For the first time, pig hearts were transplanted into humans

A 57-year-old man with life-threatening heart disease received a heart from a genetically modified pig. This is a promising pioneering procedure for patients with organ failure.

According to the New York Times, this is the first successful transplant of a pig’s heart into a human. According to surgeons at the University of Maryland Medical Center, the eight-hour operation was performed in Baltimore on Friday, and the patient, David Bennett, was in good condition on Monday. “It creates pulse and pressure,” said Dr. Bartley Griffith, director of the heart transplant program at the medical center, who performed the operation. This is his heart. It does work and it looks normal. We are excited but we do not know what will happen tomorrow. “Such a thing has never been done before.”

According to the non-profit organization UNOS, which coordinates organ procurement efforts in the United States, last year, about 41,354 American recipients received transplants, more than half of which were kidneys; But there is a severe shortage of organs, and every day about 12 people on the waiting list for organ transplants die. About 3,817 Americans received the human donor heart as an alternative last year, which is higher than ever, but demand is still high.

Scientists have worked tirelessly to produce pigs whose limbs are not rejected by the human body. Research in this field has accelerated in the last decade with the introduction of new technologies of gene editing and cloning (cloning). The heart transplant came just months after surgeons in New York successfully attached a genetically engineered pig kidney to a brain-dead person.

Researchers hope that such procedures will usher in a new era in medicine in which there is no shortage of alternative organs for people waiting to receive a transplant. “This is a groundbreaking event,” said Dr. David Klassen, UNOS Chief Medical Officer. “Doors are opening up, which I believe will lead to major changes in the treatment of organ failure.”

But Klasen also added that there are many obstacles that need to be overcome before such a practice can be widely used. He noted that organ rejection occurs even when the kidney of the donor is highly consistent with the recipient patient. “It takes a long time for this type of treatment to mature and complete,” said Dr. Klassen.

Mr. Bennett decided to take the risk of experimental treatment because he would die without a new heart, was tired of other treatments, and was so ill that he was not eligible to receive a human donated heart. His prognosis is unclear. Mr. Bennett is still attached to the cardiopulmonary bypass machine that kept him alive before the operation, but this is not uncommon for a new heart transplant recipient. The new heart of the valley is currently doing most of the work, and doctors say it could be removed from the device soon.

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Mr. Bennett is closely monitored for signs that his body is rejecting a new organ, but has been ruled out without incident for the first 48 hours, when it is considered critical. He is also on the lookout for infections, including swine retrovirus, which may be transmitted to humans, although the risk is low. “It was my and Thierry’s last choice in the dark,” Mr Bennett said before the operation.

Dr. Griffith first shared this experimental treatment with the patient in a memorable and bizarre conversation in mid-December. “I said we can not give you a human heart, you do not have the conditions,” he recalled. But we may be able to use the heart of an animal like a pig. This has never been done before, but we think we can do it. I was not sure he understood me. “Then he said, ‘Well, will I hear a pig?’

Animal-to-human transplantation (xenotransplantation) has a long history. Attempts to use animal blood and skin go back hundreds of years. In the 1960s, chimpanzee kidneys were transplanted into some human patients, but the recipient’s longest lifespan was nine months. In 1983, Baboon’s heart was transplanted to a baby named Baby Fae, but he died 20 days later.

Pigs have advantages over primates in terms of organ production, because they are easy to raise and reach the size of a human in 6 months. Pork heart valves are commonly transplanted into humans, and some patients with diabetes have received pig pancreatic cells. Pig skin has also been used as a temporary graft for burn patients.

Two newer technologies (gene editing and cloning) have produced genetically modified pig limbs that are less likely to be rejected by humans. Pig hearts were successfully transplanted into chamomiles by Dr. Mohammad Mohieddin, a professor of surgery at the University of Maryland School of Medicine; Until recently, however, safety concerns and fears of a life-threatening safety response prevented their use in humans.

Dr. J. Fishman, director of the Transplant Center at Massachusetts General Hospital, said the use of pig limbs would enable the ability to perform genetic manipulations, as well as provide more time to be screened for infectious diseases. In addition, it is possible to get a new organ whenever the patient needs it. “There are certainly challenges, but there are also opportunities,” he said.

The heart transplanted to Mr. Bennett comes from a genetically modified pig produced by Revivicor. This pig had 10 genetic modifications. Four genes were defective, including one that encodes a molecule that triggers an aggressive rejection reaction in humans.

“A growth gene was also inactivated to prevent pigs from continuing to grow after transplantation,” said Dr. Mohi-ud-Din, who did a lot of research leading to the transplant with Dr. Griffith. In addition, six human genes were inserted into the donor pig genome. The purpose of these changes was to make the human immune system more tolerant of pigs.

The team used a new experimental drug that was partly developed by Dr. Mohieddin and developed by Kiniksa Pharmaceuticals. The purpose of this drug was to suppress the immune system and prevent organ rejection.

The surgeons encountered unexpected cases during the surgery. “The anatomy was a bit abnormal and we had to have several plastic surgeries to match,” said Dr. Griffith. “When the team removed the clamp on the blood supply to the organ, the heart started beating and started working.”

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