In another step in animal-to-human transplantation, New York doctors transplanted a kidney into a brain-dead man
New York surgeons transplanted a pig’s kidney into a brain-dead man, and it functioned normally for more than a month, a crucial step toward a process the team hopes to eventually test on live patients.
Scientists across the country are racing to learn how to use animal organs to save human lives, and cadavers donated for research offer an extraordinary experience.
The latest trial announced Wednesday by NYU Langone Health represents the longest-running A Pig kidney It worked on man, although it died and did not end. Researchers are willing to track performance college for the second month.
“Is this organ really going to function like a human organ? It looks so far,” Robert Montgomery, director of the Langone Institute for Transplantation at New York University, told The Associated Press.
“It will be in the medical books and it will remain forever,” he added.
Attempts to transplant organs from an animal to a human failed decades ago, as human immune systems attacked the foreign tissue. Researchers are now using genetically engineered pigs to better match their organs to those of humans.
Last year, with special permission from the organizers, surgeons at the University of Maryland transplanted a genetically modified pig’s heart into a dying man with no other options. He only survived for two months before the device failed for reasons not fully understood but which offer lessons for future attempts.
Then, rather than a last-minute effort, the FDA considers whether to allow some small but rigorous studies of heart transplants or Pig kidney in volunteer patients.
Dr. Robert Montgomery, director of the New York University Langone Institute for Transplantation, attends A Pig kidney to be transplanted into a brain-dead man in New York on July 14, 2023. Researchers across the country are racing to learn how to use animal organs to save human lives. . (AP Photo/Shelby Lum)
The NYU trial is one in a series of developments aimed at accelerating the start of such clinical trials. Also on Wednesday, the University of Alabama at Birmingham recorded another major success: a pair of normally functioning pig kidneys inside another donated body for seven days.
The kidneys not only produce urine, but they provide a wide range of functions in the body. In the journal JAMA Surgery, UAB transplant surgeon Dr. Jaime Locke reports on lab tests documenting the performance of transgenic pig organs. She said the week-long trial shows they can “provide life-sustaining kidney function.”
said Montgomery, MD, a transplant surgeon college A NYU Ph.D. who also received a heart transplant, he is acutely aware of the need for a new source of organs.
More than 100,000 patients are on the country’s transplant list, and thousands die each year while they wait.
It’s unclear how closely a dead body mimics the reactions of a live patient to a pig’s organ, warns Dr. Mohamed Mohieldin of Maryland. But he said the research is educating the public about external organ transplants so that “people aren’t surprised” when it comes time to try again at life.
Previously, NYU and a team from the University of Alabama at Birmingham have tested transplants Pig kidney In deceased recipients for only two to three days. The NYU team also transplanted pig hearts into donated bodies during three days of intense testing.
But how do pig organs react to a more common human immune attack that takes about a month to form? Only longer tests can tell.
The surgery itself isn’t much different from the thousands he’s had, “but somewhere in the back of your mind is the immensity of what you’re doing…the realization that this could have a huge impact on the future of implants,” Montgomery said. .
The process was carefully timed. Early that morning dr. Adam Griesemer and Jeffrey Stern flew hundreds of miles to a facility where Revivicor Inc. Virginia-based transgenic pigs and restored kidneys that lack a gene that would cause immediate destruction of the human immune system.
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While they were back at NYU, Montgomery was removing his own kidneys from the donated body, so there would be no question whether the soon-to-arrival pig version works. were planted a Pig kidneyand the other was stored for comparison when the experiment ended.
Another trick: Surgeons put a pig’s thymus in transplanted kidney It is hoped that the gland, which helps train immune cells, will increase human tolerance to the organ. Otherwise, the team relies on the standard immunosuppressant medications used by transplant patients today.
“You’re always nervous,” said Griesemer. Seeing it start so fast, “there was a lot of excitement and a lot of sense of relief.”
How long should these experiments last? It’s not clear, said Locke of Alabama, and ethical questions include how long a family feels comfortable or increases their pain. Since keeping a brain-dead person on a ventilator is difficult, it also depends on how stable the donated body is.
In his own experience, the donated body was stable enough that if the study had not been required to be terminated after a week, “I think we could have continued for much longer, which I think provides great hope,” he says.