A CRISPR-edited pig kidney has been transplanted into a living person for the first time

In a world first, doctors at Massachusetts General Hospital (MGH) have successfully transplanted a genetically modified pig kidney into a living human recipient. The patient, 62-year-old Richard “Rick” Slayman, was living with end-stage kidney disease and was dependent on dialysis to survive after a previously transplanted human kidney began to fail.

The medical team praised Slayman’s courage despite this experimental procedure. “Today’s real hero is the patient, Mr. Slayman, as the success of this groundbreaking surgery, once considered unimaginable, would not have been possible without his courage and willingness to take a journey into unknown medical territory ” said Dr. Joren C. Madsen, director of the MGH Transplant Center, in a statement.

This journey toward xenotransplantation – the technical term for transplanting animal tissue into humans – has been strange and winding indeed. Bizarre experiments, like that of the Russian scientist who inserted slices of chimpanzee testicles into a “significant number” of men, laid the foundation for where we are today.

Thanks to advanced gene editing technology, organs and tissues can now be modified to make them more acceptable to the human immune system, reducing the chance of rejection. Proof-of-concept studies in primates have shown that animal-to-human transplants don’t always have to be relegated to science fiction, and in recent years we’ve seen a number of successful xenotransplants in brain-dead human patients.

But the ultimate goal has always been to perform a transplant on a living patient. Organ transplants can easily be considered a medical miracle, but there is a huge supply problem. Data from the United Network for Organ Sharing shows that more than 100,000 people are currently waiting for a transplant in the US alone, and unfortunately, people on the waiting list are dying every day.

Slayman’s case is not unusual; Kidneys are the most common organs required for transplantation. After living with type 2 diabetes and high blood pressure for years, and eventually needing dialysis due to kidney disease, Slayman was fortunate enough to receive a kidney from a deceased donor in 2018. However, after several years that kidney began to show signs of kidney disease. failed, leading the medical team to consider other options.

“My nephrologist, Dr. Winfred Williams, MD, and the team at the Transplant Center suggested a porcine kidney transplant, carefully explaining the pros and cons of this procedure,” said Slayman. “I saw it not only as a way to help me, but also as a way to offer hope to the thousands of people who need a transplant to survive.”

The kidney itself was supplied by the Cambridge, Massachusetts-based company eGenesis, which has been working with MGH’s scientists and physicians for years. They have developed a method that uses CRISPR-Cas9 gene editing technology to remove some pig genes and add certain human genes to make the kidneys as compatible as possible with the human body. They also inactivate endogenous retroviruses present in the donor pig, to eliminate the potential risk that these viruses may pose to humans.

pork kidney on ice;  The hands of surgeons using tools are visible as they prepare the kidney for transplantation

The pig kidney is prepared for transplantation.

Image credit: Massachusetts General Hospital

We’ve come a long way since the first human transplant – which also happened to be a kidney – was performed in 1954 at MGH’s sister institution, Brigham and Women’s Hospital. It’s long been hoped that animal organs could be the gamechanger when it comes to offering more people a life-saving transplant or keeping them in better health for longer while they wait, and now it looks like this vision is a big step closer brought to reality.

“The success of this transplant is the result of the efforts of thousands of scientists and physicians over decades. We are privileged to have played an important role in this milestone,” said Dr. Tatsuo Kawai, director of the Legorreta Center for Clinical Transplant Tolerance.

Dr. Madsen concluded, “As the global medical community celebrates this monumental achievement, Mr. Slayman becomes a beacon of hope for countless people suffering from end-stage renal disease and opens a new frontier in organ transplantation.”

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