Patient with transplanted pig kidney leaves hospital and returns home | Trending Viral hub


The first patient receive a kidney transplanted from a genetically modified pig He has done so well that he was discharged from the hospital on Wednesday, just two weeks after the groundbreaking surgery.

The transplant and its encouraging outcome represent a remarkable moment in medicine, scientists say, and possibly herald an era of interspecies organ transplants.

Two previous organ transplants from genetically modified pigs failed. Both patients received hearts and both died a few weeks later. In one patient there were signs that the immune system had rejected the organ, a constant risk.

But the kidney transplanted to Richard Slayman, 62, produces urine, removes waste products from the blood, balances the body’s fluids and performs other key functions, according to his doctors at Massachusetts General Hospital.

Slayman no longer needs dialysis, an expensive procedure used to filter the blood of patients with compromised kidneys.

“This moment – leaving the hospital today with one of the best health outcomes I’ve had in a long time – is one I’ve been looking forward to for many years,” he said in a statement released by the hospital. “Now it is a reality.”

He said he had received “exceptional care” and thanked his doctors and nurses, as well as well-wishers who reached out to him, including kidney patients waiting for an organ.

“Today marks a new beginning not only for me, but for them as well,” Slayman said.

The procedure significantly brings the prospect of xenotransplants, or organ transplants from animals to humans, closer to reality, said Dr. David Klassen, medical director of the United Network for Organ Sharing, which manages the country’s organ transplant system.

“While there is still a lot of work to be done, I think the potential of this to benefit a large number of patients will be realized, and that was a question mark hanging over the field,” Dr. Klassen said.

It is still unknown whether Mr. Slayman’s body will eventually reject the transplanted organ, Dr. Klassen said. And there are other obstacles: A successful operation would have been replicated in numerous patients and studied in clinical trials before xenotransplants became widely available.

If these transplants are to be expanded and integrated into the health care system, there are “enormous” logistical challenges, he said, starting with ensuring an adequate supply of organs from genetically modified animals.

Of course, cost can become a major obstacle. “Is this something we can really try as a healthcare system?” Dr. Klassen said. “We need to think about that.”

Treating kidney disease already involves a huge expense. End-stage kidney disease, the point at which the organs are failing, affects 1 percent of Medicare beneficiaries but it accounts for 7 percent of Medicare spending, according to the National Kidney Foundation.

However, the medical potential of transplanting pigs into humans is tremendous.

The kidney transplanted into Mr. Slayman came from a pig genetically modified by the biotechnology company eGenesis. The company’s scientists removed three genes that could cause organ rejection, inserted seven human genes to improve compatibility, and took steps to inactivate retroviruses carried by pigs that can infect humans.

More than 550,000 Americans have kidney failure and require dialysis, and more than 100,000 are on the waiting list to receive a kidney transplant from a human donor.

Additionally, tens of millions of Americans suffer from chronic kidney disease, which can lead to organ failure. African Americans, Hispanic Americans, and Native Americans have the highest rates of end-stage renal disease. Black patients generally fare worse than white patients and have less access to a donated kidney.

While dialysis keeps people alive, the treatment of choice for many patients is kidney transplant, which dramatically improves quality of life. But only 25,000 kidney transplants are performed each year and thousands of patients die each year while waiting for a human organ due to lack of donors.

Xenotransplantation has been discussed as a possible solution for decades.

The challenge in any organ transplant is that the human immune system is primed to attack foreign tissue, causing potentially life-threatening complications for recipients. Patients who receive transplanted organs generally must take medications aimed at suppressing the immune system response and preserving the organ.

Mr. Slayman showed signs of rejection on the eighth day after surgery, according to Dr. Leonardo V. Riella, medical director of kidney transplantation at Mass General. (The hospital’s parent organization, Mass General Brigham, developed the transplant program.)

The rejection was of a type called cellular rejection, which is the most common form of acute graft rejection. It can occur at any time but especially within the first year of an organ transplant. Up to 25 percent of organ recipients experience cellular rejection within the first three months.

The rejection was not unexpected, although Slayman experienced it more quickly than usual, Dr. Riella said. Doctors managed to reverse the rejection with steroids and other medications used to curb the immune reaction.

“The first week was a roller coaster,” Dr. Riella said. Reassuringly, he added, Mr. Slayman responded to treatment like patients receiving organs from human donors.

Mr. Slayman is taking several immunosuppressive medications and will continue to be closely monitored with blood and urine tests three times a week, as well as twice-weekly doctor visits.

His doctors do not want Mr. Slayman to return to work, at the state transportation department, for at least six weeks, and he must take precautions to avoid infections from medications that suppress his immune system.

“Ultimately, we want patients to get back to doing the things they love to improve their quality of life,” Dr. Riella said. “We want to avoid restrictions.”

On Wednesday, Slayman was clearly ready to go home, Riella said.

“When we first arrived, I was very apprehensive and anxious about what would happen,” Dr. Riella said. “But when we approached him at 7am this morning, you could see a big smile on his face and he was making plans.”

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