Brazilian doctor performs 1st pig-to-human kidney transplant

This Thursday (21), doctors at Massachusetts General Hospital (MGH) announced the world’s first successful transplant of a genetically modified pig kidney into a human. The pioneering procedure, which could mark the beginning of a new era for those waiting for an organ transplant, was led by a Brazilian doctor, Leonardo Riella.

The pig kidney transplant to a human was carried out on Saturday (16) and took four hours to complete. As the porcine organ has 69 genetic edits, the expectation is that this will reduce the risk of rejection and complications. However, it is still necessary to observe how the patient’s health status evolves.

Until now, pig-to-human kidney transplants had only been performed for brain-dead patients. Differently, the surgery performed in the United States involved Richard ‘Rick’ Slayman, a 62-year-old man, with advanced stage kidney disease — there is no known possibility of a cure based on the therapies available today.

Patient’s health status

In addition to advanced stage kidney disease, patient Rick, who agreed to participate in the experimental procedure, has lived with type 2 diabetes and hypertension for many years. He needs to undergo constant hemodialysis sessions.

In 2018, Rick received a kidney transplant from a human donor, but the donated organ began to fail in May of last year. Since then, doctors were looking for alternatives that were still being tested for patients with terminal disease, such as a pig kidney transplant.

“I saw this not only as a way to help myself, but also as a way to give hope to the thousands of people who need a transplant to survive,” says Rick, in a statement.

Genetic modifications in pig kidney

To reduce the risk of rejection during xenotransplantation — organ transplantation between different species — as much as possible, the organ was genetically edited using the CRISPR tool, a type of scissors that can cut parts of the DNA and add others.

With this technique, harmful pig genes were removed. Certain human genes were also added to improve compatibility after transplantation. The endogenous retroviruses were inactivated, preventing the patient from contracting any infection.

The hope of xenotransplants

“I am firmly convinced that xenotransplantation represents a promising solution to the organ shortage crisis,” says Riella, after performing the first transplant from a pig kidney to a living human.

For the doctor, “we are on the verge of a [novo] monumental advance in transplantation”, which comes 70 years after the first kidney transplant and 60 years after the discovery of immunosuppressive drugs.

Based on this transplant and further studies in the area, xenotransplants can become a viable alternative for people. It is worth remembering that tests involving the transplantation of a pig heart into a human have also taken place.

Source: MGH

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