That day, at NYU Langone Hospital in New York City, a genetically modified pig kidney was successfully transplanted into a man. The kidney itself was not implanted inside the body, but was connected to blood vessels in the leg of a brain-dead patient.
PHOTO JOE CARROTTA, FRANCE-PRESS AGENCY
A genetically modified pig kidney was successfully transplanted into a man at NYU Langone Hospital in New York on September 25.
During the two and a half days of the experiment, the kidney functioned well, it produced urine and was not rejected by humans. The patient’s life support was turned off 48 hours after the transplant, which ended the experiment.
“I am an eternal optimist. I still find that encouraging. This is a very good step forward, ”said Michel Lallier, pediatric surgeon and specialist in transplants in children at the Sainte-Justine University Hospital Center.
Although the experience was of limited duration, doctors believe it is an important first step for the future of organ transplants. “It opens the door to going a little further, so it’s a very big step in xenotransplantation [transplantation d’une espèce à une autre] », Believes the Dr Lallier.
Some numbers
390
Number of people who may have had a transplant in Quebec in 2020, including 215 for a kidney.
48%
Percentage of donors who were 50 to 70 years old.
802
Number of people waiting for an organ in 2020, including 537 for a kidney.
43
Number of Quebecers who died while waiting for a transplant in 2020.
Source: Transplant Quebec
PHOTO ROBERT SKINNER, PRESS ARCHIVES
The DD Marie-Chantal Fortin, nephrologist in the renal transplant team at the Center hospitalier de l’Université de Montréal
In Quebec, people wait about 2 years, or 538 days, for a kidney transplant and some die while waiting for a transplant. The message is to sign your organ card and tell your loved ones about it. If we have the opportunity to be a living donor, for those around them or for a stranger, it is also something that can help transplant more patients.
The DD Marie-Chantal Fortin, nephrologist in the renal transplant team at the Center hospitalier de l’Université de Montréal
History of rejection
PHOTO MATHIEU WADDELL, PRESS ARCHIVES
The risks of transplant rejection are accentuated in the case of a transplant from an animal to a human.
Transplant rejection occurs when the patient’s immune system responds to the new organ, which they perceive as a threat. A different blood group between the donor and the recipient is a common cause of organ rejection.
“It happened to me once. There had been a laboratory error and a patient was transplanted with a kidney that did not have the same blood type. An hour after we finished our sutures and put the recipient’s blood back into the organ, the organ was black. I had never seen that, ”recalled the Dr Lallier.
The risks of transplant rejection are accentuated in the case of a transplant from an animal to a human. “We are not used to having a pig kidney, so our antibodies react strongly”, explained the surgeon.
The human body contains antibodies that attack a type of sugar that is normally present on all cells in pigs, causing immediate rejection of the organ. In the case of the experiment, the animal had been genetically modified to no longer produce this sugar, which avoided the rapid rejection of the organ.
Pig, primate or goat?
Pig kidneys are often preferred during transplants, since the organ is very similar to that of humans. “On the other hand, we could not take pork liver, because it does not look at all like human liver,” said the surgeon. Pig heart valves are already widely used in humans, and the skin of this animal can be used for grafts on severe burns.
The organs of primates would ideally be taken, because they are the most similar to humans, D added.r Lallier. “But I think that learned societies would have great difficulty accepting that primates are raised for organ donation. Pigs are already raised for food, so it goes a lot easier, ”he explained.
Some stories of transplants
Xenografts, from one species to another, are not new. Doctors have tried the experiment for decades, but these transplants have often ended in failure. Here are a few :
1906
Mathieu Jaboulay, a French researcher, made the first attempts at xenografting in the early 1900s. He transplanted pig and goat kidneys in patients with chronic renal failure. The operations all ended in failure.
WIKIPEDIA PHOTO
Mathieu Jaboulay
1963
In the United States, Dr. Keith Reemtsma has performed a dozen chimpanzee transplants to humans. The longest survival was that of a 23-year-old teacher, who survived nine months. She was regularly taking immunosuppressive drugs to prevent organ rejection and had even returned to work.
WIKIPEDIA PHOTO
KEITH REEMTSMA
1984
A baboon heart was transplanted to a baby. The toddler, Stephanie Fae Beauclair, nicknamed Baby Fae, only survived 20 days. Baby Fae became the first child to undergo a xenograft procedure.
PHOTO FROM YOUTUBE
Stephanie Fae Beauclair
2016
Researchers at the National Heart, Lung, and Blood Institute (NHLBI) in the United States have worked for years to develop procedures for transplanting pig hearts to primates. Using immunosuppressive drugs, pig hearts survived in baboons for an average of 433 days. The longest lasted more than two and a half years, a record for heart transplants between pigs and primates.
PHOTO GETTY IMAGES
Pig hearts survived in baboons for an average of 433 days.
The future
Pig kidneys or 3D printed organs: several avenues for the future of transplants seem promising. But specialists will need long-term studies before considering using pig kidneys for everyone. “We need more scientific data to be sure that it works well and that it is safe”, summarized the DD Marie-Chantal Fortin.
With Agence France-Presse