Kidney transplant - don't be a pig. Or, go ahead, it might work!

[George K]

@mik said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

I guess then I wouldn't be halal. A small sacrifice.

You misspelled "kosher."

Akshually, pig valves are OK and considered kosher, iirc.

[Jolly]

Oink. Oink. You've been moinked.

[George K]

https://jamanetwork.com/journals/jamasurgery/fullarticle/2808483

A male in his 50s who was declared brain dead and had acute kidney injury superimposed on a history of CKD (stage 2) and hypertension underwent bilateral native nephrectomy and cessation of dialysis followed by crossmatch-compatible xenotransplant with 10-gene–edited pig kidneys (UKidney). The decedent received a complement inhibitor (anti-C5; eculizumab) 24 hours before xenotransplant followed by standard induction therapy, including a solumedrol taper, antithymocyte globulin (6 mg/kg total), and rituximab. Maintenance immunosuppression included tacrolimus, mycophenolate mofetil, and prednisone. Goal tacrolimus levels (8-10 ng/dL) were reached by postoperative day (POD) 2 and maintained through study completion. Xenografts were transplanted en bloc with pig vasculature anastomosed to the decedent’s right-side common iliac artery and distal inferior vena cava and the pig ureters anastomosed to the decedent’s bladder. Within 4 minutes of reperfusion, the xenografts made urine, producing more than 37 L in the first 24 hours. Urine concentrated over time, with concurrent decreases in urine volume to a median of 14.1 L (IQR, 13.8-20 L) on PODs 1 to 3 and a median of 5.1 L (IQR, 5-6 L) on PODs 4 to 7. Before xenotransplant, serum creatinine was 3.9 mg/dL after cessation of dialysis and bilateral native nephrectomy. After xenotransplant, serum creatinine decreased to 1.9 mg/dL within the first 24 hours, normalized to 1.1 mg/dL at 48 hours, remained within normal limits through study duration, and was 0.9 mg/dL on POD 7 at study completion. Creatinine clearance also improved (POD 0, 0 mL/min; POD 7, 200 mL/min) (Figure 1). Xenografts were serially biopsied and showed normal histology by light microscopy without evidence of thrombotic microangiopathy (Figure 2).

The English translation:

https://www.washingtonpost.com/health/2023/08/16/pig-kidney-transplant-organ/

A genetically altered pig kidney transplanted into a brain-dead man has continued to function for 32 days, an advance toward the possible use of animal organs in humans, surgeons at NYU Langone Health said Wednesday.
The kidney was not rejected in the minutes after it was transplanted — a problem in xenotransplantation, the use of organs from a different species. It began producing urine and took over the functions of a human kidney such as filtering toxins, the physicians said at a news conference.

Also Wednesday, researchers at the University of Alabama at Birmingham Heersink School of Medicine published a similar case study, of a brain-dead patient who received two pig kidneys that underwent 10 gene alterations earlier this year. The kidneys were not rejected and continued to function for seven days. The results were peer-reviewed and published in the journal JAMA Surgery.

Managing the condition of the brain-dead man, who on Wednesday still had a heart beat and was breathing with the aid of a ventilator, for an extended period of time also requires extensive efforts by critical care personnel. But the work has revealed information about longer-term use of animal organs, the doctors said.

The researchers expect to follow the patient for another month.

The man whose body underwent the kidney transplant at NYU was identified as 57-year-old Maurice “Mo” Miller, who died of a brain tumor. His sister spoke at Wednesday morning’s news conference, saying her brother would have valued the contribution he was able to make to the science of transplantation.

It was only two years ago that Montgomery transplanted the first pig kidneys into human decedents. Separately, in January 2022, University of Maryland surgeons implanted a genetically modified pig’s heart in a critically ill man, who died two months later. The donor heart was found to be infected with a porcine virus.

[taiwan_girl]

https://medicalxpress.com/news/2023-10-maryland-pig-heart-transplant-dies.html#google_vignette

The second person to receive a transplanted heart from a pig has died, nearly six weeks after the highly experimental surgery, his Maryland doctors announced Tuesday.

Lawrence Faucette, 58, was dying from heart failure and ineligible for a traditional heart transplant when he received the genetically modified pig heart on Sept. 20.

