First patient undergoes combined heart pump implant and pig kidney transplant

A groundbreaking medical procedure has successfully taken place, marking a significant milestone in the field. For the first time ever, a patient with a terminal illness has undergone a groundbreaking gene-edited pig kidney transplant. In addition to this pioneering procedure, the patient has also received a surgical implant of a mechanical heart pump. This remarkable achievement opens up new possibilities in the realm of medical innovation and offers hope to those in need of life-saving treatments.

Surgeons at NYU Langone Health, located in New York City, conducted a two-step operation. Initially, they implanted a heart pump. Subsequently, several days later, they performed a transplant involving a genetically modified pig kidney and the pig’s thymus gland. The purpose of the transplant was to aid in preventing rejection and bolster the immune system’s ability to combat diseases.

Lisa Pisano, a 54-year-old patient from New Jersey, was confronted with the challenges of heart failure and end-stage kidney disease, as reported by NYU Langone. The hospital explains that due to her chronic conditions, including reliance on dialysis, she was not eligible for either a heart or kidney transplant.

According to the hospital, Pisano’s high levels of antibodies that are harmful to human tissue pose a challenge in finding a suitable match for a human kidney transplant. However, these antibodies do not pose a threat to gene-edited pig organs.

Pisano expressed her desire for a better life, stating, “All I want is the opportunity to have a better life.” As she faced the grim reality of not being eligible for a human transplant, she realized that time was running out. In a discussion with her family and husband, Pisano learned about the potential possibility of receiving a gene-edited pig kidney, which her doctors believed could be a viable option.

The NYU team claims that this is the first recorded instance where a patient with a mechanical heart pump has successfully undergone an organ transplant. Furthermore, the hospital highlights that this is only the second case of a gene-edited pig kidney being transplanted into a living individual, and the first time it has been combined with the thymus.

Last month, a surgical team at Massachusetts General Hospital successfully performed a groundbreaking procedure. They transplanted a pig kidney into Richard Slayman, a 62-year-old man suffering from end-stage kidney disease. The team skillfully connected the pig kidney’s blood vessels and ureter to Mr. Slayman’s, and he is currently in the process of making a successful recovery.

Pisano underwent two procedures, which were carried out by different surgical teams with a gap of approximately nine days. The first procedure took place on April 4 and involved the surgical placement of a left ventricular assist device (LVAD). This device assists in pumping blood from the lower left chamber of the heart to the rest of the body.

According to NYU Langone, the LVAD is commonly employed for patients who are awaiting a heart transplant or are not eligible for one. The hospital emphasized that, without the LVAD, Pisano would have only a few days or weeks left to live.

Doctors say that even though end-stage kidney disease would normally disqualify patients from receiving an LVAD, they were able to use a gene-edited pig kidney to help her get approved for the procedure.

Dr. Nader Moazami, chief of the division of heart and lung transplantation and mechanical circulatory support for the department of cardiothoracic surgery at NYU Grossman School of Medicine, emphasized the importance of a kidney transplant in determining a patient’s eligibility for an LVAD. He explained that without the option of a kidney transplant, a person on dialysis would not be considered a candidate for a heart pump like the LVAD due to the increased risk of mortality. Dr. Moazami was part of the medical team that performed the LVAD surgery.

According to Moazami, this groundbreaking method marks the first-ever instance of performing LVAD surgery on a dialysis patient, with the intention of then proceeding with a kidney transplant. The ultimate goal is to enhance Lisa’s quality of life and provide her with additional time to cherish moments with her loved ones.

According to doctors, the pig kidney has been genetically modified to eliminate the production of a sugar called alpha-gal. This modification has been found to be effective in reducing the risk of rejection in xenotransplanted organs.

Dr. Robert Montgomery, chair of the department of surgery and director of the NYU Langone Transplant Institute, emphasized the significance of utilizing pigs with a single genetic modification in order to gain a deeper understanding of how a single stable change in the genome can contribute to the feasibility of xenotransplantation. In a statement, he stated, “This approach allows us to explore the potential of xenotransplantation as a viable alternative.”

According to Montgomery, using pigs that can be bred instead of relying on cloning for complex gene edits offers a sustainable and scalable solution to the organ shortage. He suggests that by minimizing modifications and medications, we can save more lives efficiently.

Pisano’s two-step procedure involved obtaining clearance from NYU Langone’s institutional review board and seeking approval from the Food and Drug Administration (FDA) through its “compassionate use” program. This program permits the use of non-traditional methods in cases where a patient’s condition is serious or life-threatening.

The hospital reported that Pisano underwent xenotransplantation on April 11 and is currently recovering smoothly.

Researchers at NYU Langone Health in New York City conducted a two-month study on a genetically engineered pig kidney that was transplanted into a 58-year-old man who had been declared brain-dead, with the consent of his family. During the study, the team observed only mild rejection of the transplant, which was successfully reversed by intensifying the medication for immunosuppression.

There is optimism among experts regarding the potential of animal-to-human organ transplantation to revolutionize the field of organ supply.

According to the Health Resources and Services Administration (HRSA), an agency of the Department of Health and Human Services, there are currently over 103,000 individuals waiting for a transplant in the United States. Tragically, 17 people lose their lives every day while waiting for a transplant. Additionally, a new patient is added to the transplant list every eight minutes.

According to research, it has been found that a significant number of donor organs, including kidneys, are being wasted every year. This means that potentially life-saving transplants are not taking place. The good news is that if these kidney transplants are proven to be effective and safe, it could potentially eliminate the need for dialysis for the over 500,000 individuals in the United States who currently rely on it to stay alive, as reported by the National Kidney Foundation.

According to Montgomery, it is truly remarkable to contemplate the scientific breakthroughs that have made it possible for us to save Lisa’s life. It is a testament to the collective efforts of our society in providing life-saving organs to those who are in desperate need.

The use of genetically modified animal organs raises concerns regarding their long-term functionality, safety, and the ethical implications of raising animals specifically for human organ transplantation.

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