The world's first! Pig hearts are successfully transplanted into humans

According to USA Today, on January 10, the University of Maryland Medical Center recently transplanted a pig heart into a male patient, which marked the first time that gene-edited pigs became organ donors, which is expected to bring new hope to a large number of heart disease patients.

On Friday, January 7, local time, a 57-year-old patient named David Bennett successfully transplanted a pig heart after a 9-hour operation in Baltimore, Maryland, USA, which was performed by Dr. Bartley Griffith, director of the heart transplant program at the University of Maryland Medical Center. Currently, Bennett can breathe on his own without a ventilator, but he is still using "artificial lungs" (ECMO), which assist blood circulation. Postoperatively, Griffith said:

"It's working and looks normal. We're excited, but we don't know what tomorrow will be, it's something that has never been done before. ”

The "donor pig" that supplied Bennett with his heart was a 1-year-old, 240-pound GMO pig bred by Revivicor, a regenerative pharmaceutical company from Blacksburg, Virginia, whose entire breeding process was for organ transplantation.

As of the 10th, the man had survived for 3 days and the transplanted heart was functioning stably. During the critical 48 hours after the operation, Bennett was closely monitored by doctors for immune rejection, but fortunately, no accidents have occurred so far. In addition, the patient was tested for viral infection by doctors to prevent infection with viruses such as swine retroviruses. At present, the doctor still keeps a close eye on the patient's physical condition.

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The prospect of xenotransplantation is beginning to emerge, a new hope for heart disease patients

According to United Network for Organ Sharing, a nonprofit that coordinates organ procurement in the United States, although about 3,817 patients in the United States received human heart transplants last year, the potential demand is higher, and more than a dozen patients die every day in a painful wait.

Therefore, scientists have been focusing on xenotransplantation, hoping to successfully transplant animal organs or tissues into the human body. If this technology succeeds, humans will have access to endless sources of organs or tissues, and a new era of medicine will begin.

As a technology that people have been dreaming of, xenotransplantation has a long history. To succeed in this technology, the first problem that needs to be solved is how to get the human body to accept these "xenotransplantations" without causing a tragic immune system response.

As early as 1667 in France, doctors tried to use animal blood to save patients' lives. In the 1960s, chimpanzees' kidneys were transplanted into some patients, but the maximum life expectancy for patients undergoing this procedure was 9 months. In 1983, a baboon's heart was transplanted into a baby named "Baby Fae," but she died 20 days later.

Fortunately, in the past decade, the rapid development of gene editing technology and cloning technology has laid a solid foundation for breakthroughs in xenotransplantation technology, and the possibility of organs bred by these two new technologies being rejected by the human body has been greatly reduced. Pig organs, in turn, have become the focus of research in this field because they are easy to breed and have an organ structure similar to human organs.

Previously, Dr. Muhammad Mohiuddin, a professor of surgery at the University of Maryland School of Medicine, had successfully transplanted a pig heart into baboons, and subsequently collaborated with Dr. Griffith to tackle the study of heart xenotransplantation. However, for safety reasons and concerns about triggering a potentially life-threatening and dangerous immune response, the technology has not been previously used in any human patient.

In mid-December 2021, due to his critical illness and inability to obtain human hearts, Bennett, driven by a strong desire to survive, chose to fight hard and made the decision to transplant pig hearts. While earning themselves the hope of a living, this choice also provides an opportunity for Dr. Mohiuddin and Dr. Griffith to apply their research to the clinic.

In order to ensure the success of the operation, the scientists made 10 modifications to the donor pig's genome, of which 4 genes were knocked out or inactivated, because there was a gene encoding the molecule that caused the body to cause an aggressive rejection reaction in the human body; and 6 human genes were inserted into the donor pig's genome, and the inserted genes were designed to make the pig organs more compatible with the human immune system. In addition, a range of new medicines and technologies have been put into use.

In response, Robert Montgomery, a researcher who led a pig kidney transplant last September and a doctor at New York University Longiny, believes that surgery at the University of Maryland has pushed such a level of technology to a new level. He said:

"It's a really remarkable breakthrough."

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There is still a long way to go

Dr. David Klassen, Chief Medical Officer of the United Network for Organ Sharing, also commented:

"This is a watershed event that I believe will make a significant difference in the way we treat organ failure."

However, he also stressed that there are still many difficult obstacles that need to be overcome before the technology can be widely adopted. In particular, it is important to note that even transplantation of well-matched human donor kidneys and other organs may lead to organ rejection. He said:

"The media may dramatize such events, it's important to maintain a perspective, and it will take a long time for such therapies to really mature."

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