A groundbreaking medical procedure has taken place in the United States, with surgeons successfully transplanting a genetically engineered pig kidney into a brain-dead man. The kidney has continued to function well for an impressive 32 days, marking the longest period that a gene-edited pig kidney has been operational in a human body. The surgeons at New York University (NYU) Langone Health view this achievement as a significant step towards establishing a sustainable and alternative source of organs for transplantation.
The procedure, which took place on July 14, 2023, was the fifth xenotransplant performed at the New York facility. Xenotransplantation involves the transplantation of non-human tissues into humans. The observation of the patient is ongoing, and the study will continue until mid-September 2023. The researchers leading the study believe that their work could potentially save countless lives in the future. The success of this procedure was made possible by the generosity of the family of the 57-year-old male patient, who had chosen to donate his body to science.
Dr. Robert Montgomery, a surgeon and director of the NYU Langone Transplant Institute, expressed his satisfaction with the results, stating, “This work demonstrates that a pig kidney, with only one genetic modification and without experimental medications or devices, can replace the function of a human kidney for at least 32 days without being rejected.” Dr. Montgomery himself performed the world’s first genetically modified pig kidney transplant into a human on September 25, 2021.
One of the main challenges in xenotransplants is preventing the human body from rejecting the animal organ once it is connected to the circulatory system. In this study, the researchers “knocked out” a specific gene that has been identified as triggering rapid rejection of pig organs in humans. Additionally, the pig’s thymus gland, responsible for educating the immune system, was embedded beneath the outer layer of the kidney to prevent delayed immune responses. Both of the recipient’s native kidneys were surgically removed, and the pig kidney was successfully transplanted, immediately producing urine without any signs of rejection. Throughout the study, the levels of creatinine, a waste product indicating kidney function, remained within the optimal range, and there was no evidence of rejection in the biopsy.
Previous genetically engineered pig-organ transplants have involved up to 10 genetic modifications. However, this latest study demonstrates that a single-gene knockout pig kidney can perform optimally for at least 32 days without rejection. Dr. Montgomery emphasized the significance of these findings, stating, “We’ve now gathered more evidence to show that, at least in kidneys, just eliminating the gene that triggers a hyperacute rejection may be enough, along with clinically approved immunosuppressive drugs, to successfully manage the transplant in a human for optimal performance, potentially in the long-term.”
In the United States, there are currently over 103,000 people on the waiting list for organ transplants, with nearly 88,000 of them waiting for a kidney, according to recent official data. In 2022, approximately 26,000 people received kidney transplants, highlighting the urgent need for more available organs. End-stage kidney disease affects nearly 808,000 people in the US. Dr. Montgomery stressed the importance of xenotransplantation as a viable solution to address the organ shortage, stating, “There are simply not enough organs available for everyone who needs one. Too many people are dying because of the lack of available organs, and I strongly believe xenotransplantation is a viable way to change that.”
The monitoring of the pig kidney recipient will continue for another month, with the permission of the family.