AI: The journal Nature reports that on March 16, 2024, the first pig kidney transplant into a human took place. The recipient was 62-year-old Richard Sleiman with end-stage renal failure. The transplant surgeon who performed the operation reports that the patient’s recovery is going well. The kidney was taken from a miniature pig with a record 69 genomic changes, which were aimed at reducing the likelihood of transplant rejection and the risk of the recipient becoming infected with viruses hiding in the organ.
Once surgeons restored blood flow to the pig’s transplanted organ, it turned pink and started producing urine, a sign of a successful transplant. Another indicator of kidney health is your creatinine level. A high level indicates that the kidneys are not doing a good job of filtering waste. Before the transplant, Sleiman’s creatinine level was 10 milligrams per deciliter, but by the fourth day it had dropped to 2.4. These figures are still almost twice the norm, but there is hope that a decrease to normal levels will soon occur.
This case shows that, at least in the short term, these organs are safe and function as intended. The company that produces genetically modified pigs is currently in talks with the FDA about planning clinical trials for the transplantation of pig kidneys, as well as a pig liver that will be connected to the recipient from outside. The operation also brings doctors closer to eliminating the shortage of vital human organs by using animal organs. In the United States alone, almost 90,000 people are waiting for a kidney transplant, and more than 3,000 people die each year without receiving a transplant. Despite the fact that the level of organ donation has increased significantly, the problem of acute organ shortage is still relevant.
Sleiman’s newest kidney came from a pig that had undergone CRISPR-Cas9 genome editing by eGenesis scientists. Monkeys called cynomolgus macaques that received pig organs with the same genomic changes survived for months and even years. It is hoped that Sleiman’s xenotransplanted kidney will live as long or even longer. The organ was further refined with humans rather than apes in mind. The changes included deleting three genes that promote the production of three sugars on the surface of pig cells. The human immune system attacks cells carrying these three sugars, perceiving them as a sign of a foreign invader. Seven genes that produce human proteins were added to prevent rejection.
Another 59 genetic changes were made to inactivate viruses embedded in the pig genome. These changes are aimed at eliminating the risk of viruses activating when they enter the human body. So far, researchers have not encountered this in transplantation into living people, clinically dead people, or nonhuman primates. But some laboratory experiments have shown that these viruses can be transmitted from pig tissue into cells of humans and mice with weakened immune systems.
Despite the fact that not much time has passed since Sleiman’s operation, the first transplant of a pig kidney into a human gives transplantologists great hope that the shortage of donor organs can be ended. However, it is worth waiting and watching how the first transplanted organ will behave, and how the further history of Richard Sleiman will develop.