Doctors at Massachusetts General Hospital have reached a medical milestone by transplanting a genetically modified pig kidney into a 62-year-old man who was suffering from advanced renal failure.
The four-hour procedure performed on March 16 marks a pivotal advancement in providing viable organs for patients in dire need.
The kidney came from a biotech firm specializing in human-compatible engineered organs. Leveraging CRISPR-Cas9 gene-editing technology, scholars modified the pig's genes, eliminating three of them involved in producing carbohydrates targeted by the human immune system.
Moreover, seven human genes were introduced into the organs to prevent immune-related complications that could lead to rejection. Additionally, snippets of viral DNA known as endogenous retroviruses, which pose risks to humans, were deactivated within the pigs' genomes.
Before the transplant, the recipient, identified as Rick Slayman, underwent two antibody-based treatments and received immune-suppressing medications to stave off organ rejection.
Leonardo V. Riella, the medical director for kidney transplantation and a Harold and Ellen Danser associate professor of surgery at HMS, expressed optimism for the medical procedure's fate, envisioning a future where dialysis becomes obsolete.
“At MGH alone, there are over 1,400 patients on the waiting list for a kidney transplant. Some of these patients will unfortunately die or get too sick to be transplanted due to the long waiting time on dialysis. I am firmly convinced that xenotransplantation represents a promising solution to the organ shortage crisis,” Riella noted.
The patient, afflicted with type 2 diabetes and hypertension, had been on dialysis for seven years before undergoing a human kidney transplant in December 2018. However, the transplanted organ exhibited signs of failure five years later, prompting a return to dialysis in May 2023, accompanied by severe complications necessitating frequent hospital visits.
“I have been a Mass General Transplant Center patient for 11 years and have the highest level of trust in the doctors, nurses, and clinical staff who have cared for me,” Slayman said in a statement.
Slayman stated that when his transplanted kidney started failing in 2023, he once again placed his trust in the care team at MGH to fulfill their objectives of not only enhancing their quality of life but also prolonging it.
His nephrologist, Dr. Winfred Williams, and the team at the Transplant Center, proposed a pig kidney transplant, thoroughly discussing the advantages and disadvantages of this procedure with him.
While not the first ever pig-to-human kidney transplant, this achievement builds on past endeavors, with previous attempts conducted on brain-dead individuals sustained by life support. The most recent such transplant, performed by Robert Montgomery at NYU Langone Health in July 2023, saw the kidney function for over a month without rejection or infection.
This medical feat follows a line of successes from the first human organ transplant in 1954 to the nation's initial penile transplant in 2016.
With over 100,000 Americans awaiting organ transplants and 17 dying daily due to organ shortages, urgent solutions are imperative, particularly amid projections of escalating terminal kidney disease cases in the US from 29 to 68 percent.
“The continued success of this groundbreaking kidney transplant represents a true milestone in the field of transplantation. It also represents a potential breakthrough in solving one of the more intractable problems in our field, that being unequal access for ethnic minority patients to the opportunity for kidney transplants due to the extreme donor organ shortage and other system-based barriers,” said nephrologist Winfred Williams, associate professor of medicine at HMS.