Heralding a major advancement to overcome shortage of human organs for transplant, a successful pig kidney transplantation into a human was done for the first time at NYU Langone Health in New York City without triggering immediate rejection by the recipient’s immune system.
The procedure involved use altering the genes of pig so that its tissues no longer contained a molecule known to trigger almost immediate rejection of the organ in this case kidney.
The recipient was a brain-dead patient with signs of kidney dysfunction whose family consented to the experiment before she was due to be taken off of life support.
For three days, the new kidney was attached to her blood vessels and maintained outside her body, giving researchers access to it. Test results of the transplanted kidney’s function “looked pretty normal,” said transplant surgeon Dr. Robert Montgomery, who led the study.
The kidney made “the amount of urine that you would expect” from a transplanted human kidney, he said, and there was no evidence of the vigorous, early rejection seen when unmodified pig kidneys are transplanted into non-human primates.
The recipient’s abnormal creatinine level, which is an indicator of poor kidney function, returned to normal after the transplant, Montgomery said.
In the United States, nearly 107,000 people are presently waiting for organ transplants, including more than 90,000 awaiting a kidney, according to the United Network for Organ Sharing. Wait times for a kidney average three-to-five years.
Researchers have been working for decades on the possibility of using animal organs for transplants, but have been stymied over how to prevent immediate rejection by the human body.
Montgomery’s team theorized that knocking out the pig gene for a carbohydrate that triggers rejection – a sugar molecule, or glycan, called alpha-gal – would prevent the problem.
The genetically altered pig, dubbed GalSafe, was developed by United Therapeutics Corp’s Revivicor unit. It was approved by the US Food and Drug Administration in December 2020, for use as food for people with a meat allergy and as a potential source of human therapeutics.
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