead individual's abdomen.

Differing Approaches: Pig kidneys and genetic modifications.

The experimental pig kidneys used in Alabama and New York vary slightly, though both originated from pigs provided by Revivicor, a subsidiary of United Therapeutics Corporation. The U.A.B. utilized pig kidneys with ten gene modifications, while N.Y.U. Langone Health employed kidneys with a single genetic alteration. The latter procedure also involves embedding the pig's thymus gland, responsible for immune system education, beneath the new kidney's outer layer to prevent immune attacks.

The Future Path: Pioneering human clinical trials.

Current genetically modified pig kidney transplants have solely been conducted on brain-dead patients. Dr. Locke and her team are actively engaged in discussions with the Food and Drug Administration to initiate the first human clinical trial involving live patients.