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Researchers from the University of Alabama in Birmingham have discovered that a genetically modified pig kidney that was transplanted into a brain-dead patient more than a month ago is still functioning normally. It is the longest time a human kidney made with altered genes has ever worked.
In July 2023, a surgical team removed the recipient's human kidneys and replaced them with the pig kidney and thymus. Alpha-gal, a sugar molecule on the surface of pig cells that causes an uncommon allergy to red meat as well as organ rejection, was removed from the pig kidney prior to the transplant.
Maurice Miller, a 57-year-old man, received the transplant. Mary Miller-Duff, his sister, expressed joy over her brother's participation in the historical transplant.
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What procedure was followed for pig kidney transplantation?
The treatment, carried out on July 14, 2023, was the fifth xenotransplant carried out at NYU Langone and under Robert Montgomery, MD, DPhil, Chair of the Department of Surgery and Director of the NYU Langone Transplant Institute.
The genetic modification used in the NYU Langone study was done with the elimination of a carbohydrate molecule known as Alpha-gal. The fact that humans cannot synthesize the chemical and build large amounts of antibodies against it has historically proven to be a serious barrier to xenotransplantation. The researchers will continue the observation until mid-September 2023.
Dr. Montgomery, who had previously carried out the gene-modified pig kidney transplant into a human decedent on September 25, 2021, and a second similar procedure on November 22, 2021, said:
" This work demonstrates 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."
How is this a promising move?
The study is a component of an innovative scientific initiative to find a new source of transplant organs for Americans whose kidneys, hearts, and other organs have failed. Kidneys are the organ most in demand. Over 100,000 people in the United States are waiting for kidney transplants, while more than 800,000 Americans have renal failure. Patients can survive on kidney dialysis, but an organ transplant is the best course of action.
Despite this, less than 25,000 kidney transplants are carried out every year due to the lack of human organ donors, and every year, thousands of people on the waiting list pass away.
Doctors, surgeons, and scientists are looking at alternatives since there aren't enough human organs to go around. These possibilities include artificial organs, ones made in a lab from living tissue, and ones from suitably compatible animals. Pigs are particularly preferred because their internal organs resemble ours in many respects.
The kidney has now survived and has been functioning normally for more than 32 days, which is a new record. Biopsies and monitoring reveal that the organ is operating at its best.
Due to the potential for virus transmission, the U.S. Food and Drug Administration has not permitted living human xenotransplantation clinical studies. Montgomery said he believes that Miller's lack of infection will persuade the government to reevaluate its current position.
