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A Promising Future for Transplant Recipients

Nassir Azimi, MD Nassir Azimi, MD
Medically reviewed by Nassir Azimi, MD and Marianne Madsen

There is a pressing need all around the world for organ donors. Indeed, there is a whole industry based on organ harvesting and huge ethical issues–in some parts of the world, organs for human transplant are being sold.

 

Patients with end-stage chronic kidney failure, chronic heart failure, chronic lung failure, and many others often wait on a transplant list. Many die before getting an organ due to supply/demand mismatch and widespread shortage of organs suitable for transplant.  Every year, there are far more patients awaiting transplantation than there are potential donors.

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Kidney Transplantation Surgery - Procedure

Kidney Transplantation Surgery - Procedure

In the past, there has been experimentation of using animal organs in humans (xenotransplantation). The main issue in this type of transplant has been rejection as there is a significant immune reaction from the host. The host’s body almost immediately rejects the organ–particularly with xenotransplantation.  However, for the first time, a pig’s kidney has been transplanted into a human without immediate rejection.  

 

On September 25, 2021, at New York University, surgeons performed this xenotransplantation in a two-hour procedure. The kidney, which was obtained from a genetically engineered pig, was placed in a brain-dead human who had been placed on a ventilator with the consent of her family. The kidney was attached to the blood vessels in the host’s upper leg and kept outside the abdomen, under a protective shield, for the duration of the 54-hour study. For the duration of the study, the monitored kidney produced the expected amounts of urine with improved kidney function for the recipient.

 

We know that scientists have developed hearts in pigs that would have human antigens instead of porcine antigens. Thus, it was only a matter of time until similar procedures were undertaken with “humanized” hearts harvested in pigs for xenotransplantation into David Bennett.

 

This is indeed a “transformative moment,” as the researchers called it. This promises to change the supply/demand equation of organs and lead to widespread organ availability for those awaiting transplantation. However, further research is needed as unfortunately David Bennett died two months later from progressive heart failure due to a pig virus.

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