A 62-Year-Old Man Received a Kidney From an Unexpected Donor: a Pig

unrecognizable female doctor holding shield and graphic virtual visualization of kidneys organ in hands
Genetically Edited Pig Kidney Performing in Humanmi-viri - Getty Images
  • A Harvard Medical School-led procedure at Massachusetts General Hospital transplanted a genetically edited pig kidney in a 62-year-old human.

  • The world’s first procedure offers promising signs, at least in the short term.

  • Scientists hope successful xenotransplantation saves human lives as 17 people die each day waiting for an organ transplant.

Scientists genetically modified a pig kidney, doctors transplanted that kidney into a 62-year-old human, and that man is roughly one week beyond the transplant looking toward a release from Massachusetts General Hospital.

“The success of this transplant is the culmination of efforts by thousands of scientists and physicians over several decades,” Tatsuo Kawai, Harvard Medical School professor of surgery and director of the Legorreta Center for Clinical Transplant Tolerance at Mass General, says in a statement.

The world’s first-ever transplant of a pig kidney into a human marks a milestone. Doctors now believe it serves as a starting point. “Our hope is that this transplant approach will offer a lifeline to millions of patients worldwide,” Kawai says, “who are suffering from kidney failure.”

Rick Slayman of Massachusetts was already on his second kidney, following a 2018 transplant. This one was failing too, leading to end-stage kidney failure. Dialysis wasn’t taking. That’s when doctors presented the patient—Harvard Medical School surgeons were the first to perform a successful human organ transplant (also a kidney) in 1954—with quite the concept, an experimental procedure only allowed thanks to an FDA-approved compassionate use designation.

“I saw it not only as a way to help me, but a way to provide hope for the thousands of people who need a transplant to survive,” Slayman says in a statement.

“Our hope is that dialysis will become obsolete,” Leonardo Riella, Harvard Medical School Harold and Ellen Danser associate professor of surgery and medical director for kidney transplantation at Mass General, says in a statement. “We feel strongly that xenotransplantation is a reasonable option either as a bridge [on the way to receiving a human kidney] or hopefully in the future as a permanent treatment.”

Once the surgical team, led by Riella, Kawai, and Nahel Elias, connected the kidney, the new organ “immediately pinked up,” Winfred Williams, Harvard Medical School associate professor, says in a statement. “They held up the ureter and it was producing urine. Applause broke out in the OR. It was quite an amazing experience.”

To make it happen, scientists first needed to get the pig kidney ready for human use. Cambridge company eGenesis Bio used CRISPR-Cas9 technology to make 69 genomic edits to the pig’s DNA, adding and subtracting elements aimed at convincing the human body to accept the kidney.

Key edits included removing three genes for sugars that a human body recognizes and attacks and deactivating pig retroviruses that can infect humans. The eGenesis team inserted seven human transgenes involved in the regulation of pathways to modulate rejection. Without the modifications, the pig kidney would be immediately rejected. Pharmaceutical companies crafted unique monoclonal antibody drugs designed to suppress immune reactions against pig tissue.

“This successful procedure heralds a new era in medicine in which we have the potential to eliminate organ supply as a barrier to transplantation and realize our vision that no patient dies waiting for an organ,” Michael Curt, chief executive officer of eGensis, says in a statement.

Of course, one week in is not a solution achieved. “There are so many unknowns,” Riella says. “This is the first time we’re doing it.” Doctors don’t know what to expect moving forward but are hoping for more than two years on the pig kidney.

A team of doctors and scientists will monitor Slayman’s health and the efficiency of the kidney, looking for even more genetic edits needed for optimal results. There’s also the chance that xenotransplantation may help reduce health complications following organ transplant.

With 17 people dying daily while waiting for an organ transplant and over 1,400 patients on the waiting list for a kidney transplant at Mass General alone, Riella believes xenotransplantation “represents a promising solution to the organ shortage crisis.”

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