According to the University of Maryland School of Medicine, the heart had seemed healthy for the first month but began showing signs of rejection in recent days. Faucette died Monday.

[Copper]

Surgeons attached the pig kidney to a pair of large blood vessels outside the body of a deceased recipient so they could observe it for two days.

Really?

[George K]

Surgeons Transplant Pig Kidney Into a Patient

Surgeons in Boston have transplanted a kidney from a genetically engineered pig into an ailing 62-year-old man, the first procedure of its kind. If successful, the breakthrough offers hope to hundreds of thousands of Americans whose kidneys have failed.

So far, the signs are promising.

Kidneys remove waste products and excess fluid from the blood. The new kidney began producing urine shortly after the surgery last weekend and the patient’s condition continues to improve, according to physicians at Massachusetts General Hospital, known as Mass General. He is already walking the halls of the hospital and may be discharged soon.

The patient is a Black man, and the procedure may have special significance for Black patients, who suffer high rates of end-stage kidney disease.

A new source of kidneys “could solve an intractable problem in the field — the inadequate access of minority patients to kidney transplants,” said Dr. Winfred Williams, associate chief of the nephrology division at Mass General and the patient’s primary kidney doctor.

If kidneys from genetically modified animals can be transplanted on a large scale, dialysis “will become obsolete,” said Dr. Leonardo V. Riella, medical director for kidney transplantation at Mass General. The hospital’s parent organization, Mass General Brigham, developed the transplant program.

Of course, PETA objects:

The surgery was not without critics. Xenotransplantation raises the prospect of still greater exploitation of animals and may introduce new pathogens into human populations, said Kathy Guillermo, senior vice president at People for the Ethical Treatment of Animals.
“Using pigs as a source of spare parts is dangerous to the human patients, deadly for the animals and may bring about the next pandemic,” she said. “It’s impossible to eliminate, or even identify, all the viruses that pigs carry. Researchers need to focus on cleaning up the organ donation system and leave the animals alone.”

The four-hour operation was carried out by a team of surgeons, including Dr. Tatsuo Kawai, director of the Legorreta Center for Clinical Transplant Tolerance at Mass General, and Dr. Nahel Elias.

Surprised it took this long. Back in the day, our guys would do a transplant in about two hours. It's not a particularly challenging procedure.

[Mik]

All for it. I suspect if we compared the number of pigs for transplant to the number of pigs we eat it would be insignificant.

Besides, we only need to take one, and the pig can live happily ever after. Maybe we could develop all-inclusive pig resorts for the donor pigs.

[bachophile]

@George-K said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

@mik said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

I guess then I wouldn't be halal. A small sacrifice.

You misspelled "kosher."

Akshually, pig valves are OK and considered kosher, iirc.

Yea no problem.

Remember when insulin was made from pigs?

[George K]

https://apnews.com/article/pig-kidney-transplant-recipient-dies-d6cf10ac76a4bcde1b3021f45b9695b4

The first recipient of a genetically modified pig kidney transplant has died nearly two months after he underwent the procedure, his family and the hospital that performed the surgery said Saturday.

Richard “Rick” Slayman had the transplant at Massachusetts General Hospital in March at the age of 62. Surgeons said they believed the pig kidney would last for at least two years.

The transplant team at Massachusetts General Hospital said in a statement it was deeply saddened by Slayman’s passing and offered condolences to his family. They said they didn’t have any indication that he died as a result of the transplant.

The Weymouth, Massachusetts, man was the first living person to have the procedure. Previously, pig kidneys had been temporarily transplanted into brain-dead donors. Two men received heart transplants from pigs, although both died within months.

[Mik]

Then what DID he die of? That would seem relevant.

[George K]

@Mik said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

Then what DID he die of? That would seem relevant.

Yup - my questions as well.

Infection from a suppressed immune system?

[Copper]

@George-K said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

Previously, pig kidneys had been temporarily transplanted into brain-dead donors.

Really?

I guess that would reduce the liability since the patient is already dead.

[Mik]

@George-K said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

@Mik said in Kidney transplant - don't be a pig. Or, go ahead, it might work!:

Then what DID he die of? That would seem relevant.

Yup - my questions as well.

Infection from a suppressed immune system?

Journalism is dead. we just get factoids, not stories.