The first transplant surgery to combine a mechanical heart pump — which helps pump blood around the body — and a gene-edited pig kidney was completed at New York University’s Langone Health, the health system said Wednesday (24). ).
Lisa Pisano, 54, from New Jersey, USA, had heart failure and end-stage kidney disease that required routine dialysis, Langone Health said in a statement.
However, she was unable to have a standard heart or kidney transplant due to other chronic medical conditions that “significantly reduced the likelihood of a good outcome” and due to the general shortage of organ donors in the US.
“When this opportunity first came up, I thought, ‘I have to try,’” Pisano recalled during a press conference this Wednesday, from his bed in the intensive care unit.
Pisano received the heart pump on April 4 and then, on April 12, participated in the transplant of a gene-edited pig kidney along with the pig’s thymus gland.
“I tried everything and exhausted all other resources. So when this opportunity came up, I said, ‘I’m going to take advantage of this,’” she reported, hoping to “spend time with my grandchildren and play with them.”
This case is the first organ transplant reported in a person with a mechanical heart pump, according to Langone Health, and the second known transplant of a gene-edited pig kidney into a living recipient — in this case, it is the first transplant along with the thymus .
The first living recipient of a genetically engineered pig kidney, 62-year-old Rick Slayman, received the organ at Massachusetts General Hospital in March and was able to return home this month.
Slayman’s surgery was led by a Brazilian doctor, who spoke to CNN about the procedure and what it means for the advancement of medicine.
Pig hearts were also transplanted on other occasions into two living people who died weeks after receiving the organs.
Organ donor shortage
The need for organs far exceeds the number available in the US. Every day, 17 people die waiting for an organ in the country, and kidneys are scarce.
According to the Organ Procurement and Transplant Network, around 27,000 kidneys were transplanted in 2023, but almost 89,000 people were on the waiting list for these organs.
Experts say that xenotransplants – organ transplants from animals to people – are crucial to solving this problem.
Gene editing makes precise edits to the pig’s DNA to help prevent the human body from rejecting the animal’s organ.
In addition to kidney disease, Pisano has congestive heart failure and has had stents placed in her heart, as well as multiple catheterizations, according to her in a video provided by NYU Langone.
In 2020, she discovered she had colon cancer and had “a large portion” of her colon removed, said her husband, Todd.
Pisano “was getting sicker and sicker and, in fact, his life expectancy could be measured in days or weeks,” said Dr. Robert Montgomery, director of the Langone Transplant Institute, who led the surgery.
“She had heart and kidney failure, but was not a candidate for a combined heart and kidney transplant because of her other health problems,” Montgomery explained.
Doctors received permission from the U.S. Food and Drug Administration, the national regulatory agency, to perform the new procedures under its expanded access or “compassionate use” policies, which give terminally ill patients access to experimental medical products outside of clinical trials. no other options.
The kidney came from a pig genetically modified to interrupt a gene responsible for producing a sugar found on the surface of animal cells called alpha-gal, which can be recognized by human antibodies and attacked.
The pig’s thymus gland, which plays a role in immunity, was placed under the covering of the kidney in an attempt to help Pisano’s immune system recognize the organ.
Montgomery noted that the gene edits used in the pig in this case are much simpler than those used in other xenotransplants in living humans.
“We will have the opportunity to really solve the problem we are trying to solve, which is the shortage of organs, and the more complex the genetic edits, the less likely you are to be able to reproduce those edits in a herd,” he highlighted.
“You would have to clone the entire pig for every organ. This is not something that can be easily scaled. So we feel less is more in this case,” she added.
Pisano has “a long way to go,” the doctor mused, but “his kidney is working perfectly. Her heart is in much better shape.”
Now, experts are paying attention to issues such as rejection and infection. They anticipate at least another month of rehabilitation before she is discharged.
Before the procedures, she had significant problems just walking, Pisano reported. “I couldn’t stand up and breathe. I couldn’t do anything,” she commented.
Now, she says, “I feel better than ever,” and is optimistic about the outcome.
“Worst case scenario, if it doesn’t work, it might work for the next person. At least someone will benefit from this,” she concluded.
