Surgeons at the University of Alabama at Birmingham reported an incredible marvel in medicine on Thursday: For the first time ever, they had successfully transplanted kidneys from a genetically modified pig into the body of a 57-year-old brain-dead man. The new breakthrough, reported in the American Journal of Transplantation, is a milestone in the quest to find a solution to organ transplant shortages that affect millions.
The surgeons removed the patient’s own kidneys and replaced them with the pig kidneys in a fairly standard procedure (besides the whole pig thing). Just 23 minutes after they were implanted into the abdomen, the kidneys started to filter blood and produce urine without problems (although one inexplicably produced much more urine than the other). They worked well for 77 hours before the study was ended. At no point during that time were there any signs of organ transplant rejection.
“This game-changing moment in the history of medicine represents a paradigm shift and a major milestone in the field of xenotransplantation, which is arguably the best solution to the organ shortage crisis,” Dr. Jayme Locke, the lead surgeon of the new study, said in a statement. “We have bridged critical knowledge gaps and obtained the safety and feasibility data necessary to begin a clinical trial in living humans with end-stage kidney failure disease.”
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The results are hot on the heels of another feat in transplantation science earlier this month, when Maryland surgeons announced they had successfully transplanted a genetically modified pig heart into a 57-year-old man diagnosed with life-threatening heart disease. And last September, researchers at New York University attached a genetically modified pig kidney to a brain-dead individual on a ventilator—though this kidney functioned outside the body, for 54 hours.
All of this work is part of a larger effort to solve the organ shortage crisis. In the U.S. alone, 17 people die each day waiting for an organ transplant. More than 800,000 Americans suffer from kidney failure and rely on dialysis to survive. The vast majority are eligible for an organ transplant, but very few will actually get one.
The immediate goal for this new study was to establish the safety and efficacy of this type of pig-to-human transplantation procedure and set up the groundwork for running a small clinical trial with living patients before the end of the year. Such a trial would look to confirm whether or not these kidneys could function for a much longer period of time, among other things.
The new kidneys were taken from pigs that had 10 specific gene edits designed to make their organs more viable for humans and prevent rejection. Four were designed to knock out the function of a few pig-specific enzymes and hormones that would otherwise make the kidneys grow in a pig-specific shape and size, while six were human genes meant to help trick the human immune system into accepting the new organs.
Clinical researchers have always been very interested in the potential of pig organs, since they're similar in size to human organs. Pigs are also easy to breed and live for about 30 years, so they could be a plentiful source for new organs.
The recipient of the kidneys was Jim Parsons, a registered donor from Huntsville who sustained a debilitating brain injury in a motorcycle race in September, and whose family consented to the research.
“Jim would have wanted to save as many people as he could with his death, and if he knew he could potentially save thousands and thousands of people by doing this, he would have had no hesitation,” his ex-wife, Julie O’Hara, said in a statement. “Our dream is that no other person dies waiting for a kidney, and we know that Jim is very proud that his death could potentially bring so much hope to others.”